Low-dose computed tomography scans with automatic exposure control for patients of different ages undergoing cardiac PET/CT and SPECT/CT.

Science.gov (United States)

Yang, Ching-Ching; Yang, Bang-Hung; Tu, Chun-Yuan; Wu, Tung-Hsin; Liu, Shu-Hsin

2017-06-01

This study aimed to evaluate the efficacy of automatic exposure control (AEC) in order to optimize low-dose computed tomography (CT) protocols for patients of different ages undergoing cardiac PET/CT and single-photon emission computed tomography/computed tomography (SPECT/CT). One PET/CT and one SPECT/CT were used to acquire CT images for four anthropomorphic phantoms representative of 1-year-old, 5-year-old and 10-year-old children and an adult. For the hybrid systems investigated in this study, the radiation dose and image quality of cardiac CT scans performed with AEC activated depend mainly on the selection of a predefined image quality index. Multiple linear regression methods were used to analyse image data from anthropomorphic phantom studies to investigate the effects of body size and predefined image quality index on CT radiation dose in cardiac PET/CT and SPECT/CT scans. The regression relationships have a coefficient of determination larger than 0.9, indicating a good fit to the data. According to the regression models, low-dose protocols using the AEC technique were optimized for patients of different ages. In comparison with the standard protocol with AEC activated for adult cardiac examinations used in our clinical routine practice, the optimized paediatric protocols in PET/CT allow 32.2, 63.7 and 79.2% CT dose reductions for anthropomorphic phantoms simulating 10-year-old, 5-year-old and 1-year-old children, respectively. The corresponding results for cardiac SPECT/CT are 8.4, 51.5 and 72.7%. AEC is a practical way to reduce CT radiation dose in cardiac PET/CT and SPECT/CT, but the AEC settings should be determined properly for optimal effect. Our results show that AEC does not eliminate the need for paediatric protocols and CT examinations using the AEC technique should be optimized for paediatric patients to reduce the radiation dose as low as reasonably achievable.

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)

Positron Emission Tomography (PET)

International Nuclear Information System (INIS)

Welch, M.J.

1990-01-01

Positron emission tomography (PET) assesses biochemical processes in the living subject, producing images of function rather than form. Using PET, physicians are able to obtain not the anatomical information provided by other medical imaging techniques, but pictures of physiological activity. In metaphoric terms, traditional imaging methods supply a map of the body's roadways, its, anatomy; PET shows the traffic along those paths, its biochemistry. This document discusses the principles of PET, the radiopharmaceuticals in PET, PET research, clinical applications of PET, the cost of PET, training of individuals for PET, the role of the United States Department of Energy in PET, and the futures of PET. 22 figs

Positron Emission Tomography (PET)

Science.gov (United States)

Welch, M. J.

1990-01-01

Positron emission tomography (PET) assesses biochemical processes in the living subject, producing images of function rather than form. Using PET, physicians are able to obtain not the anatomical information provided by other medical imaging techniques, but pictures of physiological activity. In metaphoric terms, traditional imaging methods supply a map of the body's roadways, its, anatomy; PET shows the traffic along those paths, its biochemistry. This document discusses the principles of PET, the radiopharmaceuticals in PET, PET research, clinical applications of PET, the cost of PET, training of individuals for PET, the role of the United States Department of Energy in PET, and the futures of PET.

Positron Emission Tomography (PET)

Energy Technology Data Exchange (ETDEWEB)

Welch, M.J.

1990-01-01

Positron emission tomography (PET) assesses biochemical processes in the living subject, producing images of function rather than form. Using PET, physicians are able to obtain not the anatomical information provided by other medical imaging techniques, but pictures of physiological activity. In metaphoric terms, traditional imaging methods supply a map of the body's roadways, its, anatomy; PET shows the traffic along those paths, its biochemistry. This document discusses the principles of PET, the radiopharmaceuticals in PET, PET research, clinical applications of PET, the cost of PET, training of individuals for PET, the role of the United States Department of Energy in PET, and the futures of PET. 22 figs.

Computed tomography automatic exposure control techniques in 18F-FDG oncology PET-CT scanning.

Science.gov (United States)

Iball, Gareth R; Tout, Deborah

2014-04-01

Computed tomography (CT) automatic exposure control (AEC) systems are now used in all modern PET-CT scanners. A collaborative study was undertaken to compare AEC techniques of the three major PET-CT manufacturers for fluorine-18 fluorodeoxyglucose half-body oncology imaging. An audit of 70 patients was performed for half-body CT scans taken on a GE Discovery 690, Philips Gemini TF and Siemens Biograph mCT (all 64-slice CT). Patient demographic and dose information was recorded and image noise was calculated as the SD of Hounsfield units in the liver. A direct comparison of the AEC systems was made by scanning a Rando phantom on all three systems for a range of AEC settings. The variation in dose and image quality with patient weight was significantly different for all three systems, with the GE system showing the largest variation in dose with weight and Philips the least. Image noise varied with patient weight in Philips and Siemens systems but was constant for all weights in GE. The z-axis mA profiles from the Rando phantom demonstrate that these differences are caused by the nature of the tube current modulation techniques applied. The mA profiles varied considerably according to the AEC settings used. CT AEC techniques from the three manufacturers yield significantly different tube current modulation patterns and hence deliver different doses and levels of image quality across a range of patient weights. Users should be aware of how their system works and of steps that could be taken to optimize imaging protocols.

The impact of PET scanning on management of paediatric oncology patients

International Nuclear Information System (INIS)

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

2005-01-01

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

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

DEFF Research Database (Denmark)

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

2012-01-01

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

Clinical Utility of 4D FDG-PET/CT Scans in Radiation Treatment Planning

Energy Technology Data Exchange (ETDEWEB)

Aristophanous, Michalis, E-mail: maristophanous@lroc.harvard.edu [Department of Radiation Oncology, Dana-Farber/Brigham and Women' s Cancer Center and Harvard Medical School, Boston, MA (United States); Berbeco, Ross I.; Killoran, Joseph H. [Department of Radiation Oncology, Dana-Farber/Brigham and Women' s Cancer Center and Harvard Medical School, Boston, MA (United States); Yap, Jeffrey T. [Department of Radiology, Dana-Farber Cancer Institute and Harvard Medical School, Boston, MA (United States); Sher, David J.; Allen, Aaron M.; Larson, Elysia; Chen, Aileen B. [Department of Radiation Oncology, Dana-Farber/Brigham and Women' s Cancer Center and Harvard Medical School, Boston, MA (United States)

2012-01-01

Purpose: The potential role of four-dimensional (4D) positron emission tomography (PET)/computed tomography (CT) in radiation treatment planning, relative to standard three-dimensional (3D) PET/CT, was examined. Methods and Materials: Ten patients with non-small-cell lung cancer had sequential 3D and 4D [{sup 18}F]fluorodeoxyglucose PET/CT scans in the treatment position prior to radiation therapy. The gross tumor volume and involved lymph nodes were contoured on the PET scan by use of three different techniques: manual contouring by an experienced radiation oncologist using a predetermined protocol; a technique with a constant threshold of standardized uptake value (SUV) greater than 2.5; and an automatic segmentation technique. For each technique, the tumor volume was defined on the 3D scan (VOL3D) and on the 4D scan (VOL4D) by combining the volume defined on each of the five breathing phases individually. The range of tumor motion and the location of each lesion were also recorded, and their influence on the differences observed between VOL3D and VOL4D was investigated. Results: We identified and analyzed 22 distinct lesions, including 9 primary tumors and 13 mediastinal lymph nodes. Mean VOL4D was larger than mean VOL3D with all three techniques, and the difference was statistically significant (p < 0.01). The range of tumor motion and the location of the tumor affected the magnitude of the difference. For one case, all three tumor definition techniques identified volume of moderate uptake of approximately 1 mL in the hilar region on the 4D scan (SUV maximum, 3.3) but not on the 3D scan (SUV maximum, 2.3). Conclusions: In comparison to 3D PET, 4D PET may better define the full physiologic extent of moving tumors and improve radiation treatment planning for lung tumors. In addition, reduction of blurring from free-breathing images may reveal additional information regarding regional disease.

Extensive Tattoos Mimicking Lymphatic Metastasis on Positron Emission Tomography Scan in a Patient With Cervical Cancer.

Science.gov (United States)

Grove, Narine; Zheng, Ma; Bristow, Robert E; Eskander, Ramez N

2015-07-01

Positron emission tomography (PET) fused with computed tomography (CT) imaging is common in the clinical assessment of patients with locally advanced cervical cancer. Limitations to the utilization and interpretation of PET-CT scans in patients with cervical cancer have been described, including false-positive findings secondary to tattoo ink. A 32-year-old woman presented with clinical stage 1B1 cervical cancer and extensive tattoos of the lower extremities. Preoperative PET-CT scan identified two ileac lymph nodes with increased fluorine-18-deoxyglucose uptake suspicious for metastatic disease. At the time of surgical resection, bilateral pigmented lymph nodes were identified with histologic examination showing deposition of tattoo ink and no malignant cells. Physicians should be cognizant of the possible effects of tattoos on PET-CT findings while counseling patients and formulating a treatment program.

Recurrent surgical site infection of the spine diagnosed by dual 18F-NaF-bone PET/CT with early-phase scan

International Nuclear Information System (INIS)

Shim, Jai-Joon; Lee, Jeong Won; Jeon, Min Hyok; Lee, Sang Mi

2016-01-01

We report a case of a 31-year-old man who showed recurrently elevated level of the serum inflammatory marker C-reactive protein (CRP) after spinal operation. He underwent 18 F-flurodeoxyglucose ( 18 F-FDG) positron emission tomography/computed tomography (PET/CT) and dual 18 F-sodium-fluoride ( 18 F-NaF) PET/CT with an additional early-phase scan to find a hidden inflammation focus. Only mildly increased 18 F-FDG was found at the surgical site of T11 spine on 18 F-FDG PET/CT. In contrast, dual 18 F-NaF bone PET/CT with early-phase scan demonstrated focal active inflammation at the surgical site of T11 spine. After a revision operation of the T11 spine, serum CRP level decreased to the normal range without any symptom or sign of inflammation. Inflammatory focus in the surgical site of the spine can be detected with using dual 18 F-NaF bone PET/CT scan with early-phase scan. (orig.)

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

International Nuclear Information System (INIS)

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

2010-01-01

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

Cost-effectiveness of PET and PET/Computed Tomography

DEFF Research Database (Denmark)

Gerke, Oke; Hermansson, Ronnie; Hess, Søren

2015-01-01

measure by means of incremental cost-effectiveness ratios when considering the replacement of the standard regimen by a new diagnostic procedure. This article discusses economic assessments of PET and PET/computed tomography reported until mid-July 2014. Forty-seven studies on cancer and noncancer...

The use of PET/CT scanning technique for 3D visualization and quantification of real-time soil/plant interactions

DEFF Research Database (Denmark)

Garbout, Amin; Munkholm, Lars Juhl; Hansen, Søren Bechmann

2012-01-01

to assimilate 11CO2 for 90 min before PET scanning was initiated. We carried out PET scanning for 60 min. Subsequently, the aerial parts of the plant was cut off and the pot was rescanned using a micro-CT scanner to obtain more detailed information on structure of the root system and the growth medium structure...... of the sand. We found the highest concentration of 11C at the position of the main root. The PET images, at different time intervals, showed the translocation and metabolisation of photo-assimilates from top to root. Using the micro-CT scanner (voxel size of 90 μm), we were able to detect roots down to 100 mm...... demonstrated the simultaneous use of PET (positron emission tomography) and CT (X-ray computed tomography) to (a) non-destructively image a whole plant growing in sand, and (b) to link the observed morphology with recently assimilated C. The PET scanner was used to detect and visualize the location...

Relevance of positron emission tomography (PET) in oncology

International Nuclear Information System (INIS)

Weber, W.A.; Avril, N.; Schwaiger, M.

1999-01-01

Background: The clinical use of positron emission tomography (PET) for detection and staging of malignant tumors is rapidly increasing. Furthermore, encouraging results for monitoring the effects of radio- and chemotherapy have been reported. Methods: This review describes the technical principles of PET and the biological characteristics of tracers used in oncological research and patient studies. The results of clinical studies published in peer reviewed journals during the last 5 years are summarized and clinical indications for PET scans in various tumor types are discussed. Results and Conclusions: Numerous studies have documented the high diagnostic accuracy of PET studies using the glucose analogue F-18-fluordeoxyglucose (FDG-PET) for detection and staging of malignant tumors. In this field, FDG-PET has been particularly successful in lung cancer, colorectal cancer, malignant lymphoma and melanoma. Furthermore, FDG-PET has often proven to be superior to morphological imaging techniques for differentation of tumor recurrence from scar tissue. Due to the high glucose utilization of normal gray matter radiolabeled amino-acids like C-11-methionine are superior to FDG for detection and delineation of brain tumors by PET. In the future, more specific markers of tumor cell proliferation and gene expression may allow the application of PET not only for dianostic imaging also but for non-invasive biological characterization of malignant tumors and early monitoring of therapeutic interventions. (orig.) [de

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

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

OpenAIRE

Pan, Tinsu; Zaidi, Habib

2013-01-01

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

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

Energy Technology Data Exchange (ETDEWEB)

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

2010-03-15

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

Positron emission tomography (PET) in psychiatry

International Nuclear Information System (INIS)

Buchsbaum, M.S.

1984-01-01

In the past the approach to the brain has been necessarily indirect, employing peripheral fluids to assess central and regional neurochemical processes. Blood, urine, skin and muscle biopsy, and cerebrospinal fluid are valuable reflectors of the neurochemical and neuropharmacological activity of the brain, but are removed in time and place from disordered thought processes and diluted by the products of both functional and dysfunctional brain systems. Biopsy studies have helped in studying the functional disorders of organs like the liver, but they are destructive to the brain and less useful because unlike these organs, the brain has a regional variation in its chemistry. The experimental insights from animal studies focusing on the pharmacology of individual cell groups - in striatum or locus coeruleus, for example - cannot easily or unambigiously be applied to clinical populations. Positron emission tomography (PET) is a versatile approach utilizing the mathematics of x-ray transmission scanning (CT scanning) to produce slice images of radioisotope distribution. PET makes possible a wide range of metabolic studies. Positron emitters such as carbon-11 or fluorine-18 can be used to label glucose, amino acids, drugs, neurotransmitter precursors, and many other molecules and examine their distribution and fate in discrete cell groups

Bone position emission tomography with or without CT Is more accurate than bone scan for detection of bone metastasis

International Nuclear Information System (INIS)

Lee, Soo Jin; Lee, Wom Woo; Kim, Sang Eun

2013-01-01

Na1 8F bone positron emission tomography (bone PET) is a new imaging modality which is useful for the evaluation of bone diseases. Here, we compared the diagnostic accuracies between bone PET and bone scan for the detection of bone metastasis (BM). Sixteen cancer patients (M:F = 10:6, mean age = 60 ± 12 years) who underwent both bone PET and bone scan were analyzed. Bone PET was conducted 30 minutes after the injection of 370 MBq Na1 8F , and a bone scan was performed 3 hours after the injection of 1295 MBq 9 9mT c-hydroxymethylene diphosphonate. In the patient-based analysis (8 patients with BM and 8 without BM), the sensitivities of bone PET (100% 8/8) and bone scan (87.5% = 7/8) were not significantly different (p > 0.05), whereas the specificity of bone PET (87.5% = 7/8) was significantly greater than that of the bone scan (25% = 2/8) (p 8F bone PET is more accurate than bone scan for BM evaluation.

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.)

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

Directory of Open Access Journals (Sweden)

Aruna Kaushik

2015-01-01

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

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

Science.gov (United States)

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

2015-12-01

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

Comparison of absorbed dose of two protocols of tomographic scanning in PET/CT exams; Comparação da dose absorvida de dois protocolos de varredura tomográfica em exame de PET-CT

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Paiva, F.G., E-mail: fgpaiva92@gmail.com [Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG (Brazil). Dept. de Engenharia Nuclear; Santana, P.C. [Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG (Brazil). Faculdade de Medicina; Mourão Filho, A.P. [Centro Federal de Educação Tecnológica de Minas Gerais (CEFET-MG), Belo Horizonte, MG (Brazil)

2017-07-01

Positron Emission Tomography (PET) associated with Computed Tomography (CT) allows the fusion of functional and anatomical images. When compared to other diagnostic techniques, PET-CT subjects patients to higher levels of radiation, because two modalities are used in a single exam. In this study, the doses absorbed in 19 patient organs from the tomographic scan were evaluated. Radiochromic films were correctly positioned in the Alderson anthropomorphic simulator, male version. For evaluation, two whole body scan protocols were compared. For evaluation, two whole body scan protocols were compared. An increase of up to 600% in the absorbed dose in the pituitary was observed when the protocols were compared, with the lowest observed increase of approximately 160% for the liver. It is concluded that the dose from CT in patients submitted to PET-CT scanning is higher in the protocol used for diagnosis. Considering the high cost of PET-CT exam, in many cases it is preferable that the CT examination is of diagnostic quality, and not only for anatomical mapping, an argument based on the Principle of Justification.

Early-Dynamic Positron Emission Tomography (PET)/Computed Tomography and PET Angiography for Endoleak Detection After Endovascular Aneurysm Repair.

Science.gov (United States)

Drescher, Robert; Gühne, Falk; Freesmeyer, Martin

2017-06-01

To propose a positron emission tomography (PET)/computed tomography (CT) protocol including early-dynamic and late-phase acquisitions to evaluate graft patency and aneurysm diameter, detect endoleaks, and rule out graft or vessel wall inflammation after endovascular aneurysm repair (EVAR) in one examination without intravenous contrast medium. Early-dynamic PET/CT of the endovascular prosthesis is performed for 180 seconds immediately after intravenous injection of F-18-fluorodeoxyglucose. Data are reconstructed in variable time frames (time periods after tracer injection) to visualize the arterial anatomy and are displayed as PET angiography or fused with CT images. Images are evaluated in view of vascular abnormalities, graft configuration, and tracer accumulation in the aneurysm sac. Whole-body PET/CT is performed 90 to 120 minutes after tracer injection. This protocol for early-dynamic PET/CT and PET angiography has the potential to evaluate vascular diseases, including the diagnosis of complications after endovascular procedures.

Selective Nodal Irradiation on Basis of 18FDG-PET Scans in Limited-Disease Small-Cell Lung Cancer: A Prospective Study

International Nuclear Information System (INIS)

Loon, Judith van; De Ruysscher, Dirk; Wanders, Rinus; Boersma, Liesbeth; Simons, Jean; Oellers, Michel; Dingemans, Anne-Marie C.; Hochstenbag, Monique; Bootsma, Gerben; Geraedts, Wiel; Pitz, Cordula; Teule, Jaap; Rhami, Ali; Thimister, Willy; Snoep, Gabriel; Dehing-Oberije, Cary; Lambin, Philippe

2010-01-01

Purpose: To evaluate the results of selective nodal irradiation on basis of 18 F-deoxyglucose positron emission tomography (PET) scans in patients with limited-disease small-cell lung cancer (LD-SCLC) on isolated nodal failure. Methods and Materials: A prospective study was performed of 60 patients with LD-SCLC. Radiotherapy was given to a dose of 45 Gy in twice-daily fractions of 1.5 Gy, concurrent with carboplatin and etoposide chemotherapy. Only the primary tumor and the mediastinal lymph nodes involved on the pretreatment PET scan were irradiated. A chest computed tomography (CT) scan was performed 3 months after radiotherapy completion and every 6 months thereafter. Results: A difference was seen in the involved nodal stations between the pretreatment 18 F-deoxyglucose PET scans and computed tomography scans in 30% of patients (95% confidence interval, 20-43%). Of the 60 patients, 39 (65%; 95% confidence interval [CI], 52-76%) developed a recurrence; 2 patients (3%, 95% CI, 1-11%) experienced isolated regional failure. The median actuarial overall survival was 19 months (95% CI, 17-21). The median actuarial progression-free survival was 14 months (95% CI, 12-16). 12% (95% CI, 6-22%) of patients experienced acute Grade 3 (Common Terminology Criteria for Adverse Events, version 3.0) esophagitis. Conclusion: PET-based selective nodal irradiation for LD-SCLC resulted in a low rate of isolated nodal failures (3%), with a low percentage of acute esophagitis. These findings are in contrast to those from our prospective study of CT-based selective nodal irradiation, which resulted in an unexpectedly high percentage of isolated nodal failures (11%). Because of the low rate of isolated nodal failures and toxicity, we believe that our data support the use of PET-based SNI for LD-SCLC.

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

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

2002-09-01

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

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

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

2017-07-15

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

Water-equivalent oral contrast agents in dual-modality PET/computed tomography scanning: does a little barium make the difference?

Science.gov (United States)

Kinner, Sonja; Veit-Haibach, Patrick; Lauenstein, Thomas C; Bockisch, Andreas; Antoch, Gerald

2009-03-01

To retrospectively evaluate the performance of two water-equivalent oral contrast agents [locust bean gum (LBG)-mannitol and VoLumen] concerning their potential to distend the bowel while avoiding contrast-associated artifacts in PET/computed tomography. PET/computed tomography examinations of 30 patients with two different oral contrast agents were reviewed. Bowel distension, intraluminal density, and potential contrast-associated artifacts were assessed for stomach, jejunum, and ileum. Statistical significance was tested by Student's t-test. Distension was slightly better in the stomach with VoLumen as compared with LBG-mannitol whereas LBG-mannitol was found to slightly better distend the small bowel. This difference proved to be statistically significant for the jejunum. A statistically significant difference was detected for intraluminal density with higher densities for VoLumen. This difference, however, did not result in a higher incidence of PET artifacts with VoLumen. LBG-mannitol provides excellent bowel distension, thereby avoiding contrast-associated PET artifacts. If this solution is not available, VoLumen provides a satisfactory alternative for bowel distension without relevant PET artifacts.

PET scanning in plastic and reconstructive surgery.

Science.gov (United States)

Liodaki, Eirini; Eirini, Liodaki; Liodakis, Emmanouil; Emmanouil, Liodakis; Papadopoulos, Othonas; Othonas, Papadopoulos; Machens, Hans-Günther; Hans-Günther, Machens; Papadopulos, Nikolaos A; Nikolaos, Papadopulos A

2012-02-01

In this report we highlight the use of PET scan in plastic and reconstructive surgery. PET scanning is a very important tool in plastic surgery oncology (melanoma, soft-tissue sarcomas and bone sarcomas, head and neck cancer, peripheral nerve sheath tumors of the extremities and breast cancer after breast esthetic surgery), as diagnosis, staging, treatment planning and follow-up of cancer patients is based on imaging. PET scanning seems also to be useful as a flap monitoring system as well as an infection's imaging tool, for example in the management of diabetic foot ulcer. PET also contributes to the understanding of pathophysiology of keloids which remain a therapeutic challenge.

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

Directory of Open Access Journals (Sweden)

Atilla Pekcolaklar

2012-01-01

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

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

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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.)

List-Mode PET Motion Correction Using Markerless Head Tracking: Proof-of-Concept With Scans of Human Subject

DEFF Research Database (Denmark)

Olesen, Oline Vinter; Sullivan, Jenna M.; Mulnix, Tim

2013-01-01

A custom designed markerless tracking system was demonstrated to be applicable for positron emission tomography (PET) brain imaging. Precise head motion registration is crucial for accurate motion correction (MC) in PET imaging. State-of-the-art tracking systems applied with PET brain imaging rely...... on markers attached to the patient's head. The marker attachment is the main weakness of these systems. A healthy volunteer participating in a cigarette smoking study to image dopamine release was scanned twice for 2 h with $^{11}{\\rm C}$-racolopride on the high resolution research tomograph (HRRT) PET...... in contrast recovery of small structures....

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

International Nuclear Information System (INIS)

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

2015-01-01

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

PET Scans Obtained for Evaluation of Cognitive Dysfunction

Science.gov (United States)

Silverman, Daniel H. S.; Mosconi, Lisa; Ercoli, Linda; Chen, W; Small, Gary W.

2015-01-01

The degree of intactness of human cognitive functioning for a given individual spans a wide spectrum, ranging from normal to severely demented. The differential diagnosis for the causes of impairment along that spectrum is also wide, and often difficult to distinguish clinically, which has led to an increasing role for neuroimaging tools in that evaluation. The most frequent causes of dementia are neurodegenerative disorders, Alzheimer's disease being the most prevalent among them, and they produce significant alterations in brain metabolism with devastating neuropathologic, economic, social and clinical consequences. These alterations are detectable through positron emission tomography (PET), even in their earliest stages. The most commonly performed PET studies of the brain are carried out with [18F]fluorodeoxyglucose (FDG) as the imaged radiopharmaceutical. Such scans have demonstrated diagnostic and prognostic utility in evaluating patients with cognitive impairment, and in distinguishing among primary neurodegenerative disorders and other etiologies for cognitive decline. In addition to focusing upon the effects on cerebral metabolism examined with FDG PET, some other changes occurring in the brains of cognitively impaired patients assessable with other radiotracers will be considered. As preventive and disease-modifying treatments are developed, early detection of accurately diagnosed disease processes facilitated by the use of PET has the potential to substantially impact upon the enormous human toll exacted by these diseases. PMID:18514081

Influence of PET/CT-introduction on PET scanning frequency and indications. Results of a multicenter study

International Nuclear Information System (INIS)

Stergar, H.; Bockisch, A.; Eschmann, S.M.; Krause, B.J.; Roedel, R.; Tiling, R.; Weckesser, M.

2007-01-01

Aim: to evaluate the influence of the introduction of combined PET/CT scanners into clinical routine. This investigation addresses the quantitative changes between PET/CT and stand alone PET. Methods: the study included all examinations performed on stand alone PET- or PET/CT-scanners within 12 month prior to and after implementation of PET/CT. The final data analysis included five university hospitals and a total number of 15 497 exams. We distinguished exams on stand alone tomographs prior to and after installation of the combined device as well as PET/CT scans particularly with regard to disease entities. Various further parameters were investigated. Results: the overall number of PET scans (PET and PET/CT) rose by 146% while the number of scans performed on stand alone scanners declined by 22%. Only one site registered an increase in stand alone PET. The number of exams for staging in oncology increased by 196% while that of cardiac scans decreased by 35% and the number of scans in neurology rose by 47%. The use of scans for radiotherapy planning increased to 7% of all PET/CT studies. The increase of procedures for so-called classic PET oncology indications was moderate compared to the more common tumors. An even greater increase was observed in some rare entities. Conclusions: the introduction of PET/CT led to more than a doubling of overall PET procedures with a main focus on oncology. Some of the observed changes in scanning frequency may be caused by a rising availability of new radiotracers and advancements of competing imaging methods. Nevertheless the evident increase in the use of PET/CT for the most common tumour types demonstrates its expanding role in cancer staging. The combination of molecular and morphologic imaging has not only found its place but is still gaining greater importance with new developments in technology and radiochemistry. (orig.)

Potential for PET scanning as an aid to heat transfer modeling

International Nuclear Information System (INIS)

Samulski, T.V.; Harris, C.; Winget, J.M.; Dewhirst, M.W.

1987-01-01

Positron Emission Tomography (PET) using /sup 68/Ga labelled microspheres (15μ diam.) for quantitative imaging of perfusion is being investigated for its potential to aid in verification of parameter estimation techniques. Such techniques have been used in bioheat transfer modeling where direct measurement of perfusion has not been possible. Perfusion is needed, to utilize bioheat transfer to predict temperatures between measured points during hyperthermia therapy. A preliminary study showing that PET could be used for verification of parameter estimation was done by heating a melanoma in a dog in which multiple thermometry catheters were placed in a central plane. Microspheres were injected at the end of a one hour heat treatment session before power down. CT and PET images of the same plane were aligned so that relative counts/pixel in 2 cm regions of interest of the PET image were measured along several catheter tracks. In all tracks measured an inverse correlation was shown between relative perfusion and temperature along the catheter during thermal steady state. These data strongly imply that PET scans obtained in the manner described bear relevance to bioheat transfer and for verification of perfusion in heated tissues as estimated by heat transfer modeling

FDG PET and PET/CT : EANM procedure guidelines for tumour PET imaging: version 1.0

NARCIS (Netherlands)

Boellaard, Ronald; O'Doherty, Mike J.; Weber, Wolfgang A.; Mottaghy, Felix M.; Lonsdale, Markus N.; Stroobants, Sigrid G.; Oyen, Wim J. G.; Kotzerke, Joerg; Hoekstra, Otto S.; Pruim, Jan; Marsden, Paul K.; Tatsch, Klaus; Hoekstra, Corneline J.; Visser, Eric P.; Arends, Bertjan; Verzijlbergen, Fred J.; Zijlstra, Josee M.; Comans, Emile F. I.; Lammertsma, Adriaan A.; Paans, Anne M.; Willemsen, Antoon T.; Beyer, Thomas; Bockisch, Andreas; Schaefer-Prokop, Cornelia; Delbeke, Dominique; Baum, Richard P.; Chiti, Arturo; Krause, Bernd J.

The aim of this guideline is to provide a minimum standard for the acquisition and interpretation of PET and PET/CT scans with [18F]-fluorodeoxyglucose (FDG). This guideline will therefore address general information about [18F]-fluorodeoxyglucose (FDG) positron emission tomography-computed

FDG PET and PET/CT: EANM procedure guidelines for tumour PET imaging: version 1.0

NARCIS (Netherlands)

Boellaard, Ronald; O'Doherty, Mike J.; Weber, Wolfgang A.; Mottaghy, Felix M.; Lonsdale, Markus N.; Stroobants, Sigrid G.; Oyen, Wim J. G.; Kotzerke, Joerg; Hoekstra, Otto S.; Pruim, Jan; Marsden, Paul K.; Tatsch, Klaus; Hoekstra, Corneline J.; Visser, Eric P.; Arends, Bertjan; Verzijlbergen, Fred J.; Zijlstra, Josee M.; Comans, Emile F. I.; Lammertsma, Adriaan A.; Paans, Anne M.; Willemsen, Antoon T.; Beyer, Thomas; Bockisch, Andreas; Schaefer-Prokop, Cornelia; Delbeke, Dominique; Baum, Richard P.; Chiti, Arturo; Krause, Bernd J.

2010-01-01

The aim of this guideline is to provide a minimum standard for the acquisition and interpretation of PET and PET/CT scans with [18F]-fluorodeoxyglucose (FDG). This guideline will therefore address general information about[18F]-fluorodeoxyglucose (FDG) positron emission tomography-computed

FDG PET and PET/CT: EANM procedure guidelines for tumour PET imaging: version 1.0

NARCIS (Netherlands)

Boellaard, R.; O'Doherty, M.J.; Weber, W.A.; Mottaghy, F.M.; Lonsdale, M.N.; Stroobants, S.G.; Oyen, W.J.G.; Kotzerke, J.; Hoekstra, O.S.; Pruim, J.; Marsden, P.K.; Tatsch, K.; Hoekstra, C.J.; Visser, E.P.; Arends, B.; Verzijlbergen, F.J.; Zijlstra, J.M.; Comans, E.F.I.; Lammertsma, A.A.; Paans, A.M.; Willemsen, A.T.; Beyer, T.; Bockisch, A.; Schaefer-Prokop, C.; Delbeke, D.; Baum, R.P.; Chiti, A.; Krause, B.J.

2010-01-01

The aim of this guideline is to provide a minimum standard for the acquisition and interpretation of PET and PET/CT scans with [18F]-fluorodeoxyglucose (FDG). This guideline will therefore address general information about [18F]-fluorodeoxyglucose (FDG) positron emission tomography-computed

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

International Nuclear Information System (INIS)

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

2009-01-01

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

Case report: PET/CT, a cautionary tale

International Nuclear Information System (INIS)

Wang, Jayson; Cook, Gary; Frank, John; Dina, Roberto; Livni, Naomi; Lynn, John; Fleming, William; Seckl, Michael J

2007-01-01

The use of combined positron emission tomography/computerised tomography (PET/CT) scanners in oncology has been shown to improve the staging of tumours and the detection of relapses. However, mis-registration errors are increasingly recognised to be a common pitfall of PET/CT studies. We report a patient with a germ cell tumour of the testis, who underwent a PET/CT scan to detect the site of relapse with a view to surgical removal. However, the PET/CT scan mislocalised the tumour site to be within the T2 vertebral body. A subsequent endoscopic ultrasound scan however showed the tumour to be anterior to the vertebral body, which was confirmed at surgery. In this report, we highlight the artefactual mislocalisation errors which may occur with PET/CT imaging, and the need to review and verify these scans

FDG PET and PET/CT: EANM procedure guidelines for tumour PET imaging: version 1.0

DEFF Research Database (Denmark)

Boellaard, Ronald; O'Doherty, Mike J; Weber, Wolfgang A

2010-01-01

The aim of this guideline is to provide a minimum standard for the acquisition and interpretation of PET and PET/CT scans with [18F]-fluorodeoxyglucose (FDG). This guideline will therefore address general information about[18F]-fluorodeoxyglucose (FDG) positron emission tomography-computed tomogr...

Textural features of (18)F-fluorodeoxyglucose positron emission tomography scanning in diagnosing aortic prosthetic graft infection

NARCIS (Netherlands)

Saleem, Ben R; Beukinga, Roelof J.; Boellaard, Ronald; Glaudemans, Andor W J M; Reijnen, Michel M P J; Zeebregts, Clark J; Slart, Riemer H J A

BACKGROUND: The clinical problem in suspected aortoiliac graft infection (AGI) is to obtain proof of infection. Although (18)F-fluorodeoxyglucose ((18)F-FDG) positron emission tomography scanning (PET) has been suggested to play a pivotal role, an evidence-based interpretation is lacking. The

Textural features of 18F-fluorodeoxyglucose positron emission tomography scanning in diagnosing aortic prosthetic graft infection

NARCIS (Netherlands)

Saleem, Ben R.; Beukinga, Roelof J.; Boellaard, Ronald; Glaudemans, Andor W.J.M.; Reijnen, Michel M.P.J.; Zeebregts, Clark J.; Slart, Riemer H.J.A.

2017-01-01

Background: The clinical problem in suspected aortoiliac graft infection (AGI) is to obtain proof of infection. Although 18F-fluorodeoxyglucose (18F-FDG) positron emission tomography scanning (PET) has been suggested to play a pivotal role, an evidence-based interpretation is lacking. The objective

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

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

2009-07-01

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

FDG-PET scan in assessing lymphomas and the application of Deauville Criteria

International Nuclear Information System (INIS)

Awan, U.E.K.; Siddiqui, N.; Muzaffar, N.; Farooqui, Z.S.

2013-01-01

To evaluate the role of Fluorine-18-fluorodexoyglucose Positron Emission Tomography (FDG-PET) scan in staging and its implications on the treatment of lymphoma, and to study the concordance between visual assessment and Deauville criteria for the interpretation of interim scans. Methods: The prospective single-arm experimental study was conducted at the Shaukat Khanum Memorial Cancer Hospital, Lahore, from May 2011 to October 2011. It comprised 53 newly diagnosed lymphoma patients who agreed to participate in the study. All patients underwent scans with contrast-enhanced computerised tomography at baseline. Treatment plan was formulated based on the final stage. Interim scans were acquired after 2 cycles of chemotherapy and were reported using visual criteria and compared with the 5-point Deauville criteria. Score of 1-3 was taken as disease-negative, while 4-5 was taken as disease-positive. SPSS 19 was used for statistical analysis. Results: Of the 53 patients, 35 (66%) had Hodgkin's Lymphoma, while 18 (34%) had Non-Hodgkin's Lymphoma. Scans resulted in disease upstaging in 4 (7.5%) patients, and detecting increased disease burden in 12 (23%). On interim scans, complete remission was achieved in 38 (71%) patients (Deauville score 1-3); 12 (23%) showed partial response (Deauville score 4-5); and 3 (6%) had progression. Kappa test was statistically significant (kappa 0.856; p <0.001). Conclusion: The positron emission tomography helped to upstage lymphoma and reflected increased disease burden. The Deauville criteria correlated very well with visual assessment criteria and can be applied in the patient population. (author)

The effect, identification and correction of misalignment between PET transmission and emission scans on brain PET imaging

International Nuclear Information System (INIS)

Zhang Xiangsong; He Zuoxiang; Tang Anwu; Qiao Suixian

2004-01-01

Objectives: To study the effect of misalignment between PET transmission and emission scans of brain on brain PET imaging, and the Methods to identify and correct it. Methods: 18F-FDG PET imaging was performed on 8 volunteers. The emission images were reconstructed with attenuation correction after some translations and rotations in the x-axis and transverse plane were given, 1 mm and 1 degree each step, respectively. The 3-D volume fusion of PET emission and transmission scans was used to identify the suspected misalignment on 10 18F-FDG PET brain imaging. Three Methods were used to correct the misalignment. First, to quantitate the amount of the misalignment by 3-D volume registration of PET emission and transmission scans, the emission images were reconstructed with corrected translations and rotations in x-direction and transverse plane. Second, the emission images were reconstructed with mathematic calculation of brain attenuation. Third, 18F-FDG PET brain imaging was redone with careful application of laser alignment. Results: The translations greater than 3 mm in x-direction and the rotations greater than 8 degrees in transverse plane could lead to visible artifacts, which were presented with decreasing radioactivity uptake in the cortex of half cerebrum and in the frontal cortex at the side in the translating or rotating direction, respectively. The 3-D volume fusion of PET emission and transmission scans could identify and quantitate the amount of misalignment between PET emission and transmission scans of brain. The PET emission images reconstructed with corrected misalignment and mathematic calculation of brain attenuation were consistent with redone PET brain imaging. Conclusions: The misalignment between PET transmission and emission scans of brain can lead to visible artifacts. The 3-D volume fusion of PET emission and transmission scans can identify and quantitate the amount of the misalignment. The visible artifacts caused by the misalignment can be

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

International Nuclear Information System (INIS)

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

2002-01-01

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

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

International Nuclear Information System (INIS)

2010-01-01

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

First PET scans in Estonia

International Nuclear Information System (INIS)

Nazarenko, Sergei

2003-01-01

First PET scans in Estonia were performed on 25th November 2002 in North Estonia Regional Hospital, Tallinn. Six patients with melanoma underwent scanning with FDG. This event was a result of thorough extensive preparations first started in 2000 during the European Association of Nuclear Medicine congress in Paris. During the congress first contacts were made with providers of mobile PET units. At the same time negotiations were begun with potential FDG suppliers. For the introduction of PET in Estonia mobile truckmounted scanning technology was chosen due to low level of initial investments. Of particular importance was also availability of maintenance personnel from the device providers. A significant prerequisite was potential availability of FDG from the neighbourhood - Finland and Sweden. The latter avoided the necessity for investments into local cyclotrons and local FDG production. For the first scanning experience the dedicated truckmounted PET-camera Accel, Siemens was brought by the International Hospital Group (IHG, Amersfoort, Netherlands). The device arrived by ferry from Stockholm to Tallinn harbour at 10 o'clock in the morning and left by ferry for Helsinki at 23 o'clock. The team-on-truck consisted of one technician for device operation, two drivers and two company representatives. North Estonia Regional Hospital provided three additional technicians for patient preparation and FDG injection, one nuclear medicine doctor and one specialist of biomedical engineering and medical physics. The FDG was provided by MAP Medical Technologies, Schering, Helsinki, Finland. The shipments were made by air. This was possible due to small distance between Tallinn and Helsinki of approximately 80 km due to the regular flight connections between the two cities. The FDG was shipped in two lots with a time interval of 4 hours. The patient selection was based on clinical and histopathology data. In all six patients the exam was justified for detailied staging and

Fluorodeoxyglucose-positron emission tomography scan-positive recurrent papillary thyroid cancer and the prognosis and implications for surgical management

Directory of Open Access Journals (Sweden)

Schreinemakers Jennifer MJ

2012-09-01

Full Text Available Abstract Background To compare outcomes for patients with recurrent or persistent papillary thyroid cancer (PTC who had metastatic tumors that were fluorodeoxyglucose-positron emission tomography (FDG-PET positive or negative, and to determine whether the FDG-PET scan findings changed the outcome of medical and surgical management. Methods From a prospective thyroid cancer database, we retrospectively identified patients with recurrent or persistent PTC and reviewed data on demographics, initial stage, location and extent of persistent or recurrent disease, clinical management, disease-free survival and outcome. We further identified subsets of patients who had an FDG-PET scan or an FDG-PET/CT scan and whole-body radioactive iodine scans and categorized them by whether they had one or more FDG-PET-avid (PET-positive lesions or PET-negative lesions. The medical and surgical treatments and outcome of these patients were compared. Results Between 1984 and 2008, 41 of 141 patients who had recurrent or persistent PTC underwent FDG-PET (n = 11 or FDG-PET/CT scans (n = 30; 22 patients (54% had one or more PET-positive lesion(s, 17 (41% had PET-negative lesions, and two had indeterminate lesions. Most PET-positive lesions were located in the neck (55%. Patients who had a PET-positive lesion had a significantly higher TNM stage (P = 0.01, higher age (P = 0.03, and higher thyroglobulin (P = 0.024. Only patients who had PET-positive lesions died (5/22 vs. 0/17 for PET-negative lesions; P = 0.04. In two of the seven patients who underwent surgical resection of their PET-positive lesions, loco-regional control was obtained without evidence of residual disease. Conclusion Patients with recurrent or persistent PTC and FDG-PET-positive lesions have a worse prognosis. In some patients loco-regional control can be obtained without evidence of residual disease by reoperation if the lesion is localized in the neck or mediastinum.

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.

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)

Serotonin synthesis studied with positron emission tomography, (PET)

DEFF Research Database (Denmark)

Honoré, Per Gustaf Hartvig; Lundquist, Pinelopi

Positron emission tomography (PET) has the potential to study the biosynthesis and release of serotonin (5HT) at brain serotonergic neurons. PET requires probe compounds with specific attributes to enable imaging and quantification of biological processes. This section focuses on probes to measure...

Positron emission tomography (PET) for oncologic applications in oral region

International Nuclear Information System (INIS)

Shozushima, Masanori; Terasaki, Kazunori

2004-01-01

A rapidly emerging clinical application of positron emission tomography (PET) is the detection of cancer with radionuclide tracer, because it provides information unavailable by ultrasound, computed tomography or magnetic resonance imaging. The most commonly used radiotracer for PET oncologic imaging is fluorine-18-labeled fluorodeoxyglucose ( 18 F-FDG). Early studies show PET has potential value in viewing the region of the tumor, detecting, staging, grading, monitoring response to anticancer therapy, and differentiating recurrent or residual disease from post treatment changes. However, limitations of FDG-PET in the head and neck region, namely, physiological FDG uptake in the salivary glands and palatine tonsils, have been reported, increasing the false-positive rates in image interpretation. This review was designed to address these distinctions of oral cancer PET imaging: specialization of PET equipment, cancer cell metabolism, proliferation and tracers, clinical diagnosis of oral cancer with PET, pitfalls in oncologic diagnosis with FDG-PET imaging. (author)

Practical use and implementation of PET in children in a hospital PET centre

DEFF Research Database (Denmark)

Borgwardt, Lise; Larsen, Helle Jung; Pedersen, Kate

2003-01-01

Children are not just small adults-they differ in their psychology, normal physiology and pathophysiology, and various aspects should be considered when planning a positron emission tomography (PET) scan in a child. PET in children is a growing area, and this article describes the practical use...... and implementation of PET in children in a hospital PET centre. It is intended to be of use to nuclear medicine departments implementing or starting to implement PET scans in children. Topics covered are: dealing with children, dosimetry, organisation within the department and relations with other departments......, preparation of the child (provision of information to the child and parents and the fasting procedure), the imaging procedure (resting, tracer injection, positioning, sedation and bladder emptying) and pitfalls in the interpretation of PET scans in children, including experiences with telemedicine....

Practical use and implementation of PET in children in a hospital PET centre

International Nuclear Information System (INIS)

Borgwardt, Lise; Larsen, Helle Jung; Pedersen, Kate; Hoejgaard, Liselotte

2003-01-01

Children are not just small adults - they differ in their psychology, normal physiology and pathophysiology, and various aspects should be considered when planning a positron emission tomography (PET) scan in a child. PET in children is a growing area, and this article describes the practical use and implementation of PET in children in a hospital PET centre. It is intended to be of use to nuclear medicine departments implementing or starting to implement PET scans in children. Topics covered are: dealing with children, dosimetry, organisation within the department and relations with other departments, preparation of the child (provision of information to the child and parents and the fasting procedure), the imaging procedure (resting, tracer injection, positioning, sedation and bladder emptying) and pitfalls in the interpretation of PET scans in children, including experiences with telemedicine. (orig.)

Practical use and implementation of PET in children in a hospital PET centre

Energy Technology Data Exchange (ETDEWEB)

Borgwardt, Lise; Larsen, Helle Jung; Pedersen, Kate; Hoejgaard, Liselotte [Department of Clinical Physiology, Nuclear Medicine and PET, University Hospital of Copenhagen, Rigshospitalet, Blegdamsvej 9, 2100, Copenhagen (Denmark)

2003-10-01

Children are not just small adults - they differ in their psychology, normal physiology and pathophysiology, and various aspects should be considered when planning a positron emission tomography (PET) scan in a child. PET in children is a growing area, and this article describes the practical use and implementation of PET in children in a hospital PET centre. It is intended to be of use to nuclear medicine departments implementing or starting to implement PET scans in children. Topics covered are: dealing with children, dosimetry, organisation within the department and relations with other departments, preparation of the child (provision of information to the child and parents and the fasting procedure), the imaging procedure (resting, tracer injection, positioning, sedation and bladder emptying) and pitfalls in the interpretation of PET scans in children, including experiences with telemedicine. (orig.)

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

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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.

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)

Clinical correlates of decreased anteroposterior metabolic gradients in positron emission tomography (PET) of schizophrenic patients

International Nuclear Information System (INIS)

DeLisi, L.E.; Buchsbaum, M.S.; Holcomb, H.H.

1985-01-01

The finding in schizophrenic patients of a reversal of the normal frontal to posterior pattern of brain metabolic activity with positron emission tomography (PET) is of interest, but its relevance to psychopathology is unknown. Using PET, the authors studied 21 patients with chronic schizophrenia and 21 age- and sex-matched control subjects. Although eight of the 21 patients and only one of the control subjects showed a relatively lower anteroposterior metabolic gradient, no clinical correlates of this finding were noted. In addition, cerebral atrophy, as determined by CAT scan, was not associated with this aberrant metabolic pattern

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

Science.gov (United States)

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

2010-05-01

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

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

International Nuclear Information System (INIS)

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

2010-01-01

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

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

International Nuclear Information System (INIS)

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

2015-01-01

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

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

Science.gov (United States)

Liu, Yiyan

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

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

International Nuclear Information System (INIS)

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

1998-01-01

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

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

International Nuclear Information System (INIS)

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

2015-01-01

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

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

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

2015-07-15

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

18F-Fluorodeoxyglucose Positron Emission Tomography/CT Scanning in Diagnosing Vascular Prosthetic Graft Infection

Science.gov (United States)

Saleem, Ben R.; Pol, Robert A.; Slart, Riemer H. J. A.; Reijnen, Michel M. P. J.; Zeebregts, Clark J.

2014-01-01

Vascular prosthetic graft infection (VPGI) is a severe complication after vascular surgery. CT-scan is considered the diagnostic tool of choice in advanced VPGI. The incidence of a false-negative result using CT is relatively high, especially in the presence of low-grade infections. 18F-fluorodeoxyglucose positron emission tomography (18F-FDG PET) scanning has been suggested as an alternative for the diagnosis and assessment of infectious processes. Hybrid 18F-FDG PET/CT has established the role of 18F-FDG PET for the assessment of suspected VPGI, providing accurate anatomic localization of the site of infection. However, there are no clear guidelines for the interpretation of the uptake patterns of 18F-FDG as clinical tool for VPGI. Based on the available literature it is suggested that a linear, diffuse, and homogeneous uptake should not be regarded as an infection whereas focal or heterogeneous uptake with a projection over the vessel on CT is highly suggestive of infection. Nevertheless, 18F-FDG PET and 18F-FDG PET/CT can play an important role in the detection of VPGI and monitoring response to treatment. However an accurate uptake and pattern recognition is warranted and cut-off uptake values and patterns need to be standardized before considering the technique to be the new standard. PMID:25210712

Positron Emission Tomography (PET) in the oncologic clinical practice

International Nuclear Information System (INIS)

Serna M, J.A.; Luviano, C.; Martinez V, D.; Maldonado S, A.

2005-01-01

We intended to determine the frequency with that the computer axial tomography (TAC), it was able to visualize the lesions extra neoplasia detected by the PET tomography in patients with fully identified primary malignant neoplasia. (Author)

Comparison of SUV and Patlak slope for monitoring of cancer therapy using serial PET scans

International Nuclear Information System (INIS)

Freedman, Nanette M.T.; Sundaram, Senthil K.; Kurdziel, Karen; Carrasquillo, Jorge A.; Whatley, Millie; Carson, Joann M.; Sellers, David; Libutti, Steven K.; Yang, James C.; Bacharach, Stephen L.

2003-01-01

The standardized uptake value (SUV) and the slope of the Patlak plot (K) have both been proposed as indices to monitor the progress of disease during cancer therapy. Although a good correlation has been reported between SUV and K, they are not equivalent, and may not be equally affected by metabolic changes occurring during disease progression or therapy. We wished to compare changes in tumor SUV with changes in K during serial positron emission tomography (PET) scans for monitoring therapy. Thirteen patients enrolled in a protocol to treat renal cell carcinoma metastases were studied. Serial dynamic fluorodeoxyglucose (FDG) PET scans and computed tomography (CT) and magnetic resonance (MR) scans were performed once prior to treatment, once at 36±2 days after the start of treatment, and (in 7/13 subjects, 16/27 lesions) a third time at 92±9 days after the start of treatment. This resulted in a total of 33 scans, and 70 tumor Patlak and SUV values (one value for each lesion at each time point). SUV and K were measured over one to four predefined tumors/patient at each time point. The input function was obtained from regions of interest over the heart, combined, if necessary, with late blood samples. Over all tumors and scans, SUV and K correlated well (r=0.97, P<0.0001). However, change in SUV with treatment over all tumor scan pairs was much less well correlated with the corresponding change in K (r=0.73, P<0.0001). The absolute difference in % change was outside the 95% confidence limits expected from previous variability studies in 6 of 43 pairs of tumor scans, and greater than 50% in 2 of 43 tumor scan pairs. In four of the six cases, the two indices predicted opposing therapeutic outcomes. Similar results were obtained for SUV normalized by body weight or body surface area and for SUVs using mean or maximum count. Changes in CT and MR tumor cross-product dimensions correlated poorly with each other (r=0.47, P=NS), and so could not be used to determine the

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

Directory of Open Access Journals (Sweden)

Saima Riaz

2017-06-01

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

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

International Nuclear Information System (INIS)

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

2009-01-01

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

Role of FDG-PET scan in the management of pediatric mature B cell non-Hodgkin’s lymphoma. CCHE experience

OpenAIRE

Abdel Rahman, Hany; Sedky, Mohamed; Hamoda, Asmaa; Raafat, Tarek; Youssef, Ayda; Omar, Walid; Hassanein, Omneya; Moussa, Emad

2016-01-01

Aim of work: To evaluate the sensitivity (Se), specificity (Sp), and predictive values (PV) of PET scan during management of pediatric mature B cell non-Hodgkin’s lymphoma (NHL) in comparison with conventional computed tomography (CT) scan. Patients and methods: A retrospective study enrolled on pediatric NHL patients at Children Cancer Hospital Egypt (CCHE) during the period from July 2007 to the end of June 2013. Results: For 115 pediatric patients diagnosed with mature B cell NHL, 15...

Low Accuracy of Computed Tomography and Positron Emission Tomography to Detect Lung and Lymph Node Metastases of Colorectal Cancer.

Science.gov (United States)

Guerrera, Francesco; Renaud, Stéphane; Schaeffer, Mickaël; Nigra, Victor; Solidoro, Paolo; Santelmo, Nicola; Filosso, Pier Luigi; Falcoz, Pierre-Emmanuel; Ruffini, Enrico; Oliaro, Alberto; Massard, Gilbert

2017-10-01

Minimally invasive surgery, stereotactic radiotherapy, and radiofrequency ablation are commonly proposed in the case of pulmonary colorectal-metastasis as alternatives to conventional open surgery. Preoperative imaging assessment by computed tomography (CT) scan and fluorodeoxyglucose positron emission tomography (FDG-PET) are critical to guide oncologic radical treatment. Our aim was to investigate the accuracy of CT and FDG-PET for the evaluation of the number of pulmonary colorectal metastases and thoracic lymph nodal involvement (LNI). Patients who underwent lung surgical resection for pulmonary colorectal metastases from 2004 to 2014 were analyzed. Concordance between histology, CT scan, and FDG-PET findings were assessed. Data of 521 patients were analyzed. Of those, FDG-PET was performed in 435 (83.5%). A moderate agreement between both CT scan (kappa index: 0.42) and FDG-PET (kappa index: 0.42) findings and the histologically proven number of metastases was observed. The number of histologically proven metastases was correctly discriminated in 61.7% of cases with CT scan and in 61.8% of cases with FDG-PET. Multiple metastases were discovered in 20.9% of clinical single metastasis cases with CT scan, and in 24.4% of those cases with FDG-PET. One hundred fifty patients (29.1%) presented with pathologic LNI. A poor agreement was observed between LNI and CT scan findings (kappa index: 0.02), and a weak agreement was observed concerning LNI and FDG-PET findings (kappa index: 0.39). Computed tomography and FDG-PET have limitations if the objective is to detect all malignant nodules and to discriminate the LNI in cases of pulmonary metastases of colorectal cancer. Copyright © 2017 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.

Intensity Modulated Radiation Therapy Dose Painting for Localized Prostate Cancer Using 11C-choline Positron Emission Tomography Scans

International Nuclear Information System (INIS)

Chang, Joe H.; Lim Joon, Daryl; Lee, Sze Ting; Gong, Sylvia J.; Anderson, Nigel J.; Scott, Andrew M.; Davis, Ian D.; Clouston, David; Bolton, Damien; Hamilton, Christopher S.; Khoo, Vincent

2012-01-01

Purpose: To demonstrate the technical feasibility of intensity modulated radiation therapy (IMRT) dose painting using 11 C-choline positron emission tomography PET scans in patients with localized prostate cancer. Methods and Materials: This was an RT planning study of 8 patients with prostate cancer who had 11 C-choline PET scans prior to radical prostatectomy. Two contours were semiautomatically generated on the basis of the PET scans for each patient: 60% and 70% of the maximum standardized uptake values (SUV 60% and SUV 70% ). Three IMRT plans were generated for each patient: PLAN 78 , which consisted of whole-prostate radiation therapy to 78 Gy; PLAN 78-90 , which consisted of whole-prostate RT to 78 Gy, a boost to the SUV 60% to 84 Gy, and a further boost to the SUV 70% to 90 Gy; and PLAN 72-90 , which consisted of whole-prostate RT to 72 Gy, a boost to the SUV 60% to 84 Gy, and a further boost to the SUV 70% to 90 Gy. The feasibility of these plans was judged by their ability to reach prescription doses while adhering to published dose constraints. Tumor control probabilities based on PET scan-defined volumes (TCP PET ) and on prostatectomy-defined volumes (TCP path ), and rectal normal tissue complication probabilities (NTCP) were compared between the plans. Results: All plans for all patients reached prescription doses while adhering to dose constraints. TCP PET values for PLAN 78 , PLAN 78-90 , and PLAN 72-90 were 65%, 97%, and 96%, respectively. TCP path values were 71%, 97%, and 89%, respectively. Both PLAN 78-90 and PLAN 72-90 had significantly higher TCP PET (P=.002 and .001) and TCP path (P 78 . PLAN 78-90 and PLAN 72-90 were not significantly different in terms of TCP PET or TCP path . There were no significant differences in rectal NTCPs between the 3 plans. Conclusions: IMRT dose painting for localized prostate cancer using 11 C-choline PET scans is technically feasible. Dose painting results in higher TCPs without higher NTCPs.

High-resolution PET [Positron Emission Tomography] for Medical Science Studies

Science.gov (United States)

Budinger, T. F.; Derenzo, S. E.; Huesman, R. H.; Jagust, W. J.; Valk, P. E.

1989-09-01

One of the unexpected fruits of basic physics research and the computer revolution is the noninvasive imaging power available to today's physician. Technologies that were strictly the province of research scientists only a decade or two ago now serve as the foundations for such standard diagnostic tools as x-ray computer tomography (CT), magnetic resonance imaging (MRI), magnetic resonance spectroscopy (MRS), ultrasound, single photon emission computed tomography (SPECT), and positron emission tomography (PET). Furthermore, prompted by the needs of both the practicing physician and the clinical researcher, efforts to improve these technologies continue. This booklet endeavors to describe the advantages of achieving high resolution in PET imaging.

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

OpenAIRE

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

2015-01-01

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

Using positron emission tomography (PET) response criteria in solid tumours (PERCIST) 1.0 for evaluation of 2'-deoxy-2'-[18F] fluoro-D-glucose-PET/CT scans to predict survival early during treatment of locally advanced non-small cell lung cancer (NSCLC).

Science.gov (United States)

Fledelius, Joan; Khalil, Azza Ahmed; Hjorthaug, Karin; Frøkiaer, Jørgen

2016-04-01

The demand for early-response evaluation with 2'-deoxy-2'-[18F] fluoro-D-glucose (F-18-FDG) positron emission tomography combined with whole body CT (PET/CT) is rapidly growing. This study was initiated to evaluate the applicability of the PET response criteria in solid tumours (PERCIST 1.0) for response evaluation. We performed a retrospective study of 21 patients with locally advanced non-small cell lung cancer (NSCLC), who had undergone both a baseline and a follow-up F-18-FDG-PET/CT scan during their treatments. The scans were performed at our institution in the period September 2009 and March 2011 and were analysed visually and according to PERCIST 1.0 by one board-certified nuclear medicine physician. The response was compared with overall survival (OS) and progression-free survival (PFS). The variation in key parameters affecting the F-18-FDG uptake was assessed. A kappa of 0.94 corresponding to an almost perfect agreement was found for the comparison of the visual evaluation with PERCIST. Patients with partial metabolic response and stable metabolic disease (as evaluated by PERCIST 1.0) had statistically significant longer median time to progression: 8.4 months (confidence interval (CI) 5.1-11.8 months) as compared with 2.7 months (CI 0-5.6 months) in patients classified with progression. The variation in uptake time between baseline and follow-up scans was more than the recommended 15 min in 48% of patients. PERCIST 1.0 is readily implementable and highly comparable with visual evaluation of response using early F-18-FDG-PET/CT scanning for locally advanced NSCLC patients. In spite of variations in parameters affecting F-18-FDG uptake, evaluation of F-18-FDG-PET/CT during treatment with PERCIST 1.0 is shown to separate non-responders from responders, each with statistically significant differences in both OS and PFS. © 2015 The Royal Australian and New Zealand College of Radiologists.

Clinical Usefulness of F-18 FDG PET/CT in papillary thyroid cancer with negative radioiodine scan and elevated thyroglobulin level or positive anti-thyroglobulin antibody

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Choi, Su Jung; Jung, Kyung Pyo; Lee, Sun Seong; Park, Yun Soo; Lee, Seok Mo [Dept. of Nuclear Medicine, Busan Paik Hospital, Inje University College of Medicine, Busan (Korea, Republic of); Bae, Sang Kyun [Dept. of Nuclear Medicine, Haeundae Paik Hospital, Inje University College of Medicine, Busan (Korea, Republic of)

2016-06-15

Elevated thyroglobulin (Tg) levels, along with a negative radioiodine scan, present a clinical problem for the diagnosis of recurrence in papillary thyroid cancer (PTC) patients. The purpose of this study was to assess (1) the usefulness of 18F-fluorodeoxyglucose (F-18 FDG) positron emission tomography (PET)/computed tomography (CT) for PTC patients with negative diagnostic radioiodine scan and elevated serum Tg level or positive anti-thyroglobulin antibody (TgAb), and (2) the effect of endogenous thyroid stimulating hormone (TSH) stimulation (ETS) on detecting recurrence in these circumstances. Eighty-four patients with negative diagnostic radioiodine scan and elevated serum Tg or positive TgAb under ETS were included. Correlation with clinicopathological features and recurrence, detectability of FDG PET/CT and cut-off value of serum Tg for recurrence in PTC patients with these circumstance were assessed. In addition, detectability of F-18 FDG PET/CT under ETS and suppression were compared. In Cox regression analysis, only serum Tg level was significantly associated with recurrence (P<0.001, HR  = 1.13; 95 % CI, 1.061–1.208). The cut-off level of Tg was 21.5 ng/mL (AUC, 0.919; P < 0.001) for discriminating the recurrence in the patients with positive PET/CT finding. The sensitivity, specificity, PPV, NPV, and accuracy of F-18 FDG PET/CT for detecting recurrence were 64 %, 94 %, 86 %, 81 %, and 83 %. In the analysis of F-18 FDG PET/CT under ETS, the sensitivity, specificity, PPV, NPV and accuracy was 64 %, 94 %, 88 %, 81 % and 83 %. Those under TSH suppression were 67 %, 92 %, 80 %, 85 % and 83 %. F-18 FDG PET/CT, although less sensitive, showed high specificity, PPV, NPV, and accuracy and therefore can be useful for the patients with negative diagnostic radioiodine scan and elevated serum Tg or positive TgAb. In addition, FDG PET/CT under ETS does not seem to have an additive role in detecting recurrence in these patients.

Positron Emission Tomography (PET in Oncology

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Andrea Gallamini

2014-09-01

Full Text Available Since its introduction in the early nineties as a promising functional imaging technique in the management of neoplastic disorders, FDG-PET, and subsequently FDG-PET/CT, has become a cornerstone in several oncologic procedures such as tumor staging and restaging, treatment efficacy assessment during or after treatment end and radiotherapy planning. Moreover, the continuous technological progress of image generation and the introduction of sophisticated software to use PET scan as a biomarker paved the way to calculate new prognostic markers such as the metabolic tumor volume (MTV and the total amount of tumor glycolysis (TLG. FDG-PET/CT proved more sensitive than contrast-enhanced CT scan in staging of several type of lymphoma or in detecting widespread tumor dissemination in several solid cancers, such as breast, lung, colon, ovary and head and neck carcinoma. As a consequence the stage of patients was upgraded, with a change of treatment in 10%–15% of them. One of the most evident advantages of FDG-PET was its ability to detect, very early during treatment, significant changes in glucose metabolism or even complete shutoff of the neoplastic cell metabolism as a surrogate of tumor chemosensitivity assessment. This could enable clinicians to detect much earlier the effectiveness of a given antineoplastic treatment, as compared to the traditional radiological detection of tumor shrinkage, which usually takes time and occurs much later.

Positron Emission Tomography (PET) in Oncology

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Gallamini, Andrea, E-mail: gallamini.a@ospedale.cuneo.it [Department of Research and Medical Innovation, Antoine Lacassagne Cancer Center, Nice University, Nice Cedex 2-06189 Nice (France); Zwarthoed, Colette [Department of Nuclear Medicine, Antoine Lacassagne Cancer Center, Nice University, Nice Cedex 2-06189 Nice (France); Borra, Anna [Hematology Department S. Croce Hospital, Via M. Coppino 26, Cuneo 12100 (Italy)

2014-09-29

Since its introduction in the early nineties as a promising functional imaging technique in the management of neoplastic disorders, FDG-PET, and subsequently FDG-PET/CT, has become a cornerstone in several oncologic procedures such as tumor staging and restaging, treatment efficacy assessment during or after treatment end and radiotherapy planning. Moreover, the continuous technological progress of image generation and the introduction of sophisticated software to use PET scan as a biomarker paved the way to calculate new prognostic markers such as the metabolic tumor volume (MTV) and the total amount of tumor glycolysis (TLG). FDG-PET/CT proved more sensitive than contrast-enhanced CT scan in staging of several type of lymphoma or in detecting widespread tumor dissemination in several solid cancers, such as breast, lung, colon, ovary and head and neck carcinoma. As a consequence the stage of patients was upgraded, with a change of treatment in 10%–15% of them. One of the most evident advantages of FDG-PET was its ability to detect, very early during treatment, significant changes in glucose metabolism or even complete shutoff of the neoplastic cell metabolism as a surrogate of tumor chemosensitivity assessment. This could enable clinicians to detect much earlier the effectiveness of a given antineoplastic treatment, as compared to the traditional radiological detection of tumor shrinkage, which usually takes time and occurs much later.

Evaluating FDG uptake changes between pre and post therapy respiratory gated PET scans

International Nuclear Information System (INIS)

Aristophanous, Michalis; Yong, Yue; Yap, Jeffrey T.; Killoran, Joseph H.; Allen, Aaron M.; Berbeco, Ross I.; Chen, Aileen B.

2012-01-01

Purpose: Whole body (3D) and respiratory gated (4D) FDG-PET/CT scans performed pre-radiotherapy (pre-RT) and post-radiotherapy (post-RT) were analyzed to investigate the impact of 4D PET in evaluating 18F-fluorodeoxyglucose (FDG) uptake changes due to therapy, relative to traditional 3D PET. Methods and materials: 3D and 4D sequential FDG-PET/CT scans were acquired pre-RT and approximately one month post-RT for patients with non-small cell lung cancer (NSCLC). The lesions of high uptake targeted with radiotherapy were identified on the pre-RT scan of each patient. Each lesion on the 3D and each of the five phases of the 4D scan were analyzed using a region of interest (ROI). For each patient the ROIs of the pre-RT scans were used to locate the areas of initial FDG uptake on the post-RT scans following rigid registration. Post-RT ROIs were drawn and the FDG uptake was compared with that of the pre-RT scans. Results: Sixteen distinct lesions from 12 patients were identified and analyzed. Standardized uptake value (SUV) maxima were significantly higher (p-value <0.005) for the lesions as measured on the 4D compared to 3D PET. Comparison of serial pre and post-RT scans showed a mean 62% decrease in SUV with the 3D PET scan (range 36–89%), and a 67% decrease with the 4D PET scan (range 30–89%). The mean absolute difference in SUV change on 3D versus 4D scans was 4.9%, with a range 0–15% (p-value = 0.07). Conclusions: Signal recovery with 4D PET results in higher SUVs when compared to standard 3D PET. Consequently, differences in the evaluation of SUV changes between pre and post-RT plans were observed. Such difference can have a significant impact in PET-based response assessment.

Positron Emission Tomography (PET) and breast cancer in clinical practice

International Nuclear Information System (INIS)

Lavayssiere, Robert; Cabee, Anne-Elizabeth; Filmont, Jean-Emmanuel

2009-01-01

The landscape of oncologic practice has changed deeply during the past few years and there is now a need, through a multidisciplinary approach, for imaging to provide accurate evaluation of morphology and function and to guide treatment (Image Guided Therapy). Increasing emphasis has been put on Position Emission Tomography (PET) role in various cancers among clinicians and patients despite a general context of healthcare expenditure limitation. Positron Emission Tomography has currently a limited role in breast cancer, but also general radiologists and specialists should be aware of these indications, especially when staging aggressive cancers and looking for recurrence. Currently, the hybrid systems associating PET and Computed Tomography (CT) and in the same device [Rohren EM, Turkington TG, Coleman RE. Clinical applications of PET in oncology. Radiology 2004;231:305-32; Blodgett TM, Meltzer CM, Townsend DW. PET/CT: form and function. Radiology 2007;242:360-85; von Schulthess GK, Steinert HC, Hany TF. Integrated PET/CT: current applications and futures directions. Radiology 2006;238(2):405-22], or PET-CT, are more commonly used and the two techniques are adding their potentialities. Other techniques, MRI in particular, may also compete with PET in some instance and as far as ionizing radiations dose limitation is considered, some breast cancers becoming some form of a chronic disease. Breast cancer is a very complex, non-uniform, disease and molecular imaging at large may contribute to a better knowledge and to new drugs development. Ongoing research, Positron Emission Mammography (PEM) and new tracers, are likely to bring improvements in patient care [Kelloff GJ, Hoffman JM, Johnson B, et al. Progress and promise of FDG-PET Imaging for cancer patient management and oncologic drug development. Clin Cancer Res 2005;1(April (8)): 2005

Positron Emission Tomography (PET) and breast cancer in clinical practice

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Lavayssiere, Robert [Centre d' Imagerie Paris-Nord, 1, avenue Charles Peguy, 95200 Sarcelles (France); Institut du Sein Henri Hartmann (ISHH), 1, rue des Dames Augustines, 92200 Neuilly sur Seine (France)], E-mail: cab.lav@wanadoo.fr; Cabee, Anne-Elizabeth [Centre d' Imagerie Paris-Nord, 1, avenue Charles Peguy, 95200 Sarcelles (France); Institut du Sein Henri Hartmann (ISHH), 1, rue des Dames Augustines, 92200 Neuilly sur Seine (France); Centre RMX, 80, avenue Felix Faure, 75105 Paris (France); Filmont, Jean-Emmanuel [Institut du Sein Henri Hartmann (ISHH), 1, rue des Dames Augustines, 92200 Neuilly sur Seine (France); American Hospital of Paris, Nuclear Medicine, 63, boulevard Victor Hugo - BP 109, 92202 Neuilly sur Seine Cedex (France)

2009-01-15

The landscape of oncologic practice has changed deeply during the past few years and there is now a need, through a multidisciplinary approach, for imaging to provide accurate evaluation of morphology and function and to guide treatment (Image Guided Therapy). Increasing emphasis has been put on Position Emission Tomography (PET) role in various cancers among clinicians and patients despite a general context of healthcare expenditure limitation. Positron Emission Tomography has currently a limited role in breast cancer, but also general radiologists and specialists should be aware of these indications, especially when staging aggressive cancers and looking for recurrence. Currently, the hybrid systems associating PET and Computed Tomography (CT) and in the same device [Rohren EM, Turkington TG, Coleman RE. Clinical applications of PET in oncology. Radiology 2004;231:305-32; Blodgett TM, Meltzer CM, Townsend DW. PET/CT: form and function. Radiology 2007;242:360-85; von Schulthess GK, Steinert HC, Hany TF. Integrated PET/CT: current applications and futures directions. Radiology 2006;238(2):405-22], or PET-CT, are more commonly used and the two techniques are adding their potentialities. Other techniques, MRI in particular, may also compete with PET in some instance and as far as ionizing radiations dose limitation is considered, some breast cancers becoming some form of a chronic disease. Breast cancer is a very complex, non-uniform, disease and molecular imaging at large may contribute to a better knowledge and to new drugs development. Ongoing research, Positron Emission Mammography (PEM) and new tracers, are likely to bring improvements in patient care [Kelloff GJ, Hoffman JM, Johnson B, et al. Progress and promise of FDG-PET Imaging for cancer patient management and oncologic drug development. Clin Cancer Res 2005;1(April (8)): 2005].

Detection of bone metastases in breast cancer patients in the PET/CT era: Do we still need the bone scan?

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Caglar, M; Kupik, O; Karabulut, E; Høilund-Carlsen, P F

2016-01-01

To examine the value of 18F-fluorodeoxyglucose positron emission tomography/computed tomography (FDG-PET/CT) for the detection of bone metastasis in breast cancer patients and assess whether whole body bone scan (BS) with (99m)Tc-methylene diphosphonate provides any additional information. Study group comprised 150 patients, mean age 52 years (range 27-85) with breast cancer, suspected of having bone metastases. All patients had undergone both FDG-PET/CT and BS with or without single photon emission tomography/computed tomography (SPECT/CT) within a period of 6 weeks. The final diagnosis of bone metastasis was established by histopathological findings, additional imaging, or clinical follow-up longer than 10 months. Cancer antigen 15-3 (CA15-3) and carcinoembryogenic antigen (CEA) were measured in all patients. Histologically 83%, 7% and 10% had infiltrating ductal, lobular and mixed carcinoma respectively. Confirmed bone metastases were present in 86 patients (57.3%) and absent in 64 (42.7%). Mean CA15-3 and CEA values in patients with bone metastases were 74.6ng/mL and 60.4U/mL respectively, compared to 21.3ng/mL and 3.2U/mL without metastases (p<0.001). The sensitivity of FDG-PET/CT for the detection of bone metastases was 97.6% compared to 89.5% with SPECT/CT. In 57 patients, FDG-PET/CT correctly identified additional pulmonary, hepatic, nodal and other soft tissue metastases, not detected by BS. Our findings suggest that FDG-PET/CT is superior to BS with or without SPECT/CT. Copyright © 2015 Elsevier España, S.L.U. and SEMNIM. All rights reserved.

The Utility and indication of FDG-PET scan in patients with cervical cancer: experience in patients with no evidence of recurrence with conventional radiologic examination and tumor markers

International Nuclear Information System (INIS)

Kim, Jong Hoon

2000-12-01

The purpose of this study was to investigate the clinical feasibility of FDG-PET(Positron Emission Tomography) scan in patients with clinically no evidence of disease after treatment of cervical cancer. One hundred and one patients with clinically NED(no evidence of disease) state after treatment of cervical cancer underwent PET scan. FDG-PET scan was obtained with a GE Advance Scanner, beginning at 50 minutes after injection of 370-555 MBq(10-15 mCi) of 18F FDG. Regional scan was also obtained with emission image. Uptake exceeding 3.0 SUV was determined as a positive finding. Recurrence was confirmed by CT, MRI, and needle biopsy if possible. Among 101 patients showing no evidence of disease, 17 patients(16.8%) showed abnormal PET scan findings. Clinically, 8 patients(7.9%) were confirmed to have recurrent lesion by CT, MRI or by needle biopsy. PET scan could detect recurrent lesions in the mediastinum or lung(10/17), pelvis(7/17), and supraclavicular lymph node(2/17). The sensitivity and specificity of PET scan in patients with cervical cancer showing no evidence of disease were 100% and 90.3%, respectively. The positive predictive value, negative predictive value and false positive rate were 47.1%, 100% and 52.9%. PET scan could detect 7.9% of early recurrence in patients with cervical cancer with NED status. FDG-PET scan may be a useful method in detecting metastases or recurrence of a cervical cancer showing no evidence of disease by routine conventional imaging studies

Positron Emission Tomography imaging with the SmartPET system

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Cooper, R.J. [Department of Physics, University of Liverpool, Liverpool, Merseyside L69 7ZE (United Kingdom)], E-mail: cooperrj@ornl.gov; Boston, A.J.; Boston, H.C.; Cresswell, J.R.; Grint, A.N.; Harkness, L.J.; Nolan, P.J.; Oxley, D.C.; Scraggs, D.P.; Mather, A.R. [Department of Physics, University of Liverpool, Liverpool, Merseyside L69 7ZE (United Kingdom); Lazarus, I.; Simpson, J. [STFC Daresbury Laboratory, Daresbury, Warrington, Cheshire WA4 4AD (United Kingdom)

2009-07-21

The Small Animal Reconstruction Tomograph for Positron Emission Tomography (SmartPET) project is the development of a small animal Positron Emission Tomography (PET) demonstrator based on the use of High-Purity Germanium (HPGe) detectors and state of the art digital electronics. The experimental results presented demonstrate the current performance of this unique system. By performing high precision measurements of one of the SmartPET HPGe detectors with a range of finely collimated gamma-ray beams the response of the detector as a function of gamma-ray interaction position has been quantified, facilitating the development of parametric Pulse Shape Analysis (PSA) techniques and algorithms for the correction of imperfections in detector performance. These algorithms have then been applied to data from PET imaging measurements using two such detectors in conjunction with a specially designed rotating gantry. In this paper we show how the use of parametric PSA approaches allows over 60% of coincident events to be processed and how the nature and complexity of an event has direct implications for the quality of the resulting image.

Prostate-Specific Antigen and Prostate-Specific Antigen Velocity as Threshold Indicators in 11C-Acetate PET/CTAC Scanning for Prostate Cancer Recurrence

Science.gov (United States)

Dusing, Reginald W.; Peng, Warner; Lai, Sue-Min; Grado, Gordon L.; Holzbeierlein, Jeffrey M.; Thrasher, J. Brantley; Hill, Jacqueline; Van Veldhuizen, Peter J.

2014-01-01

Purpose The aim of this study was to identify which patient characteristics are associated with the highest likelihood of positive findings on 11C-acetate PET/computed tomography attenuation correction (CTAC) (PET/CTAC) scan when imaging for recurrent prostate cancer. Methods From 2007 to 2011, 250 11C-acetate PET/CTAC scans were performed at a single institution on patients with prostate cancer recurrence after surgery, brachytherapy, or external beam radiation. Of these patients, 120 met our inclusion criteria. Logistic regression analysis was used to examine the relationship between predictability of positive findings and patients’ characteristics, such as prostate-specific antigen (PSA) level at the time of scan, PSA kinetics, Gleason score, staging, and type of treatment before scan. Results In total, 68.3% of the 120 11C-acetate PET/CTAC scans were positive. The percentage of positive scans and PSA at the time of scanning and PSA velocity (PSAV) had positive correlations. The putative sensitivity and specificity were 86.6% and 65.8%, respectively, when a PSA level greater than 1.24 ng/mL was used as the threshold for scanning. The putative sensitivity and specificity were 74% and 75%, respectively, when a PSAV level greater than 1.32 ng/mL/y was used as the threshold. No significant associations were found between scan positivity and age, PSA doubling time, Gleason score, staging, or type of treatment before scanning. Conclusions This retrospective study suggests that threshold models of PSA greater than 1.24 ng/mL or PSAV greater than 1.32 ng/mL per year are independent predictors of positive findings in 11C-acetate PET/CTAC imaging of recurrent prostate cancer. PMID:25036021

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

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Öztürk, Hakan

2015-10-01

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

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

International Nuclear Information System (INIS)

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

1998-01-01

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

A Case of Low-Grade Primary Cardiac Lymphoma with Pericardial Effusion Diagnosed by Combined 18F-Fluorodeoxyglucose Positron Emission Tomography and Computed Tomography (FDG-PET/CT) Imaging and Effusion Cytology.

Science.gov (United States)

Fukunaga, Hisanori; Tatewaki, Yasuko; Mutoh, Tatsushi; Shimomura, Hideo; Yamamoto, Shuzo; Terao, Chiaki; Totsune, Tomoko; Nakagawa, Manabu; Taki, Yasuyuki

2018-03-14

BACKGROUND Primary cardiac lymphoma is rare and can be an aggressive disease, depending on the grade. A case is reported of low-grade primary cardiac lymphoma associated with a pericardial effusion. 18F-fluorodeoxyglucose positron emission tomography and computed tomography (FDG-PET/CT) imaging was useful in the diagnosis and in evaluating the disease activity in this case. CASE REPORT A 72-year-old Japanese woman visited a general practitioner, complaining of dyspnea associated with cardiac tamponade. Pericardiocentesis was performed, and Group V malignant cells were identified by cytology, suspicious for malignant lymphoma. Whole-body FDG-PET/CT scans showed no pleural effusion or lymph node metastasis supporting the diagnosis of primary cardiac lymphoma diagnosed on pericardial effusion. The laboratory investigations showed that levels of serum soluble interleukin-2 (IL-2) receptor (sIL-2R), a diagnostic and prognostic marker for malignant lymphoma, were not elevated (258 U/ml). A six-month follow-up FDG-PET/CT scan showed an increased volume of the pericardial effusion and mild but abnormal uptake diffusely in the pericardial space, and the sIL-2R was slightly elevated (860 U/ml). No abnormal FDG accumulation outside the retained pericardial effusion was noted, which was compatible with a clinical picture of low-grade primary cardiac lymphoma, and in a period of watchful waiting during the first two years later, the sIL-2R had reduced to 195 U/ml. CONCLUSIONS This is a rare case of low-grade primary cardiac lymphoma detected in a pericardial effusion, and highlights the utility of the FDG-PET/CT scan as a valuable diagnostic and follow-up modality.

Reduction of motion artifacts for PET imaging by respiratory correlated dynamic scanning

International Nuclear Information System (INIS)

Chuang, K.-S.; Chen, T.-J.; Chang, C.-C.; Wu, J.; Chen, S.; Wu, L.-C.; Liu, R.-S.

2006-01-01

Organ motion caused by respiration is a major challenge in positron emission tomography (PET) imaging. This work proposes a technique to reduce smearing in PET imaging caused by respiratory motion. Dynamic scanning at 1 frame/s is used. A point source, used as a marker, is attached to the object's abdomen during the scan. The source position in the projection view moves with respiratory motion and can be used to represent the respiratory phase within the time interval in which each frame data are acquired. One hundred and twenty frames are obtained for each study. The range of the positions of the marker is divided into four groups, representing different respiratory phases. The frames in which the organ positions (phases) are the same summed to produce a static sub-sinogram. Each sub-sinogram then undergoes regular image reconstruction to yield a motion-free image. The technique is applied to one volunteer under both free and coached breathing conditions. A parameter called the volume reduction factor is adopted to evaluate the effectiveness of this motion-reduction technique. The preliminary results indicate that the proposed technique effectively reduces motion artifacts in the image. Coached breathing yields better results than free breathing condition. The advantages of this method are that (1) the scanning time remains the same; (2) free breathing is allowed during the acquisition of the image; and (3) no user intervention is required

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

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

2003-07-01

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

Prospective Comparison of F-18 Choline PET/CT Scan Versus Axial MRI for Detecting Bone Metastasis in Biochemically Relapsed Prostate Cancer Patients

Directory of Open Access Journals (Sweden)

Wouter Huysse

2017-10-01

Full Text Available We compared fluor-18 choline positron emission tomography/computed tomography (PET/CT and axial skeleton magnetic resonance imaging (MRI prospectively obtained for the detection of bone metastases in non-castrated patients with biochemically recurrent prostate cancer following primary treatment. PET/CT was performed 45 min post-injection of 3–4 MBq/kg F-18 methyl choline. MRI included T1- and fluid sensitive T2-weighted images of the spine and pelvis. Readers were initially blinded from other results and all scans underwent independent double reading. The best valuable comparator (BVC defined the metastatic status. On the basis of the BVC, 15 out of 64 patients presented with 24 bone metastases. On a patient level, the sensitivity and specificity of MRI and PET were not significantly different. On a lesion level, the sensitivity of MRI was significantly better compared to PET, and the specificity did not differ significantly. In conclusion, axial MRI is an interesting screening tool for the detection of bone metastases because of its low probability of false negative results. However, F-18 choline PET is a valuable addition as it can overrule false positive MRI results and detect non-axial metastases.

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

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

2005-08-15

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

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

International Nuclear Information System (INIS)

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

2005-01-01

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

Application of PET and PET/CT imaging for cancer screening

International Nuclear Information System (INIS)

Chen Yenkung; Hu Fenglan; Shen Yehyou; Liao, A.C.; Hung, T.Z.; Su, Chentau; Chen Liangkuang

2004-01-01

The aim of this study was to evaluate the potential application of 18F-fluorodeoxyglucose (FDG) Positron Emission Tomography (PET) and PET/CT for cancer screening in asymptomatic individuals. Methods: The subjects consisted of 3631 physical check up examinees (1947 men, 1684 women; mean age ±SD, 52.1±8.2 y) with non-specific medical histories. Whole-body FDG PET (or PET/CT), ultrasound and tumor markers were performed on all patients. Focal hypermetabolic areas with intensities equal to or exceeding the level of FDG uptake in the brain and bladder were considered abnormal and interpreted as neoplasia. Follow-up periods were longer than one year. Results: Among the 3631 FDG PET (including 1687 PET/CT), ultrasound and tumor markers examinations, malignant tumors were discovered in 47 examinees (1.29%). PET findings were true-positive in 38 of the 47 cancers (80.9%). In addition, 32 of the 47 cancers were performed with the PET-CT scan. PET detected cancer lesions in 28 of the 32 examinees. However, the CT detected cancer lesions in only 15 of 32 examinees. Conclusion: The sensitivity of FDG PET in the detection of a wide variety of cancers is high. Most cancer can be detected with FDG PET in a resectable stage. CT of the PET/CT for localization and characteristics of the lesion shows an increased specificity of the PET scan. Using ultrasound and tumor markers may complement the PET scan in cancer screening for hepatic and urologic neoplasms. (authors)

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

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Kim, Jong Hoon

1998-12-01

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

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

Science.gov (United States)

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

2016-01-01

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

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

Science.gov (United States)

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

2011-04-01

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

Positron emission tomography

International Nuclear Information System (INIS)

Yamamoto, Y.L.; Thompson, C.J.; Diksic, M.; Meyer, E.; Feindel, W.H.

1984-01-01

One of the most exciting new technologies introduced in the last 10 yr is positron emission tomography (PET). PET provides quantitative, three-dimensional images for the study of specific biochemical and physiological processes in the human body. This approach is analogous to quantitative in-vivo autoradiography but has the added advantage of permitting non-invasive in vivo studies. PET scanning requires a small cyclotron to produce short-lived positron emitting isotopes such as oxygen-15, carbon-11, nitrogen-13 and fluorine-18. Proper radiochemical facilities and advanced computer equipment are also needed. Most important, PET requires a multidisciplinary scientific team of physicists, radiochemists, mathematicians, biochemists and physicians. The most recent trends are reviewed in the imaging technology, radiochemistry, methodology and clinical applications of positron emission tomography. (author)

The significance of incidental focal colonic 18FDG uptake on PET scanning

International Nuclear Information System (INIS)

Bartholomeusz, Dylan; Schultz, Christopher

2009-01-01

Full text: The incidental discovery of colonic polyps, colonic malignancy, diverticulitis and inflammation during PET scanning is well described. This study is a retrospective review of the incidence and follow up of incidental focal FOG uptake in the colon detected during routine PET scanning. PET scan reports over 12 months were reviewed for the reporting of incidental colonic uptake and then clinical follow up performed in available patient records for the incidence of further colonic investigation and results. In 2008, 1985 PET scans were reported at the Royal Adelaide Hospital for the staging and detection of malignancy. Review of the results show that incidental focal colonic uptake was seen in 27 cases, (II female aged 56-83 years). Follow up colonoscopy was performed in 8 cases and in 4 cases showed tubulovillous adenomas, 7-9 mm in size, in the region of abnormal FOG uptake, I had divetticulae and another focal inflammation. Two colonoscopies revealed no abnormality (25% false negative rate). One patient with Head and Neck cancer did not have colonoscopy but the colonic lesion resolved on a post therapy PET scan. Of the 18 cases that did not have colonoscopic follow up 5 were reported on the PET scan to have diffuse probably physiological caecal activity but 13 had focal lesions in the large bowel. Although incidental colonic lesions were detected in only 1.3% of studies, of those having colonoscopy 75 % had significant findings.

PET with a dual-head coincidence gamma camera in head and neck cancer: A comparison with computed tomography and dedicated PET

International Nuclear Information System (INIS)

Zimny, M.

2001-01-01

Positron emission tomography with 18 F-fluoro-deoxyglucose (FDG PET) is a promising imaging tool for detecting and staging of primary or recurrent head and neck cancer. The aim of this study was to evaluate a dual-head gamma camera modified for coincidence detection (KGK-PET) in comparison to computed tomography (CT) and dedicated PET (dPET). 50 patients with known or suspected primary or recurrent head and neck cancer were enrolled. 32 patients underwent KGK-PET and dPET using a one-day protocol. The sensitivity for the detection of primary/ recurrent head and neck cancer for KGK-PET and CT was 80% and 54%, respectively, specificity was 73% and 82%, respectively. The sensitivity and specificity for the detection of lymph node metastases based on neck sides with KGK-PET was 71% (CT: 65%) and 88% (CT: 89%) respectively. In comparison to dPET, KGK-PET revealed concordant results in 32/32 patients with respect to primary tumor/recurrent disease and in 55/60 evaluated neck sides. All involved neck sides that were missed by KGK-PET were also negative with dPET. These results indicate that in patients with head and neck cancer KGK-PET reveals information, that are similar to dPET and complementary to CT. (orig.) [de

ViRPET--combination of virtual reality and PET brain imaging

Science.gov (United States)

Majewski, Stanislaw; Brefczynski-Lewis, Julie

2017-05-23

Various methods, systems and apparatus are provided for brain imaging during virtual reality stimulation. In one example, among others, a system for virtual ambulatory environment brain imaging includes a mobile brain imager configured to obtain positron emission tomography (PET) scans of a subject in motion, and a virtual reality (VR) system configured to provide one or more stimuli to the subject during the PET scans. In another example, a method for virtual ambulatory environment brain imaging includes providing stimulation to a subject through a virtual reality (VR) system; and obtaining a positron emission tomography (PET) scan of the subject while moving in response to the stimulation from the VR system. The mobile brain imager can be positioned on the subject with an array of imaging photodetector modules distributed about the head of the subject.

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

Science.gov (United States)

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

2017-08-01

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

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

International Nuclear Information System (INIS)

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

2010-01-01

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

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

Science.gov (United States)

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

2010-11-15

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

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

Science.gov (United States)

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

2016-05-01

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

Statistical image reconstruction methods for simultaneous emission/transmission PET scans

International Nuclear Information System (INIS)

Erdogan, H.; Fessler, J.A.

1996-01-01

Transmission scans are necessary for estimating the attenuation correction factors (ACFs) to yield quantitatively accurate PET emission images. To reduce the total scan time, post-injection transmission scans have been proposed in which one can simultaneously acquire emission and transmission data using rod sources and sinogram windowing. However, since the post-injection transmission scans are corrupted by emission coincidences, accurate correction for attenuation becomes more challenging. Conventional methods (emission subtraction) for ACF computation from post-injection scans are suboptimal and require relatively long scan times. We introduce statistical methods based on penalized-likelihood objectives to compute ACFs and then use them to reconstruct lower noise PET emission images from simultaneous transmission/emission scans. Simulations show the efficacy of the proposed methods. These methods improve image quality and SNR of the estimates as compared to conventional methods

Ultra-low dose CT attenuation correction for PET/CT

International Nuclear Information System (INIS)

Xia Ting; Kinahan, Paul E; Alessio, Adam M; De Man, Bruno; Manjeshwar, Ravindra; Asma, Evren

2012-01-01

A challenge for positron emission tomography/computed tomography (PET/CT) quantitation is patient respiratory motion, which can cause an underestimation of lesion activity uptake and an overestimation of lesion volume. Several respiratory motion correction methods benefit from longer duration CT scans that are phase matched with PET scans. However, even with the currently available, lowest dose CT techniques, extended duration cine CT scans impart a substantially high radiation dose. This study evaluates methods designed to reduce CT radiation dose in PET/CT scanning. We investigated selected combinations of dose reduced acquisition and noise suppression methods that take advantage of the reduced requirement of CT for PET attenuation correction (AC). These include reducing CT tube current, optimizing CT tube voltage, adding filtration, CT sinogram smoothing and clipping. We explored the impact of these methods on PET quantitation via simulations on different digital phantoms. CT tube current can be reduced much lower for AC than that in low dose CT protocols. Spectra that are higher energy and narrower are generally more dose efficient with respect to PET image quality. Sinogram smoothing could be used to compensate for the increased noise and artifacts at radiation dose reduced CT images, which allows for a further reduction of CT dose with no penalty for PET image quantitation. When CT is not used for diagnostic and anatomical localization purposes, we showed that ultra-low dose CT for PET/CT is feasible. The significant dose reduction strategies proposed here could enable respiratory motion compensation methods that require extended duration CT scans and reduce radiation exposure in general for all PET/CT imaging. (paper)

[Usefulness of (18)FDG PET-CT scan as a diagnostic tool of fever of unknown origin].

Science.gov (United States)

García-Gómez, Francisco Javier; Acevedo-Báñez, Irene; Martínez-Castillo, Rubén; García-Gutiérrez, Manuel; Tirado-Hospital, Juan Luis; Borrego-Dorado, Isabel

2015-07-20

Classic fever of unknown origin (FUO) is defined as the presence of fever greater than 38.3°C of at least 3 weeks with an uncertain diagnosis. Identification of the etiology is crucial in guiding further diagnostic procedures and subsequent patient management. The aim of this study was to evaluate the role of fluorine-18 fluorodeoxyglucose ((18)F-FDG) positron emission tomography combined with computed tomography (PET/CT) in the diagnostic orientation of FUO. An observational retrospective study was performed, including 30 consecutive patients who had been studied between March 2010 and September 2013. Twenty-six out of 30 patients (86.67%) had a definitive diagnosis after pathologic confirmation in 15 cases, microbiological findings in one patient and clinical and radiological follow-up in 10 patients (mean: 16.38 months). Among the positive scans, malignancy (n=10), inflammatory (n=8), infectious (n=4) and miscellaneous causes (n=1) were identified. (18)F-FDG PET/CT had a diagnostic accuracy of 90.00%, sensitivity of 88.46% (95% confidence interval [95% CI] 76-101), specificity of 100.00% (95% CI 100-100), positive predictive values of 100.00% (95% CI100-100) and negative predictive value of 57.14% (95% CI 20-91). (18)F-FDG PET/CT provided useful for the etiologic diagnosis of FUO, with high sensitivity and specificity. (18)F-FDG PET/CT has an incremental morphological and functional value, especially indicating the best biopsy site. Copyright © 2014 Elsevier España, S.L.U. All rights reserved.

Radiation dose to radiosensitive organs in PET/CT myocardial perfusion examination using versatile optical fibre

Science.gov (United States)

Salasiah, M.; Nordin, A. J.; Fathinul Fikri, A. S.; Hishar, H.; Tamchek, N.; Taiman, K.; Ahmad Bazli, A. K.; Abdul-Rashid, H. A.; Mahdiraji, G. A.; Mizanur, R.; Noor, Noramaliza M.

2013-05-01

Cardiac positron emission tomography (PET) provides a precise method in order to diagnose obstructive coronary artery disease (CAD), compared to single photon emission tomography (SPECT). PET is suitable for obese and patients who underwent pharmacologic stress procedures. It has the ability to evaluate multivessel coronary artery disease by recording changes in left ventricular function from rest to peak stress and quantifying myocardial perfusion (in mL/min/g of tissue). However, the radiation dose to the radiosensitive organs has become crucial issues in the Positron Emission Tomography/Computed Tomography(PET/CT) scanning procedure. The objective of this study was to estimate radiation dose to radiosensitive organs of patients who underwent PET/CT myocardial perfusion examination at Centre for Diagnostic Nuclear Imaging, Universiti Putra Malaysia in one month period using versatile optical fibres (Ge-B-doped Flat Fibre) and LiF (TLD-100 chips). All stress and rest paired myocardial perfusion PET/CT scans will be performed with the use of Rubidium-82 (82Rb). The optic fibres were loaded into plastic capsules and attached to patient's eyes, thyroid and breasts prior to the infusion of 82Rb, to accommodate the ten cases for the rest and stress PET scans. The results were compared with established thermoluminescence material, TLD-100 chips. The result shows that radiation dose given by TLD-100 and Germanium-Boron-doped Flat Fiber (Ge-B-doped Flat Fiber) for these five organs were comparable to each other where the p>0.05. For CT scans,thyroid received the highest dose compared to other organs. Meanwhile, for PET scans, breasts received the highest dose.

18F-fluorodeoxyglucose positron emission tomography in uterine carcinosarcoma

International Nuclear Information System (INIS)

Ho, Kung-Chu; Yen, Tzu-Chen; Lai, Chyong-Huey; Wu, Tzu-I; Chang, Ting-Chang; Huang, Huei-Jean; Ng, Koon-Kwan; Lin, Gigin; Wang, Chun-Chieh; Hsueh, Swei

2008-01-01

Uterine carcinosarcomas clinically confined to the uterus usually harbor occult metastases. We conducted a pilot study to evaluate the value of 18 F-fluorodeoxyglucose (FDG) positron emission tomography (PET) in uterine carcinosarcoma. Patients with histologically confirmed uterine carcinosarcoma were enrolled. Abdominal and pelvic magnetic resonance imaging (MRI)/whole-body computed tomography (CT) scan, and whole-body 18 F-FDG PET or PET/CT were undertaken for primary staging, evaluating response, and restaging/post-therapy surveillance. The clinical impact of 18 F-FDG PET was determined on a scan basis. A total of 19 patients were recruited and 31 18 F-FDG PET scans (including 8 scans performed on a PET/CT scanner) were performed. Positive impacts of scans were found in 36.8% (7/19) for primary staging, 66.7% (2/3) for monitoring response, and 11.1% (1/9) for restaging/post-therapy surveillance. PET excluded falsely inoperable disease defined by MRI in two patients. Aggressive treatment applying to three patients with PET-defined resectable stage IVB disease seemed futile. Two patients died of disease shortly after salvage therapy restaged by PET. With PET monitoring, one stage IVB patient treated by targeted therapy only was alive with good performance. Using PET did not lead to improvement of overall survival of this series compared with the historical control (n = 35) (P 0.779). The preliminary results suggest that 18 F-FDG PET is beneficial in excluding falsely inoperable disease for curative therapy and in making a decision on palliation for better quality of life instead of aggressive treatment under the guidance of PET. PET seems to have limited value in post-therapy surveillance or restaging after failure. (orig.)

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

Energy Technology Data Exchange (ETDEWEB)

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

2012-08-01

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

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

International Nuclear Information System (INIS)

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

2010-01-01

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

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

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

OpenAIRE

Tamer W. Kassem

2017-01-01

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

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

Science.gov (United States)

Joshi, Prathamesh; Lele, Vikram; Shah, Hardik

2013-01-01

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

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

Science.gov (United States)

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

2017-06-01

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

Early static {sup 18}F-FET-PET scans have a higher accuracy for glioma grading than the standard 20-40 min scans

Energy Technology Data Exchange (ETDEWEB)

Albert, Nathalie L.; Winkelmann, Isabel; Wenter, Vera; Mille, Erik; Todica, Andrei; Brendel, Matthias; Bartenstein, Peter [Ludwig-Maximilians-University Munich, Department of Nuclear Medicine, Munich (Germany); Suchorska, Bogdana; Tonn, Joerg-Christian [Ludwig-Maximilians-University Munich, Department of Neurosurgery, Munich (Germany); Schmid-Tannwald, Christine [Ludwig-Maximilians-University Munich, Institute for Clinical Radiology, Munich (Germany); La Fougere, Christian [University of Tuebingen, Division of Nuclear Medicine and Clinical Molecular Imaging, Department of Radiology, Tuebingen (Germany)

2016-06-15

Current guidelines for glioma imaging by positron emission tomography (PET) using the amino acid analogue O-(2-[{sup 18}F]fluoroethyl)-L-tyrosine ({sup 18}F-FET) recommend image acquisition from 20-40 min post injection (p.i.). The maximal tumour-to-background evaluation (TBR{sub max}) obtained in these summation images does not enable reliable differentiation between low and high grade glioma (LGG and HGG), which, however, can be achieved by dynamic {sup 18}F-FET-PET. We investigated the accuracy of tumour grading using TBR{sub max} values at different earlier time points after tracer injection. Three hundred and fourteen patients with histologically proven primary diagnosis of glioma (131 LGG, 183 HGG) who had undergone 40-min dynamic {sup 18}F-FET-PET scans were retrospectively evaluated. TBR{sub max} was assessed in the standard 20-40 min summation images, as well as in summation images from 0-10 min, 5-15 min, 5-20 min, and 15-30 min p.i., and kinetic analysis was performed. TBR{sub max} values and kinetic analysis were correlated with histological classification. ROC analyses were performed for each time frame and sensitivity, specificity, and accuracy were assessed. TBR{sub max} values in the earlier summation images were significantly better for tumour grading (P < 0.001) when compared to standard 20-40 min scans, with best results for the early 5-15 min scan. This was due to higher TBR{sub max} in the HGG (3.9 vs. 3.3; p < 0.001), while TBR{sub max} remained nearly stable in the LGG (2.2 vs. 2.1). Overall, accuracy increased from 70 % in the 20-40 min analysis to 77 % in the 5-15 min images, but did not reach the accuracy of dynamic analysis (80 %). Early TBR{sub max} assessment (5-15 min p.i.) is more accurate for the differentiation between LGG and HGG than the standard static scan (20-40 min p.i.) mainly caused by the characteristic high {sup 18}F-FET uptake of HGG in the initial phase. Therefore, when dynamic {sup 18}F-FET-PET cannot be performed

Mycobacterial Infection of the Gallbladder Masquerading as Gallbladder Cancer with a False Positive Pet Scan

Directory of Open Access Journals (Sweden)

Adeeb Majid

2013-01-01

Full Text Available Isolated mycobacterial infection of gall bladder is an extremely rare entity. Only anecdotal reports are evident in the literature. A preoperative diagnosis of mycobacterial infection of gallbladder is therefore very difficult. The case of a 72-year-old male who underwent surgery for suspected gallbladder cancer is presented. The diagnosis of cancer was based on radiological findings and an abnormal uptake of fluorine-18-fluoro-2-deoxy-D-glucose (FDG on positron emission tomography (PET scan whilst being followed up for colorectal cancer. He underwent cholecystectomy and gallbladder bed resection. Histopathology was consistent with mycobacterial infection of the gallbladder.

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

Energy Technology Data Exchange (ETDEWEB)

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

2010-09-15

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

[¹⁸F]Fluorodeoxyglucose (FDG)-Positron Emission Tomography (PET)/Computed Tomography (CT) in Suspected Recurrent Breast Cancer

DEFF Research Database (Denmark)

Hildebrandt, Malene Grubbe; Gerke, Oke; Baun, Christina

2016-01-01

PURPOSE: To prospectively investigate the diagnostic accuracy of [(18)F]fluorodeoxyglucose (FDG)-positron emission tomography (PET)/computed tomography (CT) with dual-time-point imaging, contrast-enhanced CT (ceCT), and bone scintigraphy (BS) in patients with suspected breast cancer recurrence....... PATIENTS AND METHODS: One hundred women with suspected recurrence of breast cancer underwent 1-hour and 3-hour FDG-PET/CT, ceCT, and BS within approximately 10 days. The study was powered to estimate the precision of the individual imaging tests. Images were visually interpreted using a four...

SmartPET: Applying HPGe and pulse shape analysis to small-animal PET

Energy Technology Data Exchange (ETDEWEB)

Cooper, R.J. [Department of Physics, University of Liverpool (United Kingdom)], E-mail: rjc@ns.ph.liv.ac.uk; Boston, A.J.; Boston, H.C.; Cresswell, J.R.; Grint, A.N.; Mather, A.R.; Nolan, P.J.; Scraggs, D.P.; Turk, G. [Department of Physics, University of Liverpool (United Kingdom); Hall, C.J.; Lazarus, I. [CCLRC Daresbury Laboratory, Warrington, Cheshire (United Kingdom); Berry, A.; Beveridge, T.; Gillam, J.; Lewis, R.A. [School of Physics and Materials Engineering, Monash University, Melbourne (Australia)

2007-08-21

The SmartPET project is the development of a prototype small-animal imaging system based on the use of Hyperpure Germanium (HPGe) detectors. The use of digital electronics and application of Pulse Shape Analysis (PSA) techniques provide fine spatial resolution, while the excellent intrinsic energy resolution of HPGe detectors makes the system ideal for multi-nuclide imaging. As a result, the SmartPET system has the potential to function as a dual modality imager, operating as a dual-head Positron Emission Tomography (PET) camera or in a Compton Camera configuration for Single Photon Emission Computed Tomography (SPECT) imaging. In this paper, we discuss how the use of simple PSA techniques greatly improves the position sensitivity of the detector yielding improved spatial resolution in reconstructed images. The PSA methods presented have been validated by comparison to data from high-precision scanning of the detectors. Results from this analysis are presented along with initial images from the SmartPET system, which demonstrates the impact of these techniques on PET images.

[18F]-Fluoro-Deoxy-Glucose Positron Emission Tomography Scan Should Be Obtained Early in Cases of Autoimmune Encephalitis

Directory of Open Access Journals (Sweden)

C. R. Newey

2016-01-01

Full Text Available Introduction. Autoimmune encephalitis (AE is a clinically challenging diagnosis with nonspecific neurological symptoms. Prompt diagnosis is important and often relies on neuroimaging. We present a case series of AE highlighting the importance of an early [18F]-fluoro-deoxy-glucose positron emission tomography (FDG-PET scan. Methods. Retrospective review of seven consecutive cases of autoimmune encephalitis. Results. All patients had both magnetic resonance imaging (MRI and FDG-PET scans. Initial clinical presentations included altered mental status and/or new onset seizures. Six cases had serum voltage-gated potassium channel (VGKC antibody and one had serum N-methyl-D-aspartate (NMDA antibody. MRI of brain showed mesial temporal lobe hyperintensity in five cases of VGKC. The other two patients with VGKC or NMDA AE had restiform body hyperintensity on MRI brain or a normal MRI, respectively. Mesial temporal lobe hypermetabolism was noted in three cases on FDG-PET, despite initial unremarkable MRI. Malignancy workup was negative in all patients. Conclusion. A high index of suspicion for AE should be maintained in patients presenting with cognitive symptoms, seizures, and limbic changes on neuroimaging. In cases with normal initial brain MRI, FDG-PET can be positive. Additionally, extralimbic hyperintensity on MRI may also be observed.

[18F]-Fluoro-Deoxy-Glucose Positron Emission Tomography Scan Should Be Obtained Early in Cases of Autoimmune Encephalitis

Science.gov (United States)

Sarwal, A.; Hantus, S.

2016-01-01

Introduction. Autoimmune encephalitis (AE) is a clinically challenging diagnosis with nonspecific neurological symptoms. Prompt diagnosis is important and often relies on neuroimaging. We present a case series of AE highlighting the importance of an early [18F]-fluoro-deoxy-glucose positron emission tomography (FDG-PET) scan. Methods. Retrospective review of seven consecutive cases of autoimmune encephalitis. Results. All patients had both magnetic resonance imaging (MRI) and FDG-PET scans. Initial clinical presentations included altered mental status and/or new onset seizures. Six cases had serum voltage-gated potassium channel (VGKC) antibody and one had serum N-methyl-D-aspartate (NMDA) antibody. MRI of brain showed mesial temporal lobe hyperintensity in five cases of VGKC. The other two patients with VGKC or NMDA AE had restiform body hyperintensity on MRI brain or a normal MRI, respectively. Mesial temporal lobe hypermetabolism was noted in three cases on FDG-PET, despite initial unremarkable MRI. Malignancy workup was negative in all patients. Conclusion. A high index of suspicion for AE should be maintained in patients presenting with cognitive symptoms, seizures, and limbic changes on neuroimaging. In cases with normal initial brain MRI, FDG-PET can be positive. Additionally, extralimbic hyperintensity on MRI may also be observed. PMID:27559482

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

International Nuclear Information System (INIS)

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

2015-01-01

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

PET/CT scanning guided intensity-modulated radiotherapy in treatment of recurrent ovarian cancer

Energy Technology Data Exchange (ETDEWEB)

Du, Xue-lian, E-mail: duxuelian23800@yahoo.com.cn [Department of Gynecologic Oncology, Shandong Cancer Hospital, Jinan 250117 (China); Shandong Academy of Medical Science, Jinan 250012 (China); Jiang, Tao, E-mail: melody23800@yahoo.com.cn [Department of Gynecologic Oncology, Shandong Cancer Hospital, Jinan 250117 (China); Shandong Academy of Medical Science, Jinan 250012 (China); Sheng, Xiu-gui, E-mail: jnsd2000@yahoo.cn [Department of Gynecologic Oncology, Shandong Cancer Hospital, Jinan 250117 (China); Shandong Academy of Medical Science, Jinan 250012 (China); Li, Qing-shui, E-mail: lqs1966@126.com [Department of Gynecologic Oncology, Shandong Cancer Hospital, Jinan 250117 (China); Shandong Academy of Medical Science, Jinan 250012 (China); Wang, Cong, E-mail: jnwc1981@hotmail.com [Department of Gynecologic Oncology, Shandong Cancer Hospital, Jinan 250117 (China); Shandong Academy of Medical Science, Jinan 250012 (China); Yu, Hao, E-mail: jnyh2200@sina.com [Department of Gynecologic Oncology, Shandong Cancer Hospital, Jinan 250117 (China); Shandong Academy of Medical Science, Jinan 250012 (China)

2012-11-15

Objective: This study was undertaken to evaluate the clinical contribution of positron emission tomography using {sup 18}F-fluorodeoxyglucose and integrated computer tomography (FDG-PET/CT) guided intensity-modulated radiotherapy (IMRT) for treatment of recurrent ovarian cancer. Materials and methods: Fifty-eight patients with recurrent ovarian cancer from 2003 to 2008 were retrospectively studied. In these patients, 28 received PET/CT guided IMRT (PET/CT-IMRT group), and 30 received CT guided IMRT (CT-IMRT group). Treatment plans, tumor response, toxicities and survival were evaluated. Results: Changes in GTV delineation were found in 10 (35.7%) patients based on PET-CT information compared with CT data, due to the incorporation of additional lymph node metastases and extension of the metastasis tumor. PET/CT guided IMRT improved tumor response compared to CT-IMRT group (CR: 64.3% vs. 46.7%, P = 0.021; PR: 25.0% vs. 13.3%, P = 0.036). The 3-year overall survival was significantly higher in the PET-CT/IMRT group than control (34.1% vs. 13.2%, P = 0.014). Conclusions: PET/CT guided IMRT in recurrent ovarian cancer patients improved the delineation of GTV and reduce the likelihood of geographic misses and therefore improve the clinical outcome.

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

International Nuclear Information System (INIS)

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

2015-01-01

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

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

International Nuclear Information System (INIS)

Kawano, Tsuyoshi; Ohtake, Eiji; Inoue, Tomio

2011-01-01

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

Metal artifact reduction of CT scans to improve PET/CT

NARCIS (Netherlands)

Van Der Vos, Charlotte S.; Arens, Anne I.J.; Hamill, James J.; Hofmann, Christian; Panin, Vladimir Y.; Meeuwis, Antoi P.W.; Visser, Eric P.; De Geus-Oei, Lioe Fee

2017-01-01

In recent years, different metal artifact reduction methods have been developed for CT. These methods have only recently been introduced for PET/CT even though they could be beneficial for interpretation, segmentation, and quantification of the PET/CT images. In this study, phantom and patient scans

Metal Artifact Reduction of CT Scans to Improve PET/CT

NARCIS (Netherlands)

Vos, C.S. van der; Arens, A.I.J.; Hamill, J.J.; Hofmann, C.; Panin, V.Y.; Meeuwis, A.P.W.; Visser, E.P.; Geus-Oei, L.F. de

2017-01-01

In recent years, different metal artifact reduction methods have been developed for CT. These methods have only recently been introduced for PET/CT even though they could be beneficial for interpretation, segmentation, and quantification of the PET/CT images. In this study, phantom and patient scans

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

Recent developments in positron emission tomography (PET) instrumentation

Energy Technology Data Exchange (ETDEWEB)

Derenzo, S.E.; Budinger, T.F.

1986-04-01

This paper presents recent detector developments and perspectives for positron emission tomography (PET) instrumentation used for medical research, as well as the physical processes in positron annihilation, photon scattering and detection, tomograph design considerations, and the potentials for new advances in detectors. 117 refs., 4 figs., 4 tabs.

Recent developments in positron emission tomography (PET) instrumentation

International Nuclear Information System (INIS)

Derenzo, S.E.; Budinger, T.F.

1986-04-01

This paper presents recent detector developments and perspectives for positron emission tomography (PET) instrumentation used for medical research, as well as the physical processes in positron annihilation, photon scattering and detection, tomograph design considerations, and the potentials for new advances in detectors. 117 refs., 4 figs., 4 tabs

Positron Emission Tomography (PET) in the oncologic clinical practice; Tomografia por Emision de Positrones (PET) en la practica clinica oncologica

Energy Technology Data Exchange (ETDEWEB)

Serna M, J A; Luviano, C; Martinez V, D [Hospital Angeles del Pedregal Mexico DF (Mexico); Maldonado S, A [Centro PET Complutense, Madrid (Spain)

2005-07-01

We intended to determine the frequency with that the computer axial tomography (TAC), it was able to visualize the lesions extra neoplasia detected by the PET tomography in patients with fully identified primary malignant neoplasia. (Author)

Dynamic observation by PET in epilepsy

International Nuclear Information System (INIS)

Shimizu, Hiroyuki; Ishijima, Buichi; Iio, Masaaki.

1990-01-01

Before the era when positron emission tomography (PET) has emerged, much controversy has existed concerning regional cerebral blood flow in partial epilepsy. In 1979, PET revealed that cerebral blood flow is decreased during the interictal period, but is remarkably increased in the intraictal phase. In this paper, historical process of dynamic observation in epilepsy is reviewed. Potential use and limitations of PET in the clinical setting are discussed in view of the scanning methods and the relationships between PET and electroencephalograms, magnetic resonance imaging, and surgical treatment. (N.K.) 106 refs

Tomography methods for diagnostic examination of cerebrovascular disease: a comparative evaluation of SPECT, PET and MR/CT findings

International Nuclear Information System (INIS)

Reiche, W.; Kaiser, H.J.; Weiller, C.; Altehoefer, C.; Buell, U.; Isensee, C.

1991-01-01

Single Photon Emissions Computerized Tomography (SPECT), Positron Emissions Tomography (PET), Magnetic Resonance Tomography (MR), and Transmission Computerized Tomography (CT) complement each other and lead to a consideration of the cerebrovascular disease under patho-physiological aspects. Indications for the combined application of functionally oriented (SPECT/PET) and morphologically oriented (CT/MR) examination methods with cerebrovascular disease are presented. (orig./MG) [de

{sup 18}F-fluorodeoxyglucose positron emission tomography in uterine carcinosarcoma

Energy Technology Data Exchange (ETDEWEB)

Ho, Kung-Chu; Yen, Tzu-Chen [Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Department of Nuclear Medicine and Molecular Imaging Center, Taoyuan (China); Lai, Chyong-Huey; Wu, Tzu-I; Chang, Ting-Chang; Huang, Huei-Jean [Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Kueishan, Taoyuan (China); Ng, Koon-Kwan; Lin, Gigin [Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Department of Medical Imaging and Intervention, Taoyuan (China); Wang, Chun-Chieh [Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Department of Radiation Oncology, Taoyuan (China); Hsueh, Swei [Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Department of Pathology, Taoyuan (China)

2008-03-15

Uterine carcinosarcomas clinically confined to the uterus usually harbor occult metastases. We conducted a pilot study to evaluate the value of {sup 18}F-fluorodeoxyglucose (FDG) positron emission tomography (PET) in uterine carcinosarcoma. Patients with histologically confirmed uterine carcinosarcoma were enrolled. Abdominal and pelvic magnetic resonance imaging (MRI)/whole-body computed tomography (CT) scan, and whole-body {sup 18}F-FDG PET or PET/CT were undertaken for primary staging, evaluating response, and restaging/post-therapy surveillance. The clinical impact of {sup 18}F-FDG PET was determined on a scan basis. A total of 19 patients were recruited and 31 {sup 18}F-FDG PET scans (including 8 scans performed on a PET/CT scanner) were performed. Positive impacts of scans were found in 36.8% (7/19) for primary staging, 66.7% (2/3) for monitoring response, and 11.1% (1/9) for restaging/post-therapy surveillance. PET excluded falsely inoperable disease defined by MRI in two patients. Aggressive treatment applying to three patients with PET-defined resectable stage IVB disease seemed futile. Two patients died of disease shortly after salvage therapy restaged by PET. With PET monitoring, one stage IVB patient treated by targeted therapy only was alive with good performance. Using PET did not lead to improvement of overall survival of this series compared with the historical control (n = 35) (P = 0.779). The preliminary results suggest that {sup 18}F-FDG PET is beneficial in excluding falsely inoperable disease for curative therapy and in making a decision on palliation for better quality of life instead of aggressive treatment under the guidance of PET. PET seems to have limited value in post-therapy surveillance or restaging after failure. (orig.)

Breast hemangioma mimicking metastasis at PET-CT

Energy Technology Data Exchange (ETDEWEB)

Vieira, Sabas Carlos [Universidade Federal do Piaui (UFPI), Teresina, PI (Brazil). Fac. de Medicina; Silva, Jucelia Saraiva e [MedImagem, Teresina, PI (Brazil). Clinica Medica; Madeira, Eveline Brandao; Franca, Julio Cesar Queiroz de; Martins Filho, Sebastiao Nunes [Universidade Federal do Piaui (UFPI), Teresina, PI (Brazil)

2011-11-15

Breast hemangioma is a rare benign tumor that presents either absent or low {sup 18}F-fluoro-2-deoxy-D-glucose (FDG) uptake at positron emission tomography (PET). The authors report the case of a breast nodule pathologically compatible with hemangioma in a woman whose PET-scan has demonstrated increased FDG uptake (simulating a malignant tumor). A brief review of factors leading to false positive and false negative PET results is also undertaken. (author)

Images to visualize the brain. PET: Positron Emission Tomography

International Nuclear Information System (INIS)

1992-01-01

Diagnosis instrument and research tool, Positron Emission Tomography permits advanced technological developments on positron camera, on molecule labelling and principally on very complex 3D image processing. Cyceron Centre in Caen-France works on brain diseases and try to understand the mechanism of observed troubles and to assess the treatment efficiency with PET. Service Hospitalier Frederic Joliot of CEA-France establishes a mapping of cognitive functions in PET as vision areas, anxiety regions, brain organization of language, different attention forms, voluntary actions and motor functions

Derivation of the scan time requirement for maintaining a consistent PET image quality

International Nuclear Information System (INIS)

Kim, Jin Su; Lee, Jae Sung; Kim, Seok-Ki

2015-01-01

Objectives: the image quality of PET for larger patients is relatively poor, even though the injection dose is optimized considering the NECR characteristics of the PET scanner. This poor image quality is due to the lower level of maximum NECR that can be achieved in these large patients. The aim of this study was to optimize the PET scan time to obtain a consistent PET image quality regardless of the body size, based on the relationship between the patient specific NECR (pNECR) and body weight. Methods: eighty patients (M/F=53/27, body weight: 059 ± 1 kg) underwent whole-body FDG PET scans using a Philips GEMINI GS PET/CT scanner after an injection of 0.14 mCi/kg FDG. The relationship between the scatter fraction (SF) and body weight was determined by repeated Monte Carlo simulations using a NEMA scatter phantom, the size of which varied according to the relationship between the abdominal circumference and body weight. Using this information, the pNECR was calculated from the prompt and delayed PET sinograms to obtain the prediction equation of NECR vs. body weight. The time scaling factor (F TS ) for the scan duration was finally derived to make PET images with equivalent SNR levels. Results: the SF and NECR had the following nonlinear relationships with the body weight: SF=0.15 ⋅ body weight 0.3 and NECR = 421.36 (body weight) −0.84 . The equation derived for F TS was 0.01⋅ body weight + 0.2, which means that, for example, a 120-kg person should be scanned 1.8 times longer than a 70 kg person, or the scan time for a 40-kg person can be reduced by 30%. Conclusion: the equation of the relative time demand derived in this study will be useful for maintaining consistent PET image quality in clinics

Validating PET segmentation of thoracic lesions-is 4D PET necessary?

DEFF Research Database (Denmark)

Nielsen, M. S.; Carl, J.

2017-01-01

Respiratory-induced motions are prone to degrade the positron emission tomography (PET) signal with the consequent loss of image information and unreliable segmentations. This phantom study aims to assess the discrepancies relative to stationary PET segmentations, of widely used semiautomatic PET...... segmentation methods on heterogeneous target lesions influenced by motion during image acquisition. Three target lesions included dual F-18 Fluoro-deoxy-glucose (FDG) tracer concentrations as high-and low tracer activities relative to the background. Four different tracer concentration arrangements were...... segmented using three SUV threshold methods (Max40%, SUV40% and 2.5SUV) and a gradient based method (GradientSeg). Segmentations in static 3D-PET scans (PETsta) specified the reference conditions for the individual segmentation methods, target lesions and tracer concentrations. The motion included PET...

PET-PANC: multicentre prospective diagnostic accuracy and health economic analysis study of the impact of combined modality 18fluorine-2-fluoro-2-deoxy-d-glucose positron emission tomography with computed tomography scanning in the diagnosis and management of pancreatic cancer.

Science.gov (United States)

Ghaneh, Paula; Hanson, Robert; Titman, Andrew; Lancaster, Gill; Plumpton, Catrin; Lloyd-Williams, Huw; Yeo, Seow Tien; Edwards, Rhiannon Tudor; Johnson, Colin; Abu Hilal, Mohammed; Higginson, Antony P; Armstrong, Tom; Smith, Andrew; Scarsbrook, Andrew; McKay, Colin; Carter, Ross; Sutcliffe, Robert P; Bramhall, Simon; Kocher, Hemant M; Cunningham, David; Pereira, Stephen P; Davidson, Brian; Chang, David; Khan, Saboor; Zealley, Ian; Sarker, Debashis; Al Sarireh, Bilal; Charnley, Richard; Lobo, Dileep; Nicolson, Marianne; Halloran, Christopher; Raraty, Michael; Sutton, Robert; Vinjamuri, Sobhan; Evans, Jonathan; Campbell, Fiona; Deeks, Jon; Sanghera, Bal; Wong, Wai-Lup; Neoptolemos, John P

2018-02-01

Pancreatic cancer diagnosis and staging can be difficult in 10-20% of patients. Positron emission tomography (PET)/computed tomography (CT) adds precise anatomical localisation to functional data. The use of PET/CT may add further value to the diagnosis and staging of pancreatic cancer. To determine the incremental diagnostic accuracy and impact of PET/CT in addition to standard diagnostic work-up in patients with suspected pancreatic cancer. A multicentre prospective diagnostic accuracy and clinical value study of PET/CT in suspected pancreatic malignancy. Patients with suspected pancreatic malignancy. All patients to undergo PET/CT following standard diagnostic work-up. The primary outcome was the incremental diagnostic value of PET/CT in addition to standard diagnostic work-up with multidetector computed tomography (MDCT). Secondary outcomes were (1) changes in patients' diagnosis, staging and management as a result of PET/CT; (2) changes in the costs and effectiveness of patient management as a result of PET/CT; (3) the incremental diagnostic value of PET/CT in chronic pancreatitis; (4) the identification of groups of patients who would benefit most from PET/CT; and (5) the incremental diagnostic value of PET/CT in other pancreatic tumours. Between 2011 and 2013, 589 patients with suspected pancreatic cancer underwent MDCT and PET/CT, with 550 patients having complete data and in-range PET/CT. Sensitivity and specificity for the diagnosis of pancreatic cancer were 88.5% and 70.6%, respectively, for MDCT and 92.7% and 75.8%, respectively, for PET/CT. The maximum standardised uptake value (SUV max. ) for a pancreatic cancer diagnosis was 7.5. PET/CT demonstrated a significant improvement in relative sensitivity ( p  = 0.01) and specificity ( p  = 0.023) compared with MDCT. Incremental likelihood ratios demonstrated that PET/CT significantly improved diagnostic accuracy in all scenarios ( p  diagnostic benefit in the diagnosis of pancreatic cancer and

The history of cerebral PET scanning: from physiology to cutting-edge technology.

Science.gov (United States)

Portnow, Leah H; Vaillancourt, David E; Okun, Michael S

2013-03-05

To review the discoveries underpinning the introduction of cerebral PET scanning and highlight its modern applications. Important discoveries in neurophysiology, brain metabolism, and radiotracer development in the post-World War II period provided the necessary infrastructure for the first cerebral PET scan. A complete review of the literature was undertaken to search for primary and secondary sources on the history of PET imaging. Searches were performed in PubMed, Google Scholar, and select individual journal Web sites. Written autobiographies were obtained through the Society for Neuroscience Web site at www.sfn.org. A reference book on the history of radiology, Naked to the Bone, was reviewed to corroborate facts and to locate references. The references listed in all the articles and books obtained were reviewed. The neurophysiologic sciences required to build cerebral PET imaging date back to 1878. The last 60 years have produced an evolution of technological advancements in brain metabolism and radiotracer development. These advancements facilitated the development of modern cerebral PET imaging. Several key scientists were involved in critical discoveries and among them were Angelo Mosso, Charles Roy, Charles Sherrington, John Fulton, Seymour Kety, Louis Sokoloff, David E. Kuhl, Gordon L. Brownell, Michael Ter-Pogossian, Michael Phelps, and Edward Hoffman. Neurophysiology, metabolism, and radiotracer development in the postwar era synergized the development of the technology necessary for cerebral PET scanning. Continued use of PET in clinical trials and current developments in PET-CT/MRI hybrids has led to advancement in diagnosis, management, and treatment of neurologic disorders.

Is positron emission tomography useful in stroke?

NARCIS (Netherlands)

DeReuck, J; Leys, D; DeKeyser, J

Positron emission tomography (PET) has been widely used in the study of stroke and related cerebrovascular diseases. It has shown the various stages leading to cerebral infarction and defined the significance of the ischaemic penumbra. PET scan can predict the clinical outcome of patients with acute

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.)

PET-Studies in parkinson's disease; Untersuchungen mit der Positronen-Emissions-Tomographie (PET) bei Patienten mit Morbus Parkinson

Energy Technology Data Exchange (ETDEWEB)

Schwarz, J. [Klinik fuer Neurologie, Univ. Leipzig (Germany)

2002-09-01

Positron-emission-tomography (PET) has enabled to study the metabolism and blood flow in specific brain areas. Besides, there is a variety of radiotracers that allow quantification of the function of distinct molecules. In respect to Parkinson's disease, PET allowed for the first time to assess the number of dopaminergic neurons in vivo. Thus, helping confirming a dopaminergic deficit, measuring disease progression and also help to determine the function of dopaminergic grafts. Current research has shifted to determine the role of related neurotransmitter systems in the pathophysiology of Parkinson's disease. (orig.) [German] Die positronen-emissions-tomographie (PET) bietet neben der Messung von Metabolismus und Blutfluss die Moeglichkeit der Darstellung von einzelnen Molekuelen. Bei Patienten mit Morbus Parkinson hat es diese Technik erstmals erlaubt, die Anzahl der dopaminergen Neurone zu quantifizieren, wodurch die Diagnose gesichert, die Progression der Erkrankung beurteilt und auch das Anwachsen von Implantaten beurteilt werden kann. Die PET hat einen wesentlichen Beitrag zu unserem heutigen Wissen ueber die Pathophysiologie dieser Erkrankung beigetragen. (orig.)

Positron emission tomography (PET) imaging of nicotine-induced dopamine release in squirrel monkeys using [18F]Fallypride.

Science.gov (United States)

Naylor, Jennifer E; Hiranita, Takato; Matazel, Katelin S; Zhang, Xuan; Paule, Merle G; Goodwin, Amy K

2017-10-01

Nicotine, the principal psychoactive tobacco constituent, is thought to produce its reinforcing effects via actions within the mesolimbic dopamine (DA) system. The objective of the current study was to examine the effect of nicotine on DA D 2 /D 3 receptor availability in the nonhuman primate brain with the use of the radioligand [ 18 F]fallypride and positron emission tomography (PET). Ten adult male squirrel monkeys were used in the current study. Each subject underwent two PET scans, one with an injection (IV) of saline and subsequently one with an injection of nicotine (0.032mg/kg). The DA D 2 /D 3 antagonist, [ 18 F]fallypride, was delivered IV at the beginning of each scan, and nicotine or saline was delivered at 45min into the scan. Regions of interest (ROI) were drawn on specific brain regions and these were used to quantify standard uptake values (SUVs). The SUV is defined as the average concentration of radioactivity in the ROI x body weight/injected dose. Using the cerebellum as a reference region, SUV ratios (SUV ROI /SUV cerebellum ) were calculated to compare saline and nicotine effects in each ROI. Two-way repeated ANOVA revealed a significant decrease of SUV ratios in both striatal and extrastriatal regions following an injection of nicotine during the PET scans. Like other drugs of abuse, these results indicate that nicotine administration may produce DA release, as suggested by the decrease in [ 18 F]fallypride signal in striatal regions. These findings from a nonhuman primate model provide further evidence that the mesolimbic DA system is affected by the use of products that contain nicotine. Published by Elsevier B.V.

High Dose MicroCT Does Not Contribute Toward Improved MicroPET/CT Image Quantitative Accuracy and Can Limit Longitudinal Scanning of Small Animals

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Wendy A. McDougald

2017-10-01

Full Text Available Obtaining accurate quantitative measurements in preclinical Positron Emission Tomography/Computed Tomography (PET/CT imaging is of paramount importance in biomedical research and helps supporting efficient translation of preclinical results to the clinic. The purpose of this study was two-fold: (1 to investigate the effects of different CT acquisition protocols on PET/CT image quality and data quantification; and (2 to evaluate the absorbed dose associated with varying CT parameters.Methods: An air/water quality control CT phantom, tissue equivalent material phantom, an in-house 3D printed phantom and an image quality PET/CT phantom were imaged using a Mediso nanoPET/CT scanner. Collected data was analyzed using PMOD software, VivoQuant software and National Electric Manufactures Association (NEMA software implemented by Mediso. Measured Hounsfield Unit (HU in collected CT images were compared to the known HU values and image noise was quantified. PET recovery coefficients (RC, uniformity and quantitative bias were also measured.Results: Only less than 2 and 1% of CT acquisition protocols yielded water HU values < −80 and air HU values < −840, respectively. Four out of 11 CT protocols resulted in more than 100 mGy absorbed dose. Different CT protocols did not impact PET uniformity and RC, and resulted in <4% overall bias relative to expected radioactive concentration.Conclusion: Preclinical CT protocols with increased exposure times can result in high absorbed doses to the small animals. These should be avoided, as they do not contributed toward improved microPET/CT image quantitative accuracy and could limit longitudinal scanning of small animals.

Interpretation criteria for FDG PET/CT in multiple myeloma (IMPeTUs): final results. IMPeTUs (Italian myeloma criteria for PET USe).

Science.gov (United States)

Nanni, Cristina; Versari, Annibale; Chauvie, Stephane; Bertone, Elisa; Bianchi, Andrea; Rensi, Marco; Bellò, Marilena; Gallamini, Andrea; Patriarca, Francesca; Gay, Francesca; Gamberi, Barbara; Ghedini, Pietro; Cavo, Michele; Fanti, Stefano; Zamagni, Elena

2018-05-01

ᅟ: FDG PET/CT ( 18 F-fluoro-deoxy-glucose positron emission tomography/computed tomography) is a useful tool to image multiple myeloma (MM). However, simple and reproducible reporting criteria are still lacking and there is the need for harmonization. Recently, a group of Italian nuclear medicine experts defined new visual descriptive criteria (Italian Myeloma criteria for Pet Use: IMPeTUs) to standardize FDG PET/CT evaluation in MM patients. The aim of this study was to assess IMPeTUs reproducibility on a large prospective cohort of MM patients. Patients affected by symptomatic MM who had performed an FDG PET/CT at baseline (PET0), after induction (PET-AI), and the end of treatment (PET-EoT) were prospectively enrolled in a multicenter trial (EMN02)(NCT01910987; MMY3033). After anonymization, PET images were uploaded in the web platform WIDEN® and hence distributed to five expert nuclear medicine reviewers for a blinded independent central review according to the IMPeTUs criteria. Consensus among reviewers was measured by the percentage of agreement and the Krippendorff's alpha. Furthermore, on a patient-based analysis, the concordance among all the reviewers in terms of positivity or negativity of the FDG PET/CT scan was tested for different thresholds of positivity (Deauville score (DS 2, 3, 4, 5) for the main parameters (bone marrow, focal score, extra-medullary disease). Eighty-six patients (211 FDG PET/CT scans) were included in this analysis. Median patient age was 58 years (range, 35-66 years), 45% were male, 15% of them were in stage ISS (International Staging System) III, and 42% had high-risk cytogenetics. The percentage agreement was superior to 75% for all the time points, reaching 100% of agreement in assessing the presence skull lesions after therapy. Comparable results were obtained when the agreement analysis was performed using the Krippendorff's alpha coefficient, either in every single time point of scanning (PET0, PET-AI or PET-EoT) or

FDG PET/CT in cancer

DEFF Research Database (Denmark)

Petersen, Henrik; Holdgaard, Paw Christian; Madsen, Poul Henning

2016-01-01

PURPOSE: The Region of Southern Denmark (RSD), covering 1.2 of Denmark's 5.6 million inhabitants, established a task force to (1) retrieve literature evidence for the clinical use of positron emission tomography (PET)/CT and provide consequent recommendations and further to (2) compare the actual...... use of PET/CT in the RSD with these recommendations. This article summarizes the results. METHODS: A Work Group appointed a professional Subgroup which made Clinician Groups conduct literature reviews on six selected cancers responsible for 5,768 (62.6 %) of 9,213 PET/CT scans in the RSD in 2012...... use of PET/CT and literature-based recommendations was high in the first five mentioned cancers in that 96.2 % of scans were made for grade A or B indications versus only 22.2 % in gynaecological cancers. CONCLUSION: Evidence-based usefulness was reported in five of six selected cancers; evidence...

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

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

2015-02-01

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

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

International Nuclear Information System (INIS)

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

2002-01-01

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

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

International Nuclear Information System (INIS)

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

2014-01-01

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

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

International Nuclear Information System (INIS)

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

1998-01-01

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

Quantitative Analysis of Torso FDG-PET Scans by Using Anatomical Standardization of Normal Cases from Thorough Physical Examinations.

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Takeshi Hara

Full Text Available Understanding of standardized uptake value (SUV of 2-deoxy-2-[18F]fluoro-d-glucose positron emission tomography (FDG-PET depends on the background accumulations of glucose because the SUV often varies the status of patients. The purpose of this study was to develop a new method for quantitative analysis of SUV of FDG-PET scan images. The method included an anatomical standardization and a statistical comparison with normal cases by using Z-score that are often used in SPM or 3D-SSP approach for brain function analysis. Our scheme consisted of two approaches, which included the construction of a normal model and the determination of the SUV scores as Z-score index for measuring the abnormality of an FDG-PET scan image. To construct the normal torso model, all of the normal images were registered into one shape, which indicated the normal range of SUV at all voxels. The image deformation process consisted of a whole body rigid registration of shoulder to bladder region and liver registration and a non-linear registration of body surface by using the thin-plate spline technique. In order to validate usefulness of our method, we segment suspicious regions on FDG-PET images manually, and obtained the Z-scores of the regions based on the corresponding voxels that stores the mean and the standard deviations from the normal model. We collected 243 (143 males and 100 females normal cases to construct the normal model. We also extracted 432 abnormal spots from 63 abnormal cases (73 cancer lesions to validate the Z-scores. The Z-scores of 417 out of 432 abnormal spots were higher than 2.0, which statistically indicated the severity of the spots. In conclusions, the Z-scores obtained by our computerized scheme with anatomical standardization of torso region would be useful for visualization and detection of subtle lesions on FDG-PET scan images even when the SUV may not clearly show an abnormality.

New developments in molecular imaging: positron emission tomography time-of-flight (TOF-PET)

International Nuclear Information System (INIS)

Aguilar, P.; Couce, B.; Iglesias, A.; Lois, C.

2011-01-01

Positron Emission tomography (PET) in increasingly being used in oncology for the diagnosis and staging of disease, as well as in monitoring response to therapy. One of the last advances in PET is the incorporation of Time-of-Flight (TOF) information, which improves the tomographic reconstruction process and subsequently the quality of the final image. In this work, we explain the principles of PET and the fundamentals of TOF-PET. Clinical images are shown in order to illustrate how TOF-PET improves the detectability of small lesions, particularly in patients with high body mass index. (Author) 20 refs

[F-18-fluordeoxyglucose positron emission tomography on patients with differentiated thyroid cancer who present elevated human serum thyroglobulin levels and negative I-131 whole body scan].

Science.gov (United States)

Ruiz Franco-Baux, J V; Borrego Dorado, I; Gómez Camarero, P; Rodríguez Rodríguez, J R; Vázquez Albertino, R J; Navarro González, E; Astorga Jiménez, R

2005-01-01

This study aimed to evaluate the role of Fluorine-18-fluorodeoxyglucose positron emission tomography (PET-FDG) in patients with elevated serum thyroglobulin (hTg) levels where thyroid cancer tissue does not concentrate radioiodine, rendering false-negative results on I-131 scanning. Whole-body PET imaging using FDG was performed in 54 patients (37 female, 17 male) aged 17-88 years: 45 with papillary tumors and 9 with follicular tumors who were suspected of having recurrent thyroid carcinoma due to elevated thyroglobulin levels (hTg > 2 ng/ml) under thyroid-stimulating hormone (TSH > or = 30 microIU/ml) in whom the iodine scan was negative. All whole body scans were obtained with diagnostic doses (185 MBq). Whole body PET imaging was performed in fasting patients following i.v. administration of 370 MBq FDG while the patients were receiving full thyroid hormone replacement. Before PET, 99mTc methoxyisobutylisonitrile scintigraphy (99mTc-MIBI) was done in 14 patients and morphologic imaging in 26 by CT scan. Positive PET results confirmed the presence of hypermetabolic foci in 25/54 patients (46.29 %). Positive findings were found for PET-FDG in patients with hTg levels higher than 10 ng/ml receiving full thyroid hormone replacement. 99mTc-MIBI demonstrated lesions in 7/14 patients (50 %). PET-FDG and 99mTc-MIBI had congruent positive results in 4/7 patients. All the lesions found by CT were detected by PET-FDG, while recurrent disease was found in 12/21 patients with previous negative CT. These results suggest that PET-FDG seems to be a promising tool in the follow-up of thyroid cancer and should be considered in patients suffering from differentiated thyroid cancer with suspected recurrence and/or metastases by elevated thyroglobulin levels, and negative I-131 whole body scans. PET-FDG might be more useful at hTg levels > 10 ng/ml.

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

International Nuclear Information System (INIS)

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

2010-01-01

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

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

Science.gov (United States)

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

2014-05-01

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

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

The journey: from X-rays to PET-MRI

International Nuclear Information System (INIS)

Sheikh, Tariq Hussain

2010-01-01

Full text: Medical imaging has undergone remarkable evolution over the past century. Since the discovery of the X-rays by (Wilhelm Conrad Roentgen), static emission tomography (Hal Anger) computed tomography (Godfrey Hounsfield and Alan Cormack), and magnetic resonance imaging (Paul Lauterbur and Peter Mansfield) there have been many other important discoveries and technical developments that have culminated in our current sophisticated multi-modality imaging systems. Nobel Prizes have been given for the discoveries of radioactivity (Marie Curie, Pierre Curie, and Henri Becquerel in 1903) and the positron (Carl Anderson in 1936) and for technical developments such as the radiotracer concept (George De Hevesy in 1943). Positron emission detection systems have developed since their first use in the 1950s to the high-resolution, high-sensitivity tomographic devices that we have today. In keeping pace with these milestones in the evolution of medical imaging, positron emission tomography (PET), and more recently integrated positron emission tomography-computed tomography (PET-CT), have now emerged not only as important research tools but also as significant diagnostic imaging systems in clinical medicine. The use of multi-modality imaging systems and 'smart' specific imaging agents will achieve the key task of accurate diagnosis, treatment evaluation, surveillance, and prognosis in individual patients. PET-CT instrumentation has continued to evolve rapidly, especially over the last decade A PET scanner is combined with a CT scanner into a single machine. The PET and CT components are mounted on the same aluminium support with the CT on the front and PET at the back. Metabolic information is obtained from the PET scanner (emission of annihilation photons) and anatomic information is obtained from the CT scan (transmission of X-Rays). In addition, the CT scan can be used to provide information needed for attenuation correction. The current generation of PET-CT scanners

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

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

DEFF Research Database (Denmark)

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

2007-01-01

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

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

Science.gov (United States)

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

2013-03-01

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

Magnetic resonance imaging-guided attenuation correction of positron emission tomography data in PET/MRI

OpenAIRE

Izquierdo-Garcia, David; Catana, Ciprian

2016-01-01

Attenuation correction (AC) is one of the most important challenges in the recently introduced combined positron emission tomography/magnetic resonance imaging (PET/MR) scanners. PET/MR AC (MR-AC) approaches aim to develop methods that allow accurate estimation of the linear attenuation coefficients (LACs) of the tissues and other components located in the PET field of view (FoV). MR-AC methods can be divided into three main categories: segmentation-, atlas- and PET-based. This review aims to...

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)

Thoracic cavity definition for 3D PET/CT analysis and visualization.

Science.gov (United States)

Cheirsilp, Ronnarit; Bascom, Rebecca; Allen, Thomas W; Higgins, William E

2015-07-01

X-ray computed tomography (CT) and positron emission tomography (PET) serve as the standard imaging modalities for lung-cancer management. CT gives anatomical details on diagnostic regions of interest (ROIs), while PET gives highly specific functional information. During the lung-cancer management process, a patient receives a co-registered whole-body PET/CT scan pair and a dedicated high-resolution chest CT scan. With these data, multimodal PET/CT ROI information can be gleaned to facilitate disease management. Effective image segmentation of the thoracic cavity, however, is needed to focus attention on the central chest. We present an automatic method for thoracic cavity segmentation from 3D CT scans. We then demonstrate how the method facilitates 3D ROI localization and visualization in patient multimodal imaging studies. Our segmentation method draws upon digital topological and morphological operations, active-contour analysis, and key organ landmarks. Using a large patient database, the method showed high agreement to ground-truth regions, with a mean coverage=99.2% and leakage=0.52%. Furthermore, it enabled extremely fast computation. For PET/CT lesion analysis, the segmentation method reduced ROI search space by 97.7% for a whole-body scan, or nearly 3 times greater than that achieved by a lung mask. Despite this reduction, we achieved 100% true-positive ROI detection, while also reducing the false-positive (FP) detection rate by >5 times over that achieved with a lung mask. Finally, the method greatly improved PET/CT visualization by eliminating false PET-avid obscurations arising from the heart, bones, and liver. In particular, PET MIP views and fused PET/CT renderings depicted unprecedented clarity of the lesions and neighboring anatomical structures truly relevant to lung-cancer assessment. Copyright © 2015 Elsevier Ltd. All rights reserved.

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...

Evaluation of PET Scanner Performance in PET/MR and PET/CT Systems: NEMA Tests

OpenAIRE

Mustafa Demir; Türkay Toklu; Mohammad Abuqbeitah; Hüseyin Çetin; H. Sezer Sezgin; Nami Yeyin; Kerim Sönmezoğlu

2018-01-01

Objective: The aim of the present study was to compare the performance of positron emission tomography (PET) component of PET/computed tomography (CT) with new emerging PET/magnetic resonance (MR) of the same vendor. Methods: According to National Electrical Manufacturers Association NU2-07, five separate experimental tests were performed to evaluate the performance of PET scanner of General Electric GE company; SIGNATM model PET/MR and GE Discovery 710 model PET/CT. The main investigated...

Evaluation of PET Scanner Performance in PET/MR and PET/CT Systems: NEMA Tests

OpenAIRE

Demir, Mustafa; Toklu, Türkay; Abuqbeitah, Mohammad; Çetin, Hüseyin; Sezgin, H. Sezer; Yeyin, Nami; Sönmezoğlu, Kerim

2018-01-01

Objective: The aim of the present study was to compare the performance of positron emission tomography (PET) component of PET/computed tomography (CT) with new emerging PET/magnetic resonance (MR) of the same vendor. Methods: According to National Electrical Manufacturers Association NU2-07, five separate experimental tests were performed to evaluate the performance of PET scanner of General Electric GE company; SIGNATM model PET/MR and GE Discovery 710 model PET/CT. The main investigated asp...

Positron emission tomography/computed tomography (PET/CT) in children.

Science.gov (United States)

Shore, Richard M

2008-06-01

Although PET imaging has been available for more than two decades, its use has greatly increased lately due to the advent of PET/CT, readily available sources of commercially supplied FDG, and mobile scanners. These features have enabled PET scanning to expand beyond select major university medical centers, with on-site cyclotron facilities to smaller institutions including free- standing children's hospitals. In these settings, imaging is generally limited to FDG, which suffices for most applications, with the majority of studies performed for tumor imaging. FDGI is being used for evaluation of many tumors in children, with its use in lymphoma being the most established. In lymphoma, it has proven quite useful in determining whether active tumor is present in residual masses following treatment, which may otherwise contain only residual fibrous tissue. For brain tumors, FDGI has some relation to tumor grade, although its more important role is distinguishing recurrent or residual tumor from the effects of treatment, particularly radiation necrosis. For neurological evaluation, interictal FDGI is helpful in localizing potential seizure foci for subsequent subdural EEG monitoring. Because of the relatively long uptake time of FDG, true ictal studies cannot be performed with FDG, and these remain within the domain of SPECT imaging of tracers such as Tc-99m HMPAO. Examinations utilizing radiopharmaceuticals other than FDG are significantly more limited in their availability and are limited to PET centers with on-site cyclotrons. However, these additional agents open the door to many additional studies, including more specific tumor-imaging agents of certain tumors such as neuroblastoma. Another neurotransmitter, F-18-fluoro-L-dopa, is of benefit outside of the central nervous system for evaluating infantile hyperinsulism. The use of PET/CT in children is increasing quickly, particularly FDGI imaging of tumors. It is expected that over the next few years, its role will

Multiple primary malignant tumors of upper gastrointestinal tract:A novel role of ~(18)F-FDG PET/CT

Institute of Scientific and Technical Information of China (English)

无

2010-01-01

AIM: To evaluate the capacity of 18F-fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG PET/CT) for detecting multiple primary cancer of upper gastrointestinal (UGI) tract. METHODS: Fifteen patients (12 without cancer histories and 3 with histories of upper GI tract cancer) were investigated due to the suspicion of primary cancer of UGI tract on X-ray barium meal and CT scan. Subsequent whole body 18F-FDG PET/CT scan was carried out for initial staging or restaging. All the patient...

Radiotherapy may induce enhanced uptake on F-18-fluoroestradiol PET scans

NARCIS (Netherlands)

Venema, C. M.; Veen, van der S. J.; Glaudemans, A. W. J. M.; Schroder, C. P.; de Vries, E. F. J.; Hospers, G. A. P.

2016-01-01

Introduction: Whole body imaging of 18F-fluoroestradiol (FES) uptake combined with positron emission tomography (PET) has been applied for diagnosis and prediction of therapy response in estrogen receptor (ER) positive breast cancer patients. A maximal standardized uptake value (SUVmax) of 1.5 has

Geneva University - The AX-PET experiment : A demonstrator for an axial Positron Emission Tomography

CERN Multimedia

Université de Genève

2012-01-01

Geneva University École de physique Département de physique nucléaire et corspusculaire 24, quai Ernest-Ansermet 1211 Genève 4 Tél.: (022) 379 62 73 Fax: (022) 379 69 92   Wednesday 14 March 2012 SEMINAIRE DE PHYSIQUE CORPUSCULAIRE 11.15 a.m. - Science II, Auditoire 1S081, 30, quai Ernest-Ansermet, 1211 Genève 4 The AX-PET experiment : A demonstrator for an axial Positron Emission Tomography Dr Chiara CASELLA   ETH Zurich   PET (Positron Emission Tomography) is a tool for in-vivo functional imaging, successfully used since the earliest days of nuclear medicine. It is based on the detection of the two coincident 511 keV photons from the annihilation of a positron, emitted from a radiotracer injected into the body. Tomographic analysis of the coincidence data allows for a 3D reconstructed image of the source distribution. The AX-PET experiment proposes a novel geometrical approach for a PET scanner, in which l...

Initial staging of Hodgkin's disease: role of contrast-enhanced 18F FDG PET/CT.

Science.gov (United States)

Chiaravalloti, Agostino; Danieli, Roberta; Caracciolo, Cristiana Ragano; Travascio, Laura; Cantonetti, Maria; Gallamini, Andrea; Guazzaroni, Manlio; Orlacchio, Antonio; Simonetti, Giovanni; Schillaci, Orazio

2014-08-01

The objective of this study was to compare the diagnostic accuracy of positron emission tomography/low-dose computed tomography (PET/ldCT) versus the same technique implemented by contrast-enhanced computed tomography (ceCT) in staging Hodgkin's disease (HD).Forty patients (18 men and 22 women, mean age 30 ± 9.6) with biopsy-proven HD underwent a PET/ldCT study for initial staging including an unenhanced low-dose computed tomography for attenuation correction with positron emission tomography acquisition and a ceCT, performed at the end of the PET/ldCT scan, in the same exam session. A detailed datasheet was generated for illness locations for separate imaging modality comparison and then merged in order to compare the separate imaging method results (PET/ldCT and ceCT) versus merged results positron emission tomography/contrast-enhanced computed tomography (PET/ceCT). The nodal and extranodal lesions detected by each technique were then compared with follow-up data that served as the reference standard.No significant differences were found at staging between PET/ldCT and PET/ceCT in our series. One hundred and eighty four stations of nodal involvement have been found with no differences in both modalities. Extranodal involvement was identified in 26 sites by PET/ldCT and in 28 by PET/ceCT. We did not find significant differences concerning the stage (Ann Arbor).Our study shows a good concordance and conjunction between PET/ldCT and ceCT in both nodal and extranodal sites in the initial staging of HD, suggesting that PET/ldCT could suffice in most of these patients.

Automatic extraction of forward stroke volume using dynamic PET/CT

DEFF Research Database (Denmark)

Harms, Hans; Tolbod, Lars Poulsen; Hansson, Nils Henrik Stubkjær

2015-01-01

Background The aim of this study was to develop and validate an automated method for extracting forward stroke volume (FSV) using indicator dilution theory directly from dynamic positron emission tomography (PET) studies for two different tracers and scanners. Methods 35 subjects underwent...... a dynamic 11 C-acetate PET scan on a Siemens Biograph TruePoint-64 PET/CT (scanner I). In addition, 10 subjects underwent both dynamic 15 O-water PET and 11 C-acetate PET scans on a GE Discovery-ST PET/CT (scanner II). The left ventricular (LV)-aortic time-activity curve (TAC) was extracted automatically...... from PET data using cluster analysis. The first-pass peak was isolated by automatic extrapolation of the downslope of the TAC. FSV was calculated as the injected dose divided by the product of heart rate and the area under the curve of the first-pass peak. Gold standard FSV was measured using phase...

Value of FDG-PET scans of non-demented patients in predicting rates of future cognitive and functional decline

International Nuclear Information System (INIS)

Torosyan, Nare; Mason, Kelsey; Dahlbom, Magnus; Silverman, Daniel H.S.

2017-01-01

The aim of this study was to examine the value of fluorodeoxyglucose (FDG) positron emission tomography (PET) in predicting subsequent rates of functional and cognitive decline among subjects considered cognitively normal (CN) or clinically diagnosed with mild cognitive impairment (MCI). Analyses of 276 subjects, 92 CN subjects and 184 with MCI, who were enrolled in the Alzheimer's Disease Neuroimaging Initiative, were conducted. Functional decline was assessed using scores on the Functional Activities Questionnaire (FAQ) obtained over a period of 36 months, while cognitive decline was determined using the Alzheimer's disease Assessment Scale-Cognitive subscale (ADAS-Cog) and Mini-Mental State Examination (MMSE) scores. PET images were analyzed using clinically routine brain quantification software. A dementia prognosis index (DPI), derived from a ratio of uptake values in regions of interest known to be hypometabolic in Alzheimer's disease to regions known to be stable, was generated for each baseline FDG-PET scan. The DPI was correlated with change in scores on the neuropsychological examinations to examine the predictive value of baseline FDG-PET. DPI powerfully predicted rate of functional decline among MCI patients (t = 5.75, p < 1.0E-8) and pooled N + MCI patient groups (t = 7.02, p < 1.0E-11). Rate of cognitive decline on MMSE was also predicted by the DPI among MCI (t = 6.96, p < 1.0E-10) and pooled N + MCI (t = 8.78, p < 5.0E-16). Rate of cognitive decline on ADAS-cog was powerfully predicted by the DPI alone among N (p < 0.001), MCI (t = 6.46, p < 1.0E-9) and for pooled N + MCI (t = 8.85, p = 1.1E-16). These findings suggest that an index, derivable from automated regional analysis of brain PET scans, can be used to help predict rates of functional and cognitive deterioration in the years following baseline PET. (orig.)

Value of FDG-PET scans of non-demented patients in predicting rates of future cognitive and functional decline

Energy Technology Data Exchange (ETDEWEB)

Torosyan, Nare; Mason, Kelsey; Dahlbom, Magnus; Silverman, Daniel H.S. [David Geffen School of Medicine at the University of California Los Angeles, Ahmanson Translational Imaging Division, Department of Molecular and Medical Pharmacology, Los Angeles, CA (United States); Collaboration: the Alzheimer' sDisease Neuroimaging Initiative

2017-08-15

The aim of this study was to examine the value of fluorodeoxyglucose (FDG) positron emission tomography (PET) in predicting subsequent rates of functional and cognitive decline among subjects considered cognitively normal (CN) or clinically diagnosed with mild cognitive impairment (MCI). Analyses of 276 subjects, 92 CN subjects and 184 with MCI, who were enrolled in the Alzheimer's Disease Neuroimaging Initiative, were conducted. Functional decline was assessed using scores on the Functional Activities Questionnaire (FAQ) obtained over a period of 36 months, while cognitive decline was determined using the Alzheimer's disease Assessment Scale-Cognitive subscale (ADAS-Cog) and Mini-Mental State Examination (MMSE) scores. PET images were analyzed using clinically routine brain quantification software. A dementia prognosis index (DPI), derived from a ratio of uptake values in regions of interest known to be hypometabolic in Alzheimer's disease to regions known to be stable, was generated for each baseline FDG-PET scan. The DPI was correlated with change in scores on the neuropsychological examinations to examine the predictive value of baseline FDG-PET. DPI powerfully predicted rate of functional decline among MCI patients (t = 5.75, p < 1.0E-8) and pooled N + MCI patient groups (t = 7.02, p < 1.0E-11). Rate of cognitive decline on MMSE was also predicted by the DPI among MCI (t = 6.96, p < 1.0E-10) and pooled N + MCI (t = 8.78, p < 5.0E-16). Rate of cognitive decline on ADAS-cog was powerfully predicted by the DPI alone among N (p < 0.001), MCI (t = 6.46, p < 1.0E-9) and for pooled N + MCI (t = 8.85, p = 1.1E-16). These findings suggest that an index, derivable from automated regional analysis of brain PET scans, can be used to help predict rates of functional and cognitive deterioration in the years following baseline PET. (orig.)

Target Volume Delineation in Oropharyngeal Cancer: Impact of PET, MRI, and Physical Examination

International Nuclear Information System (INIS)

Thiagarajan, Anuradha; Caria, Nicola; Schöder, Heiko; Iyer, N. Gopalakrishna; Wolden, Suzanne; Wong, Richard J.; Sherman, Eric; Fury, Matthew G.; Lee, Nancy

2012-01-01

Introduction: Sole utilization of computed tomography (CT) scans in gross tumor volume (GTV) delineation for head-and-neck cancers is subject to inaccuracies. This study aims to evaluate contributions of magnetic resonance imaging (MRI), positron emission tomography (PET), and physical examination (PE) to GTV delineation in oropharyngeal cancer (OPC). Methods: Forty-one patients with OPC were studied. All underwent contrast-enhanced CT simulation scans (CECTs) that were registered with pretreatment PETs and MRIs. For each patient, three sets of primary and nodal GTV were contoured. First, reference GTVs (GTVref) were contoured by the treating radiation oncologist (RO) using CT, MRI, PET, and PE findings. Additional GTVs were created using fused CT/PET scans (GTVctpet) and CT/MRI scans (GTVctmr) by two other ROs blinded to GTVref. To compare GTVs, concordance indices (CI) were calculated by dividing the respective overlap volumes by overall volumes. To evaluate the contribution of PE, composite GTVs derived from CT, MRI, and PET (GTVctpetmr) were compared with GTVref. Results: For primary tumors, GTVref was significantly larger than GTVctpet and GTVctmr (p 0.75), indicating that although the modalities were complementary, the added benefit was small in the context of CECTs. In addition, PE did not aid greatly in nodal GTV delineation. Conclusion: PET and MRI are complementary and combined use is ideal. However, the low CI (ctpetmr vs. ref) particularly for primary tumors underscores the limitations of defining GTVs using imaging alone. PE is invaluable and must be incorporated.

Accuracy of 18F-FDG PET/CT for lymph node staging in non-small-cell lung cancers

Institute of Scientific and Technical Information of China (English)

LIU Bao-jun; DONG Jing-cheng; XU Chang-qing; ZUO Chuan-tao; LE Jing-jing; GUAN Yi-hui; ZHAO Jun; WU Jin-feng; DUAN Xiao-hong; CAO Yu-xue

2009-01-01

Background This retrospective study evaluated the diagnostic accuracy of 2-(F18)-fluoro-2-deoxy-D-glucose-positron emission tomography(18F-FDG-PET)/COmputed tomography(PET/CT)in the preoperative diagnosis of metastatic mediastinal and hilar lymph node in patients with non-small-cell lung cancer(NSCLC).Methods A total of 39 patients received preoperative 18F-FDG PET/CT and the postoperative biopsy.We compared preoperative PET/CT scan results with corresponding intraoperative histopathalogic findings in 39 NSCLC patients.The sensitivity,specificity,accuracy,positive and negative predictive value of 18F-FDG PET/CT were assessed.Results Histopathologic examination confirmed metastasis in 57 out of the 208 excised lymph nodes;23 of the 57 nodes were mediastinal and hilar lymph nodes.The sensitivity,specificity,accuracy,positive predictive value and negative predictive value of PET/CT in the preoperative diagnosis of mediastinal lymph node metastasis in NSCLC patients were 65%,96.8%,92%,78.5%and 90%,respectively.Conclusions PET/CT scan showed good accuracy in the preoperative diagnosis of mediastinal and hilar lymph node metastasis in the patients with NSCLC.We recommend that PET/CT scanning be used as a first-line evaluation tool for tumor diagnosis,therapy evaluation and follow-up.

Feasibility of Computed Tomography-Guided Methods for Spatial Normalization of Dopamine Transporter Positron Emission Tomography Image.

Science.gov (United States)

Kim, Jin Su; Cho, Hanna; Choi, Jae Yong; Lee, Seung Ha; Ryu, Young Hoon; Lyoo, Chul Hyoung; Lee, Myung Sik

2015-01-01

Spatial normalization is a prerequisite step for analyzing positron emission tomography (PET) images both by using volume-of-interest (VOI) template and voxel-based analysis. Magnetic resonance (MR) or ligand-specific PET templates are currently used for spatial normalization of PET images. We used computed tomography (CT) images acquired with PET/CT scanner for the spatial normalization for [18F]-N-3-fluoropropyl-2-betacarboxymethoxy-3-beta-(4-iodophenyl) nortropane (FP-CIT) PET images and compared target-to-cerebellar standardized uptake value ratio (SUVR) values with those obtained from MR- or PET-guided spatial normalization method in healthy controls and patients with Parkinson's disease (PD). We included 71 healthy controls and 56 patients with PD who underwent [18F]-FP-CIT PET scans with a PET/CT scanner and T1-weighted MR scans. Spatial normalization of MR images was done with a conventional spatial normalization tool (cvMR) and with DARTEL toolbox (dtMR) in statistical parametric mapping software. The CT images were modified in two ways, skull-stripping (ssCT) and intensity transformation (itCT). We normalized PET images with cvMR-, dtMR-, ssCT-, itCT-, and PET-guided methods by using specific templates for each modality and measured striatal SUVR with a VOI template. The SUVR values measured with FreeSurfer-generated VOIs (FSVOI) overlaid on original PET images were also used as a gold standard for comparison. The SUVR values derived from all four structure-guided spatial normalization methods were highly correlated with those measured with FSVOI (P normalization methods provided reliable striatal SUVR values comparable to those obtained with MR-guided methods. CT-guided methods can be useful for analyzing dopamine transporter PET images when MR images are unavailable.

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

International Nuclear Information System (INIS)

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

2008-01-01

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

Dynamic PET scanning and compartmental model analysis to determine cellular level radiotracer distribution in vivo

International Nuclear Information System (INIS)

Smith, G.T.; Hubner, K.F.; Goodman, M.M.; Stubbs, J.B.

1992-01-01

Positron emission tomography (PET) has been used to measure tissue radiotracer concentration in vivo. Radiochemical distribution can be determined with compartmental model analysis. A two compartment model describes the kinetics of N-13 ammonia ( 13 NH 3 ) in the myocardium. The model consists of a vascular space, Q 1 and a space for 13 NH 3 bound within the tissue, Q 2 . Differential equations for the model can be written: X(t) = AX(t) + BU( t), Y(t)= CX(t)+ DU(t) (1) where X(t) is a column vector [Q 1 (t); Q 2 (t)], U(t) is the arterial input activity measured from the left ventricular blood pool, and Y(t) is the measured tissue activity using PET. Matrices A, B, C, and D are dependent on physiological parameters describing the kinetics of 13 NH 3 in the myocardium. Estimated parameter matrices in Equation 1 have been validated in dog experiments by measuring myocardial perfusion with dynamic PET scanning and intravenous injection of 13 NH 3 . Tracer concentrations for each compartment can be calculated by direct integration of Equation 1. If the cellular level distribution of each compartment is known, the concentration of tracer within the intracellular and extracellular space can be determined. Applications of this type of modeling include parameter estimation for measurement of physiological processes, organ level dosimetry, and determination of cellular radiotracer distribution

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

Novel targets for positron emission tomography (PET) radiopharmaceutical tracers for visualization of neuroinflammation

Science.gov (United States)

Shchepetkin, I.; Shvedova, M.; Anfinogenova, Y.; Litvak, M.; Atochin, D.

2017-08-01

Non-invasive molecular imaging techniques can enhance diagnosis of neurological diseases to achieve their successful treatment. Positron emission tomography (PET) imaging can identify activated microglia and provide detailed functional information based on molecular biology. This imaging modality is based on detection of isotope labeled tracers, which emit positrons. The review summarizes the developments of various radiolabeled ligands for PET imaging of neuroinflammation.

Image registration/fusion software for PET and CT/MRI by using simultaneous emission and transmission scans

International Nuclear Information System (INIS)

Kitamura, Keishi; Amano, Masaharu; Sato, Tomohiko; Okumura, Takeshi; Konishi, Norihiro; Komatsu, Masahiko

2003-01-01

When PET (positron emission tomography) is used for oncology studies, it is important to register and over-lay PET images with the images of other anatomical modalities, such as those obtained by CT (computed tomography) or MRI (magnetic resonance imaging), in order for the lesions to be anatomically located with high accuracy. The Shimadzu SET-2000W Series PET scanners provide simultaneous acquisition of emission and transmission data, which is capable of complete spatial alignment of both functional and attenuation images. This report describes our newly developed image registration/fusion software, which reformats PET emission images to the CT/MRI grid by using the transform matrix obtained by matching PET transmission images with CT/MRI images. Transmission images are registered and fused either automatically or manually, through 3-dimensional rotation and translation, with the transaxial, sagittal, and coronal fused images being monitored on the screen. This new method permits sufficiently accurate registration and efficient data processing with promoting effective use of CT/MRI images of the DICOM format, without using markers in data acquisition or any special equipment, such as a combined PET/CT scanner. (author)

A scanning point source for quality control of FOV uniformity in GC-PET imaging

International Nuclear Information System (INIS)

Bergmann, H.; Minear, G.; Dobrozemsky, G.; Nowotny, R.; Koenig, B.

2002-01-01

Aim: PET imaging with coincidence cameras (GC-PET) requires additional quality control procedures to check the function of coincidence circuitry and detector zoning. In particular, the uniformity response over the field of view needs special attention since it is known that coincidence counting mode may suffer from non-uniformity effects not present in single photon mode. Materials and methods: An inexpensive linear scanner with a stepper motor and a digital interface to a PC with software allowing versatile scanning modes was developed. The scanner is used with a source holder containing a Sodium-22 point source. While moving the source along the axis of rotation of the GC-PET system, a tomographic acquisition takes place. The scan covers the full axial field of view of the 2-D or 3-D scatter frame. Depending on the acquisition software, point source scanning takes place continuously while only one projection is acquired or is done in step-and-shoot mode with the number of positions equal to the number of gantry steps. Special software was developed to analyse the resulting list mode acquisition files and to produce an image of the recorded coincidence events of each head. Results: Uniformity images of coincidence events were obtained after further correction for systematic sensitivity variations caused by acquisition geometry. The resulting images are analysed visually and by calculating NEMA uniformity indices as for a planar flood field. The method has been applied successfully to two different brands of GC-PET capable gamma cameras. Conclusion: Uniformity of GC-PET can be tested quickly and accurately with a routine QC procedure, using a Sodium-22 scanning point source and an inexpensive mechanical scanning device. The method can be used for both 2-D and 3-D acquisition modes and fills an important gap in the quality control system for GC-PET

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

Directory of Open Access Journals (Sweden)

Erdem Sürücü

2016-10-01

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

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

Science.gov (United States)

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

2016-01-01

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

External radioactive markers for PET data-driven respiratory gating in positron emission tomography.

Science.gov (United States)

Büther, Florian; Ernst, Iris; Hamill, James; Eich, Hans T; Schober, Otmar; Schäfers, Michael; Schäfers, Klaus P

2013-04-01

Respiratory gating is an established approach to overcoming respiration-induced image artefacts in PET. Of special interest in this respect are raw PET data-driven gating methods which do not require additional hardware to acquire respiratory signals during the scan. However, these methods rely heavily on the quality of the acquired PET data (statistical properties, data contrast, etc.). We therefore combined external radioactive markers with data-driven respiratory gating in PET/CT. The feasibility and accuracy of this approach was studied for [(18)F]FDG PET/CT imaging in patients with malignant liver and lung lesions. PET data from 30 patients with abdominal or thoracic [(18)F]FDG-positive lesions (primary tumours or metastases) were included in this prospective study. The patients underwent a 10-min list-mode PET scan with a single bed position following a standard clinical whole-body [(18)F]FDG PET/CT scan. During this scan, one to three radioactive point sources (either (22)Na or (18)F, 50-100 kBq) in a dedicated holder were attached the patient's abdomen. The list mode data acquired were retrospectively analysed for respiratory signals using established data-driven gating approaches and additionally by tracking the motion of the point sources in sinogram space. Gated reconstructions were examined qualitatively, in terms of the amount of respiratory displacement and in respect of changes in local image intensity in the gated images. The presence of the external markers did not affect whole-body PET/CT image quality. Tracking of the markers led to characteristic respiratory curves in all patients. Applying these curves for gated reconstructions resulted in images in which motion was well resolved. Quantitatively, the performance of the external marker-based approach was similar to that of the best intrinsic data-driven methods. Overall, the gain in measured tumour uptake from the nongated to the gated images indicating successful removal of respiratory motion

Occipital and Cingulate Hypometabolism are Significantly Under-Reported on 18-Fluorodeoxyglucose Positron Emission Tomography Scans of Patients with Lewy Body Dementia.

Science.gov (United States)

Hamed, Moath; Schraml, Frank; Wilson, Jeffrey; Galvin, James; Sabbagh, Marwan N

2018-01-01

To determine whether occipital and cingulate hypometabolism is being under-reported or missed on 18-fluorodeoxyglucose positron emission tomography (FDG-PET) CT scans in patients with Dementia with Lewy Bodies (DLB). Recent studies have reported higher sensitivity and specificity for occipital and cingulate hypometabolism on FDG-PET of DLB patients. This retrospective chart review looked at regions of interest (ROI's) in FDG-PET CT scan reports in 35 consecutive patients with a clinical diagnosis of probable, possible, or definite DLB as defined by the latest DLB Consortium Report. ROI's consisting of glucose hypometabolism in frontal, parietal, temporal, occipital, and cingulate areas were tabulated and charted separately by the authors from the reports. A blinded Nuclear medicine physician read the images independently and marked ROI's separately. A Cohen's Kappa coefficient statistic was calculated to determine agreement between the reports and the blinded reads. On the radiology reports, 25.71% and 17.14% of patients reported occipital and cingulate hypometabolism respectively. Independent reads demonstrated significant disagreement with the proportion of occipital and cingulate hypometabolism being reported on initial reads: 91.43% and 85.71% respectively. Cohen's Kappa statistic determinations demonstrated significant agreement only with parietal hypometabolism (pOccipital and cingulate hypometabolism is under-reported and missed frequently on clinical interpretations of FDG-PET scans of patients with DLB, but the frequency of hypometabolism is even higher than previously reported. Further studies with more statistical power and receiver operating characteristic analyses are needed to delineate the sensitivity and specificity of these in vivo biomarkers.

Imaging local brain function with emission computed tomography

International Nuclear Information System (INIS)

Kuhl, D.E.

1984-01-01

Positron emission tomography (PET) using 18 F-fluorodeoxyglucose (FDG) was used to map local cerebral glucose utilization in the study of local cerebral function. This information differs fundamentally from structural assessment by means of computed tomography (CT). In normal human volunteers, the FDG scan was used to determine the cerebral metabolic response to conrolled sensory stimulation and the effects of aging. Cerebral metabolic patterns are distinctive among depressed and demented elderly patients. The FDG scan appears normal in the depressed patient, studded with multiple metabolic defects in patients with multiple infarct dementia, and in the patients with Alzheimer disease, metabolism is particularly reduced in the parietal cortex, but only slightly reduced in the caudate and thalamus. The interictal FDG scan effectively detects hypometabolic brain zones that are sites of onset for seizures in patients with partial epilepsy, even though these zones usually appear normal on CT scans. The future prospects of PET are discussed

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

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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.)

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.)

Sources and resources for oncologists to help answer the question: is PET/CT appropriate for my patient?

Science.gov (United States)

Karantanis, Dimitrios; Allen-Auerbach, Martin; Czernin, Johannes

2012-01-01

Positron emission tomography (PET)/computed tomography (CT)-subsequently referred to as PET/CT is emerging as a critically important diagnostic tool in oncology. There has been a substantial increase in the utilization of this modality over the last decade. The optimal imaging protocols are, however, still not established which results in considerable confusion and uncertainty among referring physicians and providers. Oncologists, hematologists and other physicians managing oncologic patients frequently face the dilemma of whether or not to order a PET/CT scan for their patients. The large body of evidence from clinical research often overwhelms the ability of physicians to stay adequately informed on the disease specific performance of PET/CT. Moreover, regulatory agencies have changed their requirements for reimbursement of PET/CT scans in an effort to curtail health care expenditures. In this article we attempt to inform users and providers about the appropriate use of this technology.

Clinical impact of Positron Emission Tomography (PET) on oncological patients and their potentially application context

International Nuclear Information System (INIS)

Alonso, O.

2006-01-01

(PET) Positron Emission Tomography is a technique of nuclear medicine that has ability of detecting cancer through mechanisms based on molecular alterations of neoplastic processes. This review describes the PET Oncology applications and discusses the potential application of this technology in the sanitary and national academic framework . The most widely used in Oncology plotter is an analogue of laglucosa labelled with fluo: 18F-2-fluoro-2-Deoxy-D-glucose (FDG). In this way, the PET detects tumour retention of FDG, due to the highest glycolytic of cancer cells. In addition, the PET allow the study of the entire body at the same exploratory and some teams are coupled to systems of axial tomography (PET-CT). By ET-FDG, it is possible to diagnose, staging and restaged the majority of cancers, with diagnostic accuracy close to 90 per cent higher than the values provided by the conventional imaging techniques such. It is also possible to know early response to cancer treatments and obtain relevant medical prognosis information. (author) [es

Dual-time point scanning of integrated FDG PET/CT for the evaluation of mediastinal and hilar lymph nodes in non-small cell lung cancer diagnosed as operable by contrast-enhanced CT

International Nuclear Information System (INIS)

Kasai, Takami; Motoori, Ken; Horikoshi, Takuro; Uchiyama, Katsuhiro; Yasufuku, Kazuhiro; Takiguchi, Yuichi; Takahashi, Fumiaki; Kuniyasu, Yoshio; Ito, Hisao

2010-01-01

Purpose: To evaluate whether dual-time point scanning with integrated fluorine-18 fluorodeoxyglucose ( 18 F-FDG) positron emission tomography and computed tomography (PET/CT) is useful for evaluation of mediastinal and hilar lymph nodes in non-small cell lung cancer diagnosed as operable by contrast-enhanced CT. Materials and methods: PET/CT data and pathological findings of 560 nodal stations in 129 patients with pathologically proven non-small cell lung cancer diagnosed as operable by contrast-enhanced CT were reviewed retrospectively. Standardized uptake values (SUVs) on early scans (SUVe) 1 h, and on delayed scans (SUVd) 2 h after FDG injection of each nodal station were measured. Retention index (RI) (%) was calculated by subtracting SUVe from SUVd and dividing by SUVe. Logistic regression analysis was performed with seven kinds of models, consisting of (1) SUVe, (2) SUVd, (3) RI, (4) SUVe and SUVd, (5) SUVe and RI, (6) SUVd and RI, and (7) SUVe, SUVd and RI. The seven derived models were compared by receiver-operating characteristic (ROC) analysis. k-Fold cross-validation was performed with k values of 5 and 10. p < 0.05 was considered statistically significant. Results: Model (1) including the term of SUVe showed the largest area under the ROC curve among the seven models. The cut-off probability of metastasis of 3.5% with SUVe of 2.5 revealed a sensitivity of 78% and a specificity of 81% on ROC analysis, and approximately 60% and 80% on k-fold cross-validation. Conclusion: Single scanning of PET/CT is sufficiently useful for evaluating mediastinal and hilar nodes for metastasis.

18F-FET-PET in Primary Hyperparathyroidism

DEFF Research Database (Denmark)

Krakauer, Martin; Kjær, Andreas; Bennedbæk, Finn Noe

2016-01-01

-isotope parathyroid subtraction single photon emission computed tomography had determined the exact location of the parathyroid adenoma. A dynamic FET PET/CT scan was performed with subsequent visual evaluation and calculation of target-to-background (TBR; parathyroid vs. thyroid). The maximum TBR in the two patients......Preoperative localisation of the diseased parathyroid gland(s) in primary hyperparathyroidism (PHP) is a prerequisite for subsequent minimally invasive surgery. Recently, as alternatives to conventional sestamibi parathyroid scintigraphy, the (11)C-based positron emission tomography (PET) tracers...... methionine and choline have shown promise for this purpose. We evaluated the feasibility of using the (18)F-based PET tracer fluoroethyl-l-tyrosine (FET), as the longer half-life of (18)F makes it logistically more favourable. As a proof-of-concept study, we included two patients with PHP in which dual...

Site specific measurements of bone formation using [18F] sodium fluoride PET/CT.

Science.gov (United States)

Blake, Glen M; Puri, Tanuj; Siddique, Musib; Frost, Michelle L; Moore, Amelia E B; Fogelman, Ignac

2018-02-01

Dynamic positron emission tomography (PET) imaging with fluorine-18 labelled sodium fluoride ([ 18 F]NaF) allows the quantitative assessment of regional bone formation by measuring the plasma clearance of fluoride to bone at any site in the skeleton. Today, hybrid PET and computed tomography (CT) dual-modality systems (PET/CT) are widely available, and [ 18 F]NaF PET/CT offers a convenient non-invasive method of studying bone formation at the important osteoporotic fracture sites at the hip and spine, as well as sites of pure cortical or trabecular bone. The technique complements conventional measurements of bone turnover using biochemical markers or bone biopsy as a tool to investigate new therapies for osteoporosis, and has a potential role as an early biomarker of treatment efficacy in clinical trials. This article reviews methods of acquiring and analyzing dynamic [ 18 F]NaF PET/CT scan data, and outlines a simplified approach combining venous blood sampling with a series of short (3- to 5-minute) static PET/CT scans acquired at different bed positions to estimate [ 18 F]NaF plasma clearance at multiple sites in the skeleton with just a single injection of tracer.

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

DEFF Research Database (Denmark)

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

2017-01-01

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

Histopathological correlation of 11C-choline PET scans for target volume definition in radical prostate radiotherapy

International Nuclear Information System (INIS)

Chang, Joe H.; Joon, Daryl Lim; Lee, Sze Ting; Gong, Sylvia J.; Scott, Andrew M.; Davis, Ian D.; Clouston, David; Bolton, Damien; Hamilton, Christopher S.; Khoo, Vincent

2011-01-01

Background and purpose: To evaluate the accuracy of 11 C-choline PET scans in defining dominant intraprostatic lesions (DILs) for radiotherapy target volume definition. Material and methods: Eight men with prostate cancer who had 11 C-choline PET scans prior to radical prostatectomy were studied. Several methods were used to contour the DIL on the PET scans: visual, PET Edge, Region Grow, absolute standardised uptake value (SUV) thresholds and percentage of maximum SUV thresholds. Prostatectomy specimens were sliced in the transverse plane and DILs were delineated on these by a pathologist. These were then compared with the PET scans. The accuracy of correlation was assessed by the Dice similarity coefficient (DSC) and the Youden index. Results: The contouring method resulting in both the highest DSC and the highest Youden index was 60% of the maximum SUV (SUV 60% ), with values of 0.64 and 0.51, respectively. However SUV 60% was not statistically significantly better than all of the other methods by either measure. Conclusions: Although not statistically significant, SUV 60% resulted in the best correlation between 11 C-choline PET and pathology amongst all the methods studied. The degree of correlation shown here is consistent with previous studies that have justified using imaging for DIL radiotherapy target volume definition.

Fluorine-18-fluorodeoxyglucose Positron Emission Tomography in Diffuse Large B-cell Lymphoma

DEFF Research Database (Denmark)

Mylam, Karen Juul; Nielsen, Anne Lerberg; Pedersen, Lars Møller

2014-01-01

Diffuse large B-cell lymphoma (DLBCL) is an aggressive and potentially curable type of lymphoma. Fluorine-18-fluorodeoxyglucose positron emission tomography (FDG-PET) is part of clinical routine for DLBCL in most hospitals and also recommended for staging and end-of-therapy evaluation. FDG......-PET/computed tomography (CT) is able to identify nodal and extranodal sites with greater accuracy than CT alone. Little evidence supports the use of surveillance FDG-PET imaging in the follow-up setting because of high rates of false-positive scans and because most studies are retrospective. This article discusses FDG...

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

Energy Technology Data Exchange (ETDEWEB)

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

2015-08-15

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

Computed tomography and three-dimensional imaging

International Nuclear Information System (INIS)

Harris, L.D.; Ritman, E.L.; Robb, R.A.

1987-01-01

Presented here is a brief introduction to two-, three-, and four-dimensional computed tomography. More detailed descriptions of the mathematics of reconstruction and of CT scanner operation are presented elsewhere. The complementary tomographic imaging methods of single-photon-emission tomography (SPECT) positron-emission tomography (PET), nuclear magnetic resonance (NMR) imaging, ulltrasound sector scanning, and ulltrasound computer-assisted tomography [UCAT] are only named here. Each imaging modality ''probes'' the body with a different energy form, yielding unique and useful information about tomographic sections through the body

Detectability of colorectal neoplasia with fluorine-18-2-fluoro-2-deoxy-D-glucose positron emission tomography and computed tomography (FDG-PET/CT)

International Nuclear Information System (INIS)

Hirakawa, Tomoko; Okumura, Yoshihiro; Kato, Jun

2012-01-01

The purpose of this study was to analyze the detectability of colorectal neoplasia with fluorine-18-2-fluoro-2-deoxy-D-glucose positron emission tomography/computed tomography (FDG-PET/CT). Data for a total of 492 patients who had undergone both PET/CT and colonoscopy were analyzed. After the findings of PET/CT and colonoscopy were determined independently, the results were compared in each of the six colonic sites examined in all patients. The efficacy of PET/CT was determined using colonoscopic examination as the gold standard. In all, 270 colorectal lesions 5 mm or more in size, including 70 pathologically confirmed malignant lesions, were found in 172 patients by colonoscopy. The sensitivity and specificity of PET/CT for detecting any of the colorectal lesions were 36 and 98%, respectively. For detecting lesions 11 mm or larger, the sensitivity was increased to 85%, with the specificity remaining consistent (97%). Moreover, the sensitivity for tumors 21 mm or larger was 96% (48/50). Tumors with malignant or high-grade pathology were likely to be positive with PET/CT. A size of 10 mm or smaller [odds ratio (OR) 44.14, 95% confidence interval (95% CI) 11.44-221.67] and flat morphology (OR 7.78, 95% CI 1.79-36.25) were significant factors that were associated with false-negative cases on PET/CT. The sensitivity of PET/CT for detecting colorectal lesions is acceptable, showing size- and pathology-dependence, suggesting, for the most part, that clinically relevant lesions are detectable with PET/CT. However, when considering PET/CT for screening purposes caution must be exercised because there are cases of false-negative results. (author)

X-ray Compton line scan tomography

Energy Technology Data Exchange (ETDEWEB)

Kupsch, Andreas; Lange, Axel; Jaenisch, Gerd-Ruediger [Bundesanstalt fuer Materialforschung und -pruefung (BAM), Berlin (Germany). Fachgruppe 8.5 - Mikro-ZfP; Hentschel, Manfred P. [Technische Univ. Berlin (Germany); Kardjilov, Nikolay; Markoetter, Henning; Hilger, Andre; Manke, Ingo [Helmholtz-Zentrum Berlin (HZB) (Germany); Toetzke, Christian [Potsdam Univ. (Germany)

2015-07-01

The potentials of incoherent X-ray scattering (Compton) computed tomography (CT) are investigated. The imaging of materials of very different atomic number or density at once is generally a perpetual challenge for X-ray tomography or radiography. In a basic laboratory set-up for simultaneous perpendicular Compton scattering and direct beam attenuation tomography are conducted by single channel photon counting line scans. This results in asymmetric distortions of the projection profiles of the scattering CT data set. In a first approach, corrections of Compton scattering data by taking advantage of rotational symmetry yield tomograms without major geometric artefacts. A cylindrical sample composed of PE, PA, PVC, glass and wood demonstrates similar Compton contrast for all the substances, while the conventional absorption tomogram only reveals the two high order materials. Comparison to neutron tomography reveals astonishing similarities except for the glass component (without hydrogen). Therefore, Compton CT offers the potential to replace neutron tomography, which requires much more efforts.

Role of whole body positron emission tomography/computed tomography scan with 18F-fluorodeoxyglucose in patients with biopsy proven tumor metastases from unknown primary site

International Nuclear Information System (INIS)

Pelosi, E.; Pennone, M.; Deandreis, D.; Bisi, G.

2006-01-01

Aim: The aim of this study was to evaluate the role of whole body PET/CT scan with 1 8F -fluorodeoxyglucose (FDG) in the detection of the primary tumor in patients with metastatic cancer from unknown primary origin (CUP syndrome). Methods: Sixty-eight consecutive patients, with CUP syndrome (39 lymph nodes, 29 visceral biopsy proven tumor metastases), underwent a whole-body FDG-PET/CT study. All enrolled patients were unsuccessfully studied, within the previous month, with physical examination, laboratory tests and conventional diagnostic procedures. All the pathological findings identified at PET/CT scan and suspected for primaries, were further investigated. After PET study, the minimum follow-up period for the inclusion in the studied population was 3 months. Results: The primary tumor site was correctly identified by FDG-PET/CT in 24 patients (24/68, 35.3%): long (0-9). rino/oro-pharynx (n=6), pancreas (n=5), colon (n=2). uterus (n=2). In 5 cases, FDG-PET scan did not identify a primary pathological focus, which was subsequently detected by other diagnostic methods within 3 months. In 39 patients (39168, 57.4%), the primary tumor site was not localized. However, in 9 of them, FDG-PET/CT scan identified further unexpected metastases, modifying the stage of disease. Overall, the following oncological treatment was influenced by the PET scan, in a total of 33 patients (33/68, 48.5%). Conclusion: Our data strongly support the diagnostic contribution of whole body FDG-PET/CT scan in the evaluation of patients with CUP syndrome and suggest its use in an early phase of the diagnostic iter to optimize patient management

Ultralow dose computed tomography attenuation correction for pediatric PET CT using adaptive statistical iterative reconstruction

International Nuclear Information System (INIS)

Brady, Samuel L.; Shulkin, Barry L.

2015-01-01

Purpose: To develop ultralow dose computed tomography (CT) attenuation correction (CTAC) acquisition protocols for pediatric positron emission tomography CT (PET CT). Methods: A GE Discovery 690 PET CT hybrid scanner was used to investigate the change to quantitative PET and CT measurements when operated at ultralow doses (10–35 mA s). CT quantitation: noise, low-contrast resolution, and CT numbers for 11 tissue substitutes were analyzed in-phantom. CT quantitation was analyzed to a reduction of 90% volume computed tomography dose index (0.39/3.64; mGy) from baseline. To minimize noise infiltration, 100% adaptive statistical iterative reconstruction (ASiR) was used for CT reconstruction. PET images were reconstructed with the lower-dose CTAC iterations and analyzed for: maximum body weight standardized uptake value (SUV bw ) of various diameter targets (range 8–37 mm), background uniformity, and spatial resolution. Radiation dose and CTAC noise magnitude were compared for 140 patient examinations (76 post-ASiR implementation) to determine relative dose reduction and noise control. Results: CT numbers were constant to within 10% from the nondose reduced CTAC image for 90% dose reduction. No change in SUV bw , background percent uniformity, or spatial resolution for PET images reconstructed with CTAC protocols was found down to 90% dose reduction. Patient population effective dose analysis demonstrated relative CTAC dose reductions between 62% and 86% (3.2/8.3–0.9/6.2). Noise magnitude in dose-reduced patient images increased but was not statistically different from predose-reduced patient images. Conclusions: Using ASiR allowed for aggressive reduction in CT dose with no change in PET reconstructed images while maintaining sufficient image quality for colocalization of hybrid CT anatomy and PET radioisotope uptake

Ultralow dose computed tomography attenuation correction for pediatric PET CT using adaptive statistical iterative reconstruction

Energy Technology Data Exchange (ETDEWEB)

Brady, Samuel L., E-mail: samuel.brady@stjude.org [Division of Diagnostic Imaging, St. Jude Children’s Research Hospital, Memphis, Tennessee 38105 (United States); Shulkin, Barry L. [Nuclear Medicine and Department of Radiological Sciences, St. Jude Children’s Research Hospital, Memphis, Tennessee 38105 (United States)

2015-02-15

Purpose: To develop ultralow dose computed tomography (CT) attenuation correction (CTAC) acquisition protocols for pediatric positron emission tomography CT (PET CT). Methods: A GE Discovery 690 PET CT hybrid scanner was used to investigate the change to quantitative PET and CT measurements when operated at ultralow doses (10–35 mA s). CT quantitation: noise, low-contrast resolution, and CT numbers for 11 tissue substitutes were analyzed in-phantom. CT quantitation was analyzed to a reduction of 90% volume computed tomography dose index (0.39/3.64; mGy) from baseline. To minimize noise infiltration, 100% adaptive statistical iterative reconstruction (ASiR) was used for CT reconstruction. PET images were reconstructed with the lower-dose CTAC iterations and analyzed for: maximum body weight standardized uptake value (SUV{sub bw}) of various diameter targets (range 8–37 mm), background uniformity, and spatial resolution. Radiation dose and CTAC noise magnitude were compared for 140 patient examinations (76 post-ASiR implementation) to determine relative dose reduction and noise control. Results: CT numbers were constant to within 10% from the nondose reduced CTAC image for 90% dose reduction. No change in SUV{sub bw}, background percent uniformity, or spatial resolution for PET images reconstructed with CTAC protocols was found down to 90% dose reduction. Patient population effective dose analysis demonstrated relative CTAC dose reductions between 62% and 86% (3.2/8.3–0.9/6.2). Noise magnitude in dose-reduced patient images increased but was not statistically different from predose-reduced patient images. Conclusions: Using ASiR allowed for aggressive reduction in CT dose with no change in PET reconstructed images while maintaining sufficient image quality for colocalization of hybrid CT anatomy and PET radioisotope uptake.

Intrasubject correlation between static scan and distribution volume images for [11C]flumazenil PET

International Nuclear Information System (INIS)

Mishina, Masahiro; Senda, Michio; Kimura, Yuichi

2000-01-01

Accumulation of [ 11 C]flumazenil (FMZ) reflects central nervous system benzodiazepine receptor (BZR). We searched for the optimal time for a static PET scan with FMZ as semi-quantitative imaging of BZR distribution. In 10 normal subjects, a dynamic series of decay-corrected PET scans was performed for 60 minutes, and the arterial blood was sampled during the scan to measure radioactivity and labeled metabolites. We generated 13 kinds of ''static scan'' images from the dynamic scan in each subject, and analyzed the pixel correlation for these images versus distribution volume (DV) images. We also analyzed the time for the [ 11 C]FMZ in plasma and tissue to reach the equilibrium. The intra-subject pixel correlation demonstrated that the static scan'' images for the period centering around 30 minutes post-injection had the strongest linear correlation with the DV image. The ratio of radioactivity in the cortex to that in the plasma reached a peak at 40 minutes after injection. Considering the physical decay and patient burden, we conclude that the decay corrected static scan for [ 11 C]FMZ PET as semi-quantitative imaging of BZR distribution is to be optimally acquired from 20 to 40 minutes after injection. (author)

INTEGRATED PET-CT SCAN IN THE STAGING OF NON SMALL CELL LUNG CANCER

Directory of Open Access Journals (Sweden)

I Made Ngurah Agus Surya Negara S

2013-09-01

Full Text Available Normal 0 false false false EN-US X-NONE X-NONE Lung cancer is a common disease and is a leading cause of death in many countries. The most kind of lung cancer was Non Small Cell Lung Cancer. The management of lung cancer is directed by an optimal staging of the tumour. On 1998, integrated positron emission tomography (PET-computed tomography (CT was published. PET-CT is an anatomo-metabolic imaging modality that has recently been introduced to clinical practice and combines two different techniques: CT, which provides very detailed anatomic information; and PET, which provides metabolic information. One of the advantages of PET/CT is the improved image interpretation. There wasbetter results for PET/CT in the staging of non small cell lung cancer in comparison with CT nor PET alone. /* Style Definitions */ table.MsoNormalTable {mso-style-name:"Table Normal"; mso-tstyle-rowband-size:0; mso-tstyle-colband-size:0; mso-style-noshow:yes; mso-style-priority:99; mso-style-qformat:yes; mso-style-parent:""; mso-padding-alt:0in 5.4pt 0in 5.4pt; mso-para-margin-top:0in; mso-para-margin-right:0in; mso-para-margin-bottom:10.0pt; mso-para-margin-left:0in; line-height:115%; mso-pagination:widow-orphan; font-size:11.0pt; font-family:"Calibri","sans-serif"; mso-ascii-font-family:Calibri; mso-ascii-theme-font:minor-latin; mso-fareast-font-family:"Times New Roman"; mso-fareast-theme-font:minor-fareast; mso-hansi-font-family:Calibri; mso-hansi-theme-font:minor-latin; mso-bidi-font-family:"Times New Roman"; mso-bidi-theme-font:minor-bidi;}

A computed tomography-based spatial normalization for the analysis of [18F] fluorodeoxyglucose positron emission tomography of the brain.

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Cho, Hanna; Kim, Jin Su; Choi, Jae Yong; Ryu, Young Hoon; Lyoo, Chul Hyoung

2014-01-01

We developed a new computed tomography (CT)-based spatial normalization method and CT template to demonstrate its usefulness in spatial normalization of positron emission tomography (PET) images with [(18)F] fluorodeoxyglucose (FDG) PET studies in healthy controls. Seventy healthy controls underwent brain CT scan (120 KeV, 180 mAs, and 3 mm of thickness) and [(18)F] FDG PET scans using a PET/CT scanner. T1-weighted magnetic resonance (MR) images were acquired for all subjects. By averaging skull-stripped and spatially-normalized MR and CT images, we created skull-stripped MR and CT templates for spatial normalization. The skull-stripped MR and CT images were spatially normalized to each structural template. PET images were spatially normalized by applying spatial transformation parameters to normalize skull-stripped MR and CT images. A conventional perfusion PET template was used for PET-based spatial normalization. Regional standardized uptake values (SUV) measured by overlaying the template volume of interest (VOI) were compared to those measured with FreeSurfer-generated VOI (FSVOI). All three spatial normalization methods underestimated regional SUV values by 0.3-20% compared to those measured with FSVOI. The CT-based method showed slightly greater underestimation bias. Regional SUV values derived from all three spatial normalization methods were correlated significantly (p normalization may be an alternative method for structure-based spatial normalization of [(18)F] FDG PET when MR imaging is unavailable. Therefore, it is useful for PET/CT studies with various radiotracers whose uptake is expected to be limited to specific brain regions or highly variable within study population.

Modern imaging methods: positron emission tomography (PET) and positron emission tomography/computed tomography (PET/CT) combination

International Nuclear Information System (INIS)

Votrubova, J.; Belohlavek, O.

2004-01-01

An overview of the title topic is presented. Attention is paid to the technical principles of PET and CT, indications for PET and PET/CT examination, and achievements of the PET Centre of the Na Homolce hospital. (P.A.)

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.)

WholeBbody Positron-Emission-Tomography (WB-PET) in oncology

International Nuclear Information System (INIS)

Feine, U.; Lietzenmayer, R.; Mueller-Schauenburg, W.; Geiger, L.; Hanke, J.P.; Weisser, G.; Woehrle, H.

1996-01-01

The new generation of high sensitive PET-Scanners with an FOV of about 15 cm allows to recognize with high sensitivity and good spezificity malign tumors and their metastases with 18F-FDG in a Whole-Body-Scan in 35 to 50 min scan time. 357 FDG-WB-PET-Scans have been performed in Tuebingen during 1 1/2 years since January 1994 in tumor patients and have been compared and evaluated to the results of other imaging methods performed in the same time together with clinics and in follow-up. In 4 groups of tumors - Melanoma - malign Lymphoma -Breast Cancer - Thyroid Cancer - and a fifth group of 24 various types of malign tumors we found a sensitivity of 88%, a specificity of 80% and an accuracy of 90%. Foci smaller than 6-8 mm diametre - mostly lung metastases or lymphomas - and also tumors of low malignancy such as 131l-trapping Tyroid Carcinomas and Ganglioneuroblastomas have been found false negative. Flase positive we found inflammated lymph nodes, abscesses and also benign thyroid adenomas. This high sensitivity makes 18F-FDG-WB-PET an important method for tumor searching and diagnosis of tumor spreading, esp. for primary and secondary staging in the future, but also as the unique imaging method which allows determination of resting tumor vitality after therapy. Further multi-center studies will be necessary before this method can be introduced to routine, that also is limited by the high costs of the procedure. (orig.) [de

Quantitative and Visual Assessments toward Potential Sub-mSv or Ultrafast FDG PET Using High-Sensitivity TOF PET in PET/MRI.

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Behr, Spencer C; Bahroos, Emma; Hawkins, Randall A; Nardo, Lorenzo; Ravanfar, Vahid; Capbarat, Emily V; Seo, Youngho

2018-06-01

Newer high-performance time-of-flight (TOF) positron emission tomography (PET) systems have the capability to preserve diagnostic image quality with low count density, while maintaining a high raw photon detection sensitivity that would allow for a reduction in injected dose or rapid data acquisition. To assess this, we performed quantitative and visual assessments of the PET images acquired using a highly sensitive (23.3 cps/kBq) large field of view (25-cm axial) silicon photomultiplier (SiPM)-based TOF PET (400-ps timing resolution) integrated with 3 T-MRI in comparison to PET images acquired on non-TOF PET/x-ray computed tomography (CT) systems. Whole-body 2-deoxy-2-[ 18 F]fluoro-D-glucose ([ 18 F]FDG) PET/CT was acquired for 15 patients followed by whole body PET/magnetic resonance imaging (MRI) with an average injected dose of 325 ± 84 MBq. The PET list mode data from PET/MRI were reconstructed using full datasets (4 min/bed) and reduced datasets (2, 1, 0.5, and 0.25 min/bed). Qualitative assessment between PET/CT and PET/MR images were made. A Likert-type scale between 1 and 5, 1 for non-diagnostic, 3 equivalent to PET/CT, and 5 superior quality, was used. Maximum and mean standardized uptake values (SUV max and SUV mean ) of normal tissues and lesions detected were measured and compared. Mean visual assessment scores were 3.54 ± 0.32, 3.62 ± 0.38, and 3.69 ± 0.35 for the brain and 3.05 ± 0.49, 3.71 ± 0.45, and 4.14 ± 0.44 for the whole-body maximum intensity projections (MIPs) for 1, 2, and 4 min/bed PET/MR images, respectively. The SUV mean values for normal tissues were lower and statistically significant for images acquired at 4, 2, 1, 0.5, and 0.25 min/bed on the PET/MR, with values of - 18 ± 28 % (p PET/MR datasets. High-sensitivity TOF PET showed comparable but still better visual image quality even at a much reduced activity in comparison to lower-sensitivity non-TOF PET. Our data translates to a seven times

CT vs 68Ge attenuation correction in a combined PET/CT system: evaluation of the effect of lowering the CT tube current

International Nuclear Information System (INIS)

Kamel, Ehab; Hany, Thomas F.; Burger, Cyrill; Treyer, Valerie; Schulthess von, Gustav K.; Buck, Alfred; Lonn, Albert H.R.

2002-01-01

With the introduction of combined positron emission tomography/computed tomography (PET/CT) systems, several questions have to be answered. In this work we addressed two of these questions: (a) to what value can the CT tube current be reduced while still yielding adequate maps for the attenuation correction of PET emission scans and (b) how do quantified uptake values in tumours derived from CT and germanium-68 attenuation correction compare. In 26 tumour patients, multidetector CT scans were acquired with 10, 40, 80 and 120 mA (CT 10 , CT 40 , CT 80 and CT 120 ) and used for the attenuation correction of a single FDG PET emission scan, yielding four PET scans designated PET CT10 -PET CT120 . In 60 tumorous lesions, FDG uptake and lesion size were quantified on PET CT10 -PET CT120 . In another group of 18 patients, one CT scan acquired with 80 mA and a standard transmission scan acquired using 68 Ge sources were employed for the attenuation correction of the FDG emission scan (PET CT80 , PET 68Ge ). Uptake values and lesion size in 26 lesions were compared on PET CT80 and PET 68Ge . In the first group of patients, analysis of variance revealed no significant effect of CT current on tumour FDG uptake or lesion size. In the second group, tumour FDG uptake was slightly higher using CT compared with 68 Ge attenuation correction, especially in lesions with high FDG uptake. Lesion size was similar on PET CT80 and PET 68Ge . In conclusion, low CT currents yield adequate maps for the attenuation correction of PET emission scans. Although the discrepancy between CT- and 68 Ge-derived uptake values is probably not relevant in most cases, it should be kept in mind if standardised uptake values derived from CT and 68 Ge attenuation correction are compared. (orig.)

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

DEFF Research Database (Denmark)

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

2017-01-01

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

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

International Nuclear Information System (INIS)

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

2005-01-01

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

Initial experience of Fag-PET/CT guided Imr of head-and-neck carcinoma

International Nuclear Information System (INIS)

Wang Dian; Schultz, Christopher J.; Jursinic, Paul A.; Bialkowski, Mirek; Zhu, X. Ronald; Brown, W. Douglas; Rand, Scott D.; Michel, Michelle A.; Campbell, Bruce H.; Wong, Stuart; Li, X. Allen; Wilson, J. Frank

2006-01-01

Purpose: The purpose of this study is to evaluate the impact of 18 F-fluorodeoxyglucose positron emission tomography (Fag-PET) fused with planning computed tomography (CT) on tumor localization, which guided intensity-modulated radiotherapy (Imr) of patients with head-and-neck carcinoma. Methods and Materials: From October 2002 through April 2005, we performed Fag-PET/CT guided Imr for 28 patients with head-and-neck carcinoma. Patients were immobilized with face masks that were attached with five fiducial markers. Fag-PET and planning CT scans were performed on the same flattop table in one session and were then fused. Target volumes and critical organs were contoured, and Imr plans were generated based on the fused images. Results: All 28 patients had abnormal increased uptake in Fag-PET/CT scans. PET/CT resulted in CT-based staging changes in 16 of 28 (57%) patients. PET/CT fusions were successfully performed and were found to be accurate with the use of the two commercial planning systems. Volume analysis revealed that the PET/CT-based gross target volumes (GTVs) were significantly different from those contoured from the CT scans alone in 14 of 16 patients. In addition, 16 of 28 patients who were followed for more than 6 months did not have any evidence of locoregional recurrence in the median time of 17 months. Conclusion: Fused images were found to be useful to delineate GTV required in IMRT planning. PET/CT should be considered for both initial staging and treatment planning in patients with head-and-neck carcinoma

Physical and technical basis of positron emission tomography (PET)

International Nuclear Information System (INIS)

Bauer, R.

1994-01-01

Positron emission tomography utilizes the annihilation of positrons, generating pairs of gamma quanta which are emitted in opposing directions. 'Electronic collimation' is performed by coincident detection of both quanta. Thus, there is no need for mechanical collimators and no limiting connection between sensitivity and spatial resolution. Transversal tomograms are reconstructed from the projection data by means of highly sophisticated data processing. The half life of the most positron emitters used in medical applications is short and of the order of some minutes. Therefore, many positron emitters have to be produced on-side by means of a cyclotron. PET is superior to SPECT with respect to physical and technical aspects, but the high costs of PET limit its wide-spread use up to now. (orig.) [de

Non-oncological positron emission tomography (PET): brain imaging; La tomographie par emission de positons (TEP) hors oncologie: l'exploration du cerveau

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Lomena, F. [Centro de Diagnostico por la imagen (CDIC), Hospital Clinic, Servicio de medicina nuclear, Barcelona (Spain)

2008-10-15

Positron emission tomography (PET) allows evaluation of the central nervous system function. Imaging of regional cerebral blood flow and metabolism, and of several neurotransmission systems may be obtained using PET. PET quantification is accurate and has good test-retest reliability. For research purposes, PET has been used to study brain physiology, to explore neurological and psychiatric diseases pathophysiology and for the new drugs research and development. F.D.G. is the only PET radioligand with clinical application. Following criteria of evidence-based medicine, the clinical indications of F.D.G.-PET are: evaluation of treated gliomas, pre surgical study of partial refractory epilepsy and diagnosis of Alzheimer's disease when it is impossible to differentiate clinically from fronto-temporal dementia.

High-speed X-ray phase tomography with Talbot interferometer and fringe scanning method

International Nuclear Information System (INIS)

Kibayashi, Shunsuke; Harasse, Sébastien; Yashiro, Wataru; Momose, Atsushi

2012-01-01

High-speed X-ray phase tomography based on the Fourier-transform method has been demonstrated with an X-ray Talbot interferometer using white synchrotron radiation. We report the experimental results of high-speed X-ray phase tomography with fringe-scanning method instead of Fourier-transform method to improve spatial resolution without a considerable increase of scan time. To apply fringe-scanning method to high speed tomography, we tested a scan that is a synchronous combination of one-way continuous movements of the sample rotation and the grating displacement. When this scanning method was combined with X-ray phase tomography, we were able to obtain a scan time of 5 s. A comparison of the image quality derived with the conventional approach and with the proposed approach using the fringe-scanning method showed that the latter had better spatial resolution.

[Increased glucose uptake by seborrheic keratosis on PET scan].

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Merklen-Djafri, C; Truntzer, P; Hassler, S; Cribier, B

2017-05-01

Positron emission tomography (PET) is an examination based upon the uptake of a radioactive tracer by hypermetabolic cells. It is primarily used in tandem with tomodensitometry (PET-TDM) for cancer staging because of its high sensitivity and specificity for the detection of metastases. However, unusually high uptake may occur with benign tumours, including skin tumours. Herein, we report an extremely rare case of pathological uptake levels resulting from seborrhoeic keratosis. A 55-year-old male patient with oesophageal squamous-cell carcinoma was referred to us following the discovery of an area of high marker uptake following PET-TDM and corresponding to a pigmented skin lesion. No other areas of suspect high uptake were seen. The lesion was surgically excised and histological examination indicated seborrhoeic keratosis. The histological appearance was that of standard seborrhoeic keratosis without any notable mitotic activity. PET-TDM is an examination that enables diagnosis of malignancy. However, rare cases have been described of increased marker uptake by benign cutaneous tumours such as histiocytofibroma, pilomatricoma and condyloma. To date, there have only been only very few cases of increased uptake due to seborrhoeic keratosis. This extremely unusual case of increased glucose uptake in PET-TDM due to seborrhoeic keratosis confirms that the hypermetabolic activity detected by this examination is not necessarily synonymous with malignancy and that confirmation by clinical and histological findings is essential. The reasons for increased metabolic activity within such benign tumours are not known. Copyright © 2017 Elsevier Masson SAS. All rights reserved.

PET scan perfusion imaging in the Prader-Willi syndrome: new insights into the psychiatric and social disturbances

International Nuclear Information System (INIS)

Mantoulan, C.; Payoux, P.; Mantoulan, C.; Diene, G.; Glattard, M.; Molinas, C.; Tauber, M.; Payoux, P.; Sevely, A.; Glattard, M.; Roge, B.; Molinas, C.; Tauber, M.; Zilbovicius, M.; Celsis, P.; Celsis, P.

2011-01-01

The Prader-Willi syndrome (PWS), a rare multisystem genetic disease, leads to severe disabilities, such as morbid obesity, endocrine dysfunctions, psychiatric disorders, and social disturbances. We explored the whole brain of patients with PWS to detect abnormalities that might explain the behavioral and social disturbances, as well as the psychiatric disorders of these patients. Nine patients with PWS (six males, three females; mean age 16.4 years) underwent a positron emission tomography (PET) scan with H(2)(15)O as a tracer to measure regional cerebral blood flow (rCBF). The images were compared with those acquired from nine controls (six males, three females; mean age 21.2 years). A morphologic magnetic resonance imaging (MRI) was also performed in PWS patients, and their cognitive and behavioral skills were assessed with Wechsler Intelligence Scale for Children III and the Child Behavior Check List (CBCL). The MRI images showed no evident anatomic abnormalities, whereas PET scans revealed hypo-perfused brain regions in PWS patients compared with controls, particularly in the anterior cingulum and superior temporal regions. We observed a significant relationship (P≤0.05) between rCBF in the hypo-perfused regions and CBCL scores. The functional consequences of these perfusion abnormalities in specific brain regions might explain the behavioral and social problems observed in these individuals. (authors)

Position sensitivity of the first SmartPET HPGe detector

Energy Technology Data Exchange (ETDEWEB)

Cooper, R.J. [Department of Physics, University of Liverpool, Liverpool (United Kingdom)]. E-mail: rjc@ns.ph.liv.ac.uk; Turk, G. [Department of Physics, University of Liverpool, Liverpool (United Kingdom); Boston, A.J. [Department of Physics, University of Liverpool, Liverpool (United Kingdom); Boston, H.C. [Department of Physics, University of Liverpool, Liverpool (United Kingdom); Cresswell, J.R. [Department of Physics, University of Liverpool, Liverpool (United Kingdom); Mather, A.R. [Department of Physics, University of Liverpool, Liverpool (United Kingdom); Nolan, P.J. [Department of Physics, University of Liverpool, Liverpool (United Kingdom); Hall, C.J. [CCLRC Daresbury, Warrington, Cheshire (United Kingdom); Lazarus, I. [CCLRC Daresbury, Warrington, Cheshire (United Kingdom); Simpson, J. [CCLRC Daresbury, Warrington, Cheshire (United Kingdom); Berry, A. [School of Physics and materials Engineering, Monash University, Melbourne (Australia); Beveridge, T. [School of Physics and materials Engineering, Monash University, Melbourne (Australia); Gillam, J. [School of Physics and materials Engineering, Monash University, Melbourne (Australia); Lewis, R.A. [School of Physics and materials Engineering, Monash University, Melbourne (Australia)

2007-04-01

In this paper we discuss the Smart Positron Emission Tomography (PET) imaging system being developed by University of Liverpool in conjunction with CCLRC Daresbury Laboratory. We describe the motivation for the development of a semiconductor-based PET system and the advantages it will offer over current tomographs. Details of the detectors and associated electronics are discussed and results of high precision scans are presented. Analysis of this scan data has facilitated full characterization of the detector response function and calibration of the three-dimensional position sensitivity. This work presents the analysis of the depth sensitivity of the detector.

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

Science.gov (United States)

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

2014-01-01

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

Imaging Cellular Proliferation During Chemo-Radiotherapy: A Pilot Study of Serial 18F-FLT Positron Emission Tomography/Computed Tomography Imaging for Non-Small-Cell Lung Cancer

International Nuclear Information System (INIS)

Everitt, Sarah; Hicks, Rodney J.; Ball, David; Kron, Tomas; Schneider-Kolsky, Michal; Walter, Tania; Binns, David; Mac Manus, Michael

2009-01-01

Purpose: To establish whether 18 F-3'-deoxy-3'-fluoro-L-thymidine ( 18 F-FLT) can monitor changes in cellular proliferation of non-small-cell lung cancer (NSCLC) during radical chemo-radiotherapy (chemo-RT). Methods and Materials: As part of a prospective pilot study, 5 patients with locally advanced NSCLC underwent serial 18 F-FLT positron emission tomography (PET)/computed tomography (CT) scans during treatment. Baseline 18 F-FLT PET/CT scans were compared with routine staging 18 F-FDG PET/CT scans. Two on-treatment 18 F-FLT scans were performed for each patient on Days 2, 8, 15 or 29, providing a range of time points for response assessment. Results: In all 5 patients, baseline lesional uptake of 18 F-FLT on PET/CT corresponded to staging 18 F-FDG PET/CT abnormalities. 18 F-FLT uptake in tumor was observed on five of nine (55%) on-treatment scans, on Days 2, 8 and 29, but not Day 15. A 'flare' of 18 F-FLT uptake in the primary tumor of one case was observed after 2 Gy of radiation (1.22 x baseline). The remaining eight on-treatment scans demonstrated a mean reduction in 18 F-FLT tumor uptake of 0.58 x baseline. A marked reduction of 18 F-FLT uptake in irradiated bone marrow was observed for all cases. This reduction was observed even after only 2 Gy, and all patients demonstrated a complete absence of proliferating marrow after 10 Gy. Conclusions: This proof of concept study indicates that 18 F-FLT uptake can monitor the distinctive biologic responses of epithelial cancers and highly radiosensitive normal tissue changes during radical chemo-RT. Further studies of 18 F-FLT PET/CT imaging during therapy may suggest that this tracer is useful in developing response-adapted RT for NSCLC.

Value of new MR techniques in MR-PET

International Nuclear Information System (INIS)

Attenberger, U.I.; Schoenberg, S.O.; Quick, H.H.; Guimaraes, A.; Catalano, O.; Morelli, J.N.

2013-01-01

The unparalleled soft tissue contrast of magnetic resonance imaging (MRI) and the functional information obtainable with 18-F fluorodeoxyglucose positron emission tomography (FDG-PET) render MR-PET well-suited for oncological and psychiatric imaging. The lack of ionizing radiation with MRI also makes MR-PET a promising modality for oncology patients requiring frequent follow-up and pediatric patients. Lessons learned with PET computed tomography (CT) over the last few years do not directly translate to MR-PET. For example, in PET-CT the Hounsfield units derived from CT are used for attenuation correction (AC). As 511 keV photons emitted in PET examinations are attenuated by the patient's body CT data are converted directly to linear attenuation coefficients (LAC); however, proton density measured by MRI is not directly related to the radiodensity or LACs of biological tissue. Thus, direct conversion to LAC data is not possible making AC more challenging in simultaneous MRI-PET scanning. In addition to these constraints simultaneous MRI-PET acquisitions also improve on some solutions to well-known challenges of hybrid imaging techniques, such as limitations in motion correction. This article reports on initial clinical experiences with simultaneously acquired MRI-PET data, focusing on the potential benefits and limitations of MRI with respect to motion correction as well as metal and attenuation correction artefacts. (orig.) [de

FDG PET/CT for therapeutic response monitoring in multi-site non-respiratory tuberculosis

International Nuclear Information System (INIS)

Geng Tian; Yong Xiao; Bin Chen; Jun Xia; Hong Guan; Qunyi Deng

2010-01-01

Background: Tuberculosis (TB) can produce positive signals during 18 F-fluorodeoxyglucose positron emission/computed tomography (FDG PET/CT) scanning. Until now, there has been no better method than clinical assessment to evaluate the therapeutic response of non-respiratory TB (NRTB). Purpose: To retrospectively assess the ability of FDG PET/CT to evaluate the response to anti-TB treatment in patients with NRTB. Material and Methods: Three patients with multi-site NRTB underwent repeat PET/CT scans during anti-TB treatment. Changes in maximal standard uptake value (SUVmax) of the TB lesions on PET/CT images were analyzed between two scans. Initial PET/CT scans were performed before the start of anti-TB treatment, and later scans were performed after completion of the treatment. Results: Patient 1, a 63-year-old female, and patient 2, a 50-year-old male, were diagnosed as multi-site NRTB by biopsy. Patient 3, a 37-year-old male was diagnosed clinically. These patients demonstrated multiple FDG-avid lesions in whole body on initial PET/CT images. The highest SUVmax of patient 1, 2, and 3 were 13.6, 17.7, and 13.9 separately. After completion of the treatment, all positive signals of patient 1, 2, and 3 decreased to undetectable value on repeated PET/CT scans with intervals of 318 days, 258 days, and 182 days separately. Conclusion: FDG PET/CT scan may be useful for monitoring responses to anti-TB treatment in patients with NRTB

Development and Verification of Body Armor Target Geometry Created Using Computed Tomography Scans

Science.gov (United States)

2017-07-13

Computed Tomography Scans by Autumn R Kulaga, Kathryn L Loftis, and Eric Murray Approved for public release; distribution is...Army Research Laboratory Development and Verification of Body Armor Target Geometry Created Using Computed Tomography Scans by Autumn R Kulaga...Development and Verification of Body Armor Target Geometry Created Using Computed Tomography Scans 5a. CONTRACT NUMBER 5b. GRANT NUMBER 5c

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....

Compton scatter tomography in TOF-PET

Science.gov (United States)

Hemmati, Hamidreza; Kamali-Asl, Alireza; Ay, Mohammadreza; Ghafarian, Pardis

2017-10-01

Scatter coincidences contain hidden information about the activity distribution on the positron emission tomography (PET) imaging system. However, in conventional reconstruction, the scattered data cause the blurring of images and thus are estimated and subtracted from detected coincidences. List mode format provides a new aspect to use time of flight (TOF) and energy information of each coincidence in the reconstruction process. In this study, a novel approach is proposed to reconstruct activity distribution using the scattered data in the PET system. For each single scattering coincidence, a scattering angle can be determined by the recorded energy of the detected photons, and then possible locations of scattering can be calculated based on the scattering angle. Geometry equations show that these sites lie on two arcs in 2D mode or the surface of a prolate spheroid in 3D mode, passing through the pair of detector elements. The proposed method uses a novel and flexible technique to estimate source origin locations from the possible scattering locations, using the TOF information. Evaluations were based on a Monte-Carlo simulation of uniform and non-uniform phantoms at different resolutions of time and detector energy. The results show that although the energy uncertainties deteriorate the image spatial resolution in the proposed method, the time resolution has more impact on image quality than the energy resolution. With progress of the TOF system, the reconstruction using the scattered data can be used in a complementary manner, or to improve image quality in the next generation of PET systems.

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

International Nuclear Information System (INIS)

Ryu, Sang Young

1999-12-01

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

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

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Ryu, Sang Young

1999-12-01

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

The use of 18F-fluoride and 18F-FDG PET scans to assess fracture healing in a rat femur model

International Nuclear Information System (INIS)

Hsu, W.K.; Feeley, B.T.; Krenek, L.; Stout, D.B.; Chatziioannou, A.F.; Lieberman, J.R.

2007-01-01

Currently available diagnostic techniques can be unreliable in the diagnosis of delayed fracture healing in certain clinical situations, which can lead to increased complication rates and costs to the health care system. This study sought to determine the utility of positron emission tomography (PET) scanning with 18 F-fluoride ion, which localizes in regions of high osteoblastic activity, and 18 F-fluorodeoxyglucose (FDG), an indicator of cellular glucose metabolism, in assessing bone healing in a rat femur fracture model. Fractures were created in the femurs of immunocompetent rats. Animals in group I had a fracture produced via a manual three-point bending technique. Group II animals underwent a femoral osteotomy with placement of a 2-mm silastic spacer at the fracture site. Fracture healing was assessed with plain radiographs, 18 F-fluoride, and 18 F-FDG PET scans at 1, 2, 3, and 4-week time points after surgery. Femoral specimens were harvested for histologic analysis and manual testing of torsional and bending strength 4 weeks after surgery. All fractures in group I revealed abundant callus formation and bone healing, while none of the nonunion femurs were healed via assessment with manual palpation, radiographic, and histologic evaluation at the 4-week time point. 18 F-fluoride PET images of group I femurs at successive 1-week intervals revealed progressively increased signal uptake at the union site during fracture repair. In contrast, minimal tracer uptake was seen at the fracture sites in group II at all time points after surgery. Data analysis revealed statistically significant differences in mean signal intensity between groups I and II at each weekly interval. No significant differences between the two groups were seen using 18 F-FDG PET imaging at any time point. This study suggests that 18 F-fluoride PET imaging, which is an indicator of osteoblastic activity in vivo, can identify fracture nonunions at an early time point and may have a role in the

The use of 18F-fluoride and 18F-FDG PET scans to assess fracture healing in a rat femur model

Science.gov (United States)

Hsu, W. K.; Feeley, B. T.; Krenek, L.; Stout, D. B.; Chatziioannou, A. F.; Lieberman, J. R.

2011-01-01

Purpose Currently available diagnostic techniques can be unreliable in the diagnosis of delayed fracture healing in certain clinical situations, which can lead to increased complication rates and costs to the health care system. This study sought to determine the utility of positron emission tomography (PET) scanning with 18F-fluoride ion, which localizes in regions of high osteoblastic activity, and 18F-fluorodeoxyglucose (FDG), an indicator of cellular glucose metabolism, in assessing bone healing in a rat femur fracture model. Methods Fractures were created in the femurs of immuno-competent rats. Animals in group I had a fracture produced via a manual three-point bending technique. Group II animals underwent a femoral osteotomy with placement of a 2-mm silastic spacer at the fracture site. Fracture healing was assessed with plain radiographs, 18F-fluoride, and 18F-FDG PET scans at 1, 2, 3, and 4-week time points after surgery. Femoral specimens were harvested for histologic analysis and manual testing of torsional and bending strength 4 weeks after surgery. Results All fractures in group I revealed abundant callus formation and bone healing, while none of the nonunion femurs were healed via assessment with manual palpation, radiographic, and histologic evaluation at the 4-week time point. 18F-fluoride PET images of group I femurs at successive 1-week intervals revealed progressively increased signal uptake at the union site during fracture repair. In contrast, minimal tracer uptake was seen at the fracture sites in group II at all time points after surgery. Data analysis revealed statistically significant differences in mean signal intensity between groups I and II at each weekly interval. No significant differences between the two groups were seen using 18F-FDG PET imaging at any time point. Conclusion This study suggests that 18F-fluoride PET imaging, which is an indicator of osteoblastic activity in vivo, can identify fracture nonunions at an early time point

Dual-time point scanning of integrated FDG PET/CT for the evaluation of mediastinal and hilar lymph nodes in non-small cell lung cancer diagnosed as operable by contrast-enhanced CT

Energy Technology Data Exchange (ETDEWEB)

Kasai, Takami, E-mail: takaby@hotmail.co [Department of Radiology, Chiba University Hospital, 1-8-1 Inohana, Chuo-ku, Chiba City, Chiba-ken 260-8677 (Japan); Motoori, Ken, E-mail: motoorik@faculty.chiba-u.j [Department of Radiology, Chiba University Hospital, 1-8-1 Inohana, Chuo-ku, Chiba City, Chiba-ken 260-8677 (Japan); Horikoshi, Takuro, E-mail: taku_steelfish@yahoo.co.j [Department of Radiology, Chiba University Hospital, 1-8-1 Inohana, Chuo-ku, Chiba City, Chiba-ken 260-8677 (Japan); Uchiyama, Katsuhiro, E-mail: ka-uchiyama@nifty.co [Diagnostic PET Imaging Center, Department of Radiology, Sannoh Medical Center, 166-2 Sannohcho, Inage-ku, Chiba City, Chiba-ken 263-0002 (Japan); Yasufuku, Kazuhiro, E-mail: kyasufuku@faculty.chiba-u.j [Department of Thoracic Surgery, Graduate School of Medicine, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba City, Chiba-ken 260-8670 (Japan); Takiguchi, Yuichi, E-mail: takiguchi@faculty.chiba-u.j [Department of Respirology, Graduate School of Medicine, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba City, Chiba-ken 260-8670 (Japan); Takahashi, Fumiaki, E-mail: takahashifu@pharm.kitasato-u.ac.j [Division of Biostatistics, Graduate School of Pharmaceutical Sciences, Kitasato University, 5-9-1 Shirokane, Minato-ku, Tokyo 108-8641 (Japan); Kuniyasu, Yoshio, E-mail: kuniyasu@ace.ocn.ne.j [Diagnostic PET Imaging Center, Department of Radiology, Sannoh Medical Center, 166-2 Sannohcho, Inage-ku, Chiba City, Chiba-ken 263-0002 (Japan); Ito, Hisao, E-mail: hisao@faculty.chiba-u.j [Department of Radiology, Chiba University Hospital, 1-8-1 Inohana, Chuo-ku, Chiba City, Chiba-ken 260-8677 (Japan)

2010-08-15

Purpose: To evaluate whether dual-time point scanning with integrated fluorine-18 fluorodeoxyglucose ({sup 18}F-FDG) positron emission tomography and computed tomography (PET/CT) is useful for evaluation of mediastinal and hilar lymph nodes in non-small cell lung cancer diagnosed as operable by contrast-enhanced CT. Materials and methods: PET/CT data and pathological findings of 560 nodal stations in 129 patients with pathologically proven non-small cell lung cancer diagnosed as operable by contrast-enhanced CT were reviewed retrospectively. Standardized uptake values (SUVs) on early scans (SUVe) 1 h, and on delayed scans (SUVd) 2 h after FDG injection of each nodal station were measured. Retention index (RI) (%) was calculated by subtracting SUVe from SUVd and dividing by SUVe. Logistic regression analysis was performed with seven kinds of models, consisting of (1) SUVe, (2) SUVd, (3) RI, (4) SUVe and SUVd, (5) SUVe and RI, (6) SUVd and RI, and (7) SUVe, SUVd and RI. The seven derived models were compared by receiver-operating characteristic (ROC) analysis. k-Fold cross-validation was performed with k values of 5 and 10. p < 0.05 was considered statistically significant. Results: Model (1) including the term of SUVe showed the largest area under the ROC curve among the seven models. The cut-off probability of metastasis of 3.5% with SUVe of 2.5 revealed a sensitivity of 78% and a specificity of 81% on ROC analysis, and approximately 60% and 80% on k-fold cross-validation. Conclusion: Single scanning of PET/CT is sufficiently useful for evaluating mediastinal and hilar nodes for metastasis.

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

International Nuclear Information System (INIS)

Long, Qi; Shaoyan, Wang; Hui, Wang

2015-01-01

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

Comparison of 18F-FDG PET to CT scan in the detection of recurrent colorectal carcinoma - an ROC analysis

International Nuclear Information System (INIS)

Scott, A.M.; Akhurst, T.; Berlangieri, S.U.; Fitt, G.; Schelleman, T.; Jones, R.; Hannah, A.; Tochon-Danguy, H.

2000-01-01

Full text: This study examined 43 scans performed in 40 patients from a group of 93 prospectively enrolled in a trial examining the utility of 18 F-FDG PET in patients with potentially resectable recurrent colorectal cancer. All patients had PET and CT scans prior to surgery, where a total of 84 anatomical regions were biopsied, and 364 regions examined by the surgeons. All PET and CT scans were viewed blinded to clinical and imaging data. The scans were interpreted according to a five-point confidence scale to enable an ROC analysis to be performed. An assessment of the impact of PET over CT in patients was also made. Of the 43 cases PET and CT were concordant in 24 (56%). There were 16 cases where PET added additional diagnostic information to the benefit of the patient (37%), and three (7%) where PET alone would have lead to a potentially negative outcome. The majority of cases where PET performed better were in cases with extrahepatic disease. CT was more sensitive in the detection of pulmonary nodules, although the specificity of CT was less than PET. In conclusion, 18 F-FDG PET performed significantly better than CT both in terms of a regional analysis as well as a patient by patient basis. Copyright (2000) The Australian and New Zealand Society of Nuclear Medicine Inc

Molecular Imaging and Precision Medicine: PET/Computed Tomography and Therapy Response Assessment in Oncology.

Science.gov (United States)

Sheikhbahaei, Sara; Mena, Esther; Pattanayak, Puskar; Taghipour, Mehdi; Solnes, Lilja B; Subramaniam, Rathan M

2017-01-01

A variety of methods have been developed to assess tumor response to therapy. Standardized qualitative criteria based on 18F-fluoro-deoxyglucose PET/computed tomography have been proposed to evaluate the treatment effectiveness in specific cancers and these allow more accurate therapy response assessment and survival prognostication. Multiple studies have addressed the utility of the volumetric PET biomarkers as prognostic indicators but there is no consensus about the preferred segmentation methodology for these metrics. Heterogeneous intratumoral uptake was proposed as a novel PET metric for therapy response assessment. PET imaging techniques will be used to study the biological behavior of cancers during therapy. Copyright © 2016 Elsevier Inc. All rights reserved.

Minimising medically unwarranted computed tomography scans

International Nuclear Information System (INIS)

Brenner, D.J.

2012-01-01

As computed tomography (CT) is such a superb diagnostic tool and individual CT risks are small, whenever a CT scan is clinically warranted, the CT benefit/risk balance is by far in the patient’s favour. However, if a CT scan is not clinically warranted, this balance shifts dramatically. It is likely that at least 25% of CT scans fall into this latter category, in that they could either be replaced with alternative imaging modalities or could be avoided entirely. Use of clinical decision rules for CT usage represents a powerful approach for slowing down the increase in CT usage, because they have the potential to overcome some of the major factors that result in some CT scans being undertaken when they may not be clinically helpful.

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

International Nuclear Information System (INIS)

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

1999-01-01

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

Use of PET and PET/CT for Radiation Therapy Planning: IAEA expert report 2006-2007

International Nuclear Information System (INIS)

MacManus, Michael; Nestle, Ursula; Rosenzweig, Kenneth E.; Carrio, Ignasi; Messa, Cristina; Belohlavek, Otakar; Danna, Massimo; Inoue, Tomio; Deniaud-Alexandre, Elizabeth; Schipani, Stefano; Watanabe, Naoyuki; Dondi, Maurizio; Jeremic, Branislav

2009-01-01

Positron Emission Tomography (PET) is a significant advance in cancer imaging with great potential for optimizing radiation therapy (RT) treatment planning and thereby improving outcomes for patients. The use of PET and PET/CT in RT planning was reviewed by an international panel. The International Atomic Energy Agency (IAEA) organized two synchronized and overlapping consultants' meetings with experts from different regions of the world in Vienna in July 2006. Nine experts and three IAEA staff evaluated the available data on the use of PET in RT planning, and considered practical methods for integrating it into routine practice. For RT planning, 18 F fluorodeoxyglucose (FDG) was the most valuable pharmaceutical. Numerous studies supported the routine use of FDG-PET for RT target volume determination in non-small cell lung cancer (NSCLC). There was also evidence for utility of PET in head and neck cancers, lymphoma and in esophageal cancers, with promising preliminary data in many other cancers. The best available approach employs integrated PET/CT images, acquired on a dual scanner in the radiotherapy treatment position after administration of tracer according to a standardized protocol, with careful optimization of images within the RT planning system and carefully considered rules for contouring tumor volumes. PET scans that are not recent or were acquired without proper patient positioning should be repeated for RT planning. PET will play an increasing valuable role in RT planning for a wide range of cancers. When requesting PET scans, physicians should be aware of their potential role in RT planning.

Characterizing proton-activated materials to develop PET-mediated proton range verification markers

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Cho, Jongmin; Ibbott, Geoffrey S.; Kerr, Matthew D.; Amos, Richard A.; Stingo, Francesco C.; Marom, Edith M.; Truong, Mylene T.; Palacio, Diana M.; Betancourt, Sonia L.; Erasmus, Jeremy J.; DeGroot, Patricia M.; Carter, Brett W.; Gladish, Gregory W.; Sabloff, Bradley S.; Benveniste, Marcelo F.; Godoy, Myrna C.; Patil, Shekhar; Sorensen, James; Mawlawi, Osama R.

2016-06-01

Conventional proton beam range verification using positron emission tomography (PET) relies on tissue activation alone and therefore requires particle therapy PET whose installation can represent a large financial burden for many centers. Previously, we showed the feasibility of developing patient implantable markers using high proton cross-section materials (18O, Cu, and 68Zn) for in vivo proton range verification using conventional PET scanners. In this technical note, we characterize those materials to test their usability in more clinically relevant conditions. Two phantoms made of low-density balsa wood (~0.1 g cm-3) and beef (~1.0 g cm-3) were embedded with Cu or 68Zn foils of several volumes (10-50 mm3). The metal foils were positioned at several depths in the dose fall-off region, which had been determined from our previous study. The phantoms were then irradiated with different proton doses (1-5 Gy). After irradiation, the phantoms with the embedded foils were moved to a diagnostic PET scanner and imaged. The acquired data were reconstructed with 20-40 min of scan time using various delay times (30-150 min) to determine the maximum contrast-to-noise ratio. The resultant PET/computed tomography (CT) fusion images of the activated foils were then examined and the foils’ PET signal strength/visibility was scored on a 5 point scale by 13 radiologists experienced in nuclear medicine. For both phantoms, the visibility of activated foils increased in proportion to the foil volume, dose, and PET scan time. A linear model was constructed with visibility scores as the response variable and all other factors (marker material, phantom material, dose, and PET scan time) as covariates. Using the linear model, volumes of foils that provided adequate visibility (score 3) were determined for each dose and PET scan time. The foil volumes that were determined will be used as a guideline in developing practical implantable markers.

New possibilities of three-dimensional reconstruction of computed tomography scans

International Nuclear Information System (INIS)

Herman, M.; Tarjan, Z.; Pozzi-Mucelli, R.S.

1996-01-01

Three-dimensional (3D) computed tomography (CT) scan reconstructions provide impressive and illustrative images of various parts of the human body. Such images are reconstructed from a series of basic CT scans by dedicated software. The state of the art in 3D computed tomography is demonstrated with emphasis on the imaging of soft tissues. Examples are presented of imaging the craniofacial and maxillofacial complex, central nervous system, cardiovascular system, musculoskeletal system, gastrointestinal and urogenital systems, and respiratory system, and their potential in clinical practice is discussed. Although contributing no new essential diagnostic information against conventional CT scans, 3D scans can help in spatial orientation. 11 figs., 25 refs

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

Science.gov (United States)

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

2014-01-01

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

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

International Nuclear Information System (INIS)

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

2012-01-01

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

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

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

2015-11-01

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

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

Energy Technology Data Exchange (ETDEWEB)

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

2015-11-15

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

Implementation of true continuous bed motion in 2-D and 3-D whole-body PET scanning

Science.gov (United States)

Dahlbom, M.; Reed, J.; Young, J.

2001-08-01

True continuous axial bed motion has been implemented on a high-resolution positron emission tomography (PET) scanner for use in both two-dimensional (2-D) and three-dimensional (3-D) acquisition modes. This has been accomplished by modifications in the bed motion controller firmware and by acquiring data in list mode. The new bed controller firmware was shown to provide an accurate and constant bed speed down to 0.25 mm/s with a moderate patient weight load. The constant bed motion eliminates previously reported dead-time due to bed positioning when using small discrete bed steps. The continuous bed motion was tested on uniform phantoms, in 2-D and 3-D. As a result of the continuous axial motion, a uniform axial sensitivity is achieved. This was also reflected in the reconstructed images, which showed an improvement in axial image uniformity (1.4% for continuous sampling, 5.0% for discrete) as well as an improvement in %SD uniformity in comparison to conventional step-and-shoot acquisitions. The use of the continuous axial motion also provide slight improvements in 2-D emission and transmission scanning, resulting in an overall improved image quality in whole-body PET.

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

International Nuclear Information System (INIS)

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

2002-01-01

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

Positron emission tomography in oncology

International Nuclear Information System (INIS)

Lecomte, R.; Bentourkia, M.; Benard, F.

2002-01-01

Positron Emission Tomography is a sophisticated molecular imaging technique, using a special scanner, that displays the functional status of tissues in the body at the cellular level (their metabolism). It is a diagnostic scan that provides the physician with information not available with traditional anatomic studies such as CT or MRI. PET can detect changes in cell function (disease) long before they are evident as physical (anatomic) changes seen on CT or MRI. In this way PET can add important information about many diseases allowing the physician to make a diagnosis often much earlier than with anatomic imaging techniques such as CT or MRI alone. In addition, in cases where an abnormality is noted on CT or MRI, PET can help differentiate benign changes from changes due to disease. PET scanning also typically images the entire body, unlike CT/MRI which is usually broken up into specific limited body section scans. All cells use glucose as an energy source but cancer cells use much more since they are growing much faster and out of control. This is the basis of imaging with F-18 FDG glucose, the radiotracer agent use in a PET oncology study. The abnormal, accelerated glucose used by cancer cells is detected by the PET scanner that processes the emissions from the F-18 FDG glucose by abnormally high levels of metabolism (tumor)

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

Directory of Open Access Journals (Sweden)

Canh Nguyen

2015-01-01

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

Decision logic for retreatment of asymptomatic lung cancer recurrence based on positron emission tomography findings

International Nuclear Information System (INIS)

Frank, Albert; Lefkowitz, David; Jaeger, Stanley; Gobar, Lisa; Sunderland, John; Gupta, Naresh; Scott, Walter; Mailliard, James; Lynch, Henry; Bishop, John; Thorpe, Patricia; Dewan, Naresh

1995-01-01

Purpose: The purpose of the study was to determine if Positron emission tomography (PET) 2-[F-18] fluoro-2-deoxy-D-glucose (FDG) imaging could detect subclinical local lung cancer recurrence and whether retreatment of such recurrence was feasible and beneficial. Methods and Materials: Twenty patients with biopsy proven lung cancer were studied with Positron emission tomography for the purpose of detecting subclinical lung cancer recurrence over a period of 4.25 years. All patients were treated with external radiation as part or all of their therapy. Twenty patients had baseline PET and computed tomography (CT) studies for comparison with later studies. Surviving patients had a total of 40 sequential PET scans and 35 CT scans. The follow-up interval ranged from 5 to 40 months posttreatment. The differential uptake ratio (DUR) was determined for regions of interest of increased FDG uptake. Results: The median DUR value of the 20 baseline PET studies was 5.59. The DUR value of greater than 3 was empirically selected as being positive for tumor detection. On baseline studies, PET had a 100% correlation with the CT findings in regard to detection of the site of primary tumor involvement. Four of 20 patients showed areas of discordance in the mediastinal and hilar areas on initial PET and CT studies. Seven of 17 patients showed discordant posttreatment PET-CT findings. Two false positive PET studies were due to radiation pneumonitis and one to macrophage glycolysis in tumor necrosis. For detection of asymptomatic tumor recurrence, analysis of sequential PET and CT studies, biopsy results, and the patient's clinical course suggested that PET had a sensitivity of 100%, specificity of 89.3%, and accuracy of 92.5%. Computerized Tomography was found to have a sensitivity of 67%, specificity of 85%, and accuracy of 82% for detection of such early-stage recurrence. Five patients went on to have retreatment with external irradiation based upon the PET evidence. Four retreated

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

Science.gov (United States)

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

2014-07-01

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

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

Energy Technology Data Exchange (ETDEWEB)

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

2016-04-15

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

[Principles of PET].

Science.gov (United States)

Beuthien-Baumann, B

2018-05-01

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

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

Science.gov (United States)

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

2018-07-01

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

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

Science.gov (United States)

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

2016-01-01

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

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

International Nuclear Information System (INIS)

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

2016-01-01

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

[Clinical evaluation of female pelvic tumors : Application fields of integrated PET/MRI].

Science.gov (United States)

Grueneisen, J; Umutlu, L

2016-07-01

Integrated positron emission tomography (PET) and magnetic resonance imaging (MRI) scanning has recently become established in clinical imaging. Various studies have demonstrated the great potential of this new hybrid imaging procedure for applications in the field of oncology and the diagnostics of inflammatory processes. With initial studies demonstrating the feasibility and high diagnostic potential of PET/MRI comparable to PET-computed tomography (CT), the focus of future studies should be on the identification of application fields with a potential diagnostic benefit of PET/MRI over other established diagnostic tools. Both MRI and PET/CT are widely used in the diagnostic algorithms for malignancies of the female pelvis. A simultaneous acquisition of PET and MRI data within a single examination provides complementary information which can be used for a more comprehensive evaluation of the primary tumor as well as for whole body staging. Therefore, the aim of this article is to outline potential clinical applications of integrated PET/MRI for the diagnostic work-up of primary or recurrent gynecological neoplasms of the female pelvis.

The role of FDG PET in management of neck metastasis from head-and-neck cancer after definitive radiation treatment

International Nuclear Information System (INIS)

Yao Min; Smith, Russell B.; Graham, Michael M.; Hoffman, Henry T.; Tan Huaming; Funk, Gerry F.; Graham, Scott M.; Chang, Kristi; Dornfeld, Kenneth J.; Menda, Yusuf; Buatti, John M.

2005-01-01

Purpose: The role of neck dissection after definitive radiation for head-and-neck cancer is controversial. We select patients for neck dissection based on postradiation therapy (post-RT), computed tomography (CT), and [ 18 F] fluorodeoxyglucose positron emission tomography (FDG PET). We summarize the clinical outcomes of patients treated with this policy to further elucidate the role of FDG PET in decision making for neck dissection after primary radiotherapy. Methods and Materials: Between December 1999 and February 2004, 53 eligible patients were identified. These patients had stage N2A or higher head-and-neck squamous cell carcinoma and had complete response of the primary tumor after definitive radiation with or without chemotherapy. PET or computed tomography (CT) scans were performed within 6 months after treatment. Neck dissection was performed in patients with residual lymphadenopathy (identified by clinical examination or CT) and a positive PET scan. Those without residual lymph nodes and a negative PET were observed without neck dissection. For patients with residual lymphadenopathy, but a negative PET scan, neck dissection was performed at the discretion of the attending surgeon and decision of the patient. There was a total of 70 heminecks available for analysis (17 patients had bilateral neck disease). Results: There were 21 heminecks with residual lymphadenopathy identified on CT imaging or clinical examination and negative PET. Of these, 4 had neck dissection and were pathologically negative. The remaining 17 were observed without neck dissection. There was a total of 42 heminecks without residual lymph nodes on post-RT CT imaging or clinical examination with a negative PET. They were also observed without neck dissection. Seven heminecks had a positive PET scan and residual lymphadenopathy. Six of them had neck dissection and 1 had fine-needle aspiration of a residual node; 3 contained residual viable cancer and 4 were pathologically negative. At

Residual Activity Correction in Quantitative Myocardial Perfusion N-13-Ammonia PET Imaging : A Study in Post-MI Patients

NARCIS (Netherlands)

Markousis-Mavrogenis, George; Juarez-Orozco, Luis Eduardo; Alexanderson, Erick

2017-01-01

Background/Introduction/Aim: Positron emission tomography (PET) is the gold standard for the quantification of myocardial blood flow (MBF). A standard PET scan is acquired in two phases (rest and pharmacological stress). N-13-ammonia is a perfusion radiotracer that may show residual activity, which

Scanning multiple mice in a small-animal PET scanner: Influence on image quality

International Nuclear Information System (INIS)

Siepel, Francoise J.; Lier, Monique G.J.T.B. van; Chen Mu; Disselhorst, Jonathan A.; Meeuwis, Antoi P.W.; Oyen, Wim J.G.; Boerman, Otto C.; Visser, Eric P.

2010-01-01

To achieve high throughput in small-animal positron emission tomography (PET), it may be advantageous to scan more than one animal in the scanner's field of view (FOV) at the same time. However, due to the additional activity and increase of Poisson noise, additional attenuating mass, extra photon scattering, and radial or axial displacement of the animals, a deterioration of image quality can be expected. In this study, the NEMA NU 4-2008 image quality (NU4IQ) phantom and up to three FDG-filled cylindrical 'mouse phantoms' were positioned in the FOV of the Siemens Inveon small-animal PET scanner to simulate scans with multiple mice. Five geometrical configurations were examined. In one configuration, the NU4IQ phantom was scanned separately and placed in the center of the FOV (1C). In two configurations, a mouse phantom was added with both phantoms displaced radially (2R) or axially (2A). In two other configurations, the NU4IQ phantom was scanned along with three mouse phantoms with all phantoms displaced radially (4R), or in a combination of radial and axial displacement (2R2A). Images were reconstructed using ordered subset expectation maximization in 2 dimensions (OSEM2D) and maximum a posteriori (MAP) reconstruction. Image quality parameters were obtained according to the NEMA NU 4-2008 guidelines. Optimum image quality was obtained for the 1C geometry. Image noise increased by the addition of phantoms and was the largest for the 4R configuration. Spatial resolution, reflected in the recovery coefficients for the FDG-filled rods, deteriorated by radial displacement of the NU4IQ phantom (2R, 2R2A, and 4R), most strongly for OSEM2D, and to a smaller extent for MAP reconstructions. Photon scatter, as indicated by the spill-over ratios in the non-radioactive water- and air-filled compartments, increased by the addition of phantoms, most strongly for the 4R configuration. Application of scatter correction substantially lowered the spill-over ratios, but caused an

Automatic extraction of myocardial mass and volumes using parametric images from dynamic nongated PET

DEFF Research Database (Denmark)

Harms, Hendrik Johannes; Hansson, Nils Henrik Stubkjær; Tolbod, Lars Poulsen

2016-01-01

Dynamic cardiac positron emission tomography (PET) is used to quantify molecular processes in vivo. However, measurements of left-ventricular (LV) mass and volumes require electrocardiogram (ECG)-gated PET data. The aim of this study was to explore the feasibility of measuring LV geometry using non......-gated dynamic cardiac PET. METHODS: Thirty-five patients with aortic-valve stenosis and 10 healthy controls (HC) underwent a 27-min 11C-acetate PET/CT scan and cardiac magnetic resonance imaging (CMR). HC were scanned twice to assess repeatability. Parametric images of uptake rate K1 and the blood pool were......LV and WT only and an overestimation for LVEF at lower values. Intra- and inter-observer correlations were >0.95 for all PET measurements. PET repeatability accuracy in HC was comparable to CMR. CONCLUSION: LV mass and volumes are accurately and automatically generated from dynamic 11C-acetate PET without...

Comparison of positron emission tomography/CT and bremsstrahlung imaging following Y-90 radiation synovectomy

International Nuclear Information System (INIS)

Barber, Thomas W.; Yap, Kenneth S.K.; Cherk, Martin H.; Kalff, Victor; Powell, Anne

2013-01-01

The aim of this study is to compare the results of positron emission tomography (PET)/CT with bremsstrahlung imaging following Y-90 radiation synovectomy. All patients referred to our institution for Y-90 radiation synovectomy between July 2011 and February 2012 underwent both PET/CT and bremsstrahlung planar (±single photon emission computed tomography (SPECT) or SPECT/CT) imaging at 4 or 24 h following administration of Y-90 silicate colloid. PET image acquisition was performed for between 15 and 20min. In patients who underwent SPECT, side-by-side comparison with PET was performed and image quality/resolution scored using a five-point scale. The distribution pattern of Y-90 on PET and bremsstrahlung imaging was compared with the intra- or extra-articular location of Y-90 activity on fused PET/CT. Thirteen joints (11 knees and two ankles) were imaged with both PET/CT and planar bremsstrahlung imaging with 12 joints also imaged with bremsstrahlung SPECT. Of the 12 joints imaged with SPECT, PET image quality/resolution was superior in 11 and inferior in one. PET demonstrated a concordant distribution pattern compared with bremsstrahlung imaging in all scans, with the pattern classified as diffuse in 12 and predominantly focal in one. In all 12 diffuse scans, PET/CT confirmed the Y-90 activity to be located intra-articularly. In the one predominantly focal scan, the fused PET/CT images localised the Y-90 activity to mostly lie in the extra-articular space of the knee. PET/CT can provide superior image quality compared with bremsstrahlung imaging and may enable reliable detection of extra-articular Y-90 activity when there are focal patterns on planar bremsstrahlung imaging.

Positron emission tomography/magnetic resonance imaging (PET/MRI: An update and initial experience at HC-FMUSP

Directory of Open Access Journals (Sweden)

Marcelo A. Queiroz

Full Text Available Summary The new technology of PET/MRI is a prototype of hybrid imaging, allowing for the combination of molecular data from PET scanning and morphofunctional information derived from MRI scanning. Recent advances regarding the technical aspects of this device, especially after the development of MRI-compatible silicon photomultipliers of PET, permitted an increase in the diagnostic performance of PET/MRI translated into dose reduction and higher imaging quality. Among several clinical applications, PET/MRI gains ground initially in oncology, where MRI per se plays an essential role in the assessment of primary tumors (which is limited in the case of PET/CT, including prostate, rectal and gynecological tumors. On the other hand, the evaluation of the lungs remains an enigma although new MRI sequences are being designed to overcome this. More clinical indications of PET/MRI are seen in the fields of neurology, cardiology and inflammatory processes, and the use of PET/MRI also opens perspectives for pediatric populations as it involves very low radiation exposure. Our review aimed to highlight the current indications of PET/MRI and discuss the challenges and perspectives of PET/MRI at HC-FMUSP.

Scalene muscle uptake: a potential pitfall in head and neck PET/CT

International Nuclear Information System (INIS)

Jacene, Heather A.; Goudarzi, Behnaz; Wahl, Richard L.

2008-01-01

To describe increased 2-deoxy-2-[ 18 F] fluoro-D-glucose (FDG) uptake in the scalene muscles in a large population of patients referred for evaluation with FDG positron emission tomography/computed tomography (PET/CT) imaging. The study met criteria for institutional review board exemption. FDG PET/CT images from 410 patients (179 males; mean age 56.8 years, range 6-88) were retrospectively reviewed for the presence or absence of FDG uptake in the neck that corresponded to the scalene muscles on the concurrent CT scan. Medical records were reviewed and data including age, sex, smoking history, reason for referral, and history of obstructive airways disease, thoracotomy, and thoracic radiation were recorded and evaluated. One hundred and forty-seven of the 410 scans (36%) demonstrated increased FDG uptake on PET that corresponded to the scalene muscles on the CT scan. The uptake was most often bilateral, symmetrical, and linear (n = 117). Other patterns of scalene muscle uptake included unilateral and linear uptake (n = 27) and unilateral and focal uptake (n = 3). Scalene muscle uptake was more common in patients referred for evaluation of lung carcinomas compared to other types of tumors (52% vs. 32%, p = 0.05). Linear FDG uptake in scalene muscles is a commonly seen pattern on PET/CT. This finding should be recognized as a distinct entity and not misinterpreted on transverse images as metastatic disease. (orig.)

Fluorescent scanning x-ray tomography with synchrotron radiation

Science.gov (United States)

Takeda, Tohoru; Maeda, Toshikazu; Yuasa, Tetsuya; Akatsuka, Takao; Ito, Tatsuo; Kishi, Kenichi; Wu, Jin; Kazama, Masahiro; Hyodo, Kazuyuki; Itai, Yuji

1995-02-01

Fluorescent scanning (FS) x-ray tomography was developed to detect nonradioactive tracer materials (iodine and gadolinium) in a living object. FS x-ray tomography consists of a silicon (111) channel cut monochromator, an x-ray shutter, an x-ray slit system and a collimator for detection, a scanning table for the target organ, and an x-ray detector with pure germanium. The minimal detectable dose of iodine in this experiment was 100 ng in a volume of 2 mm3 and a linear relationship was shown between the photon counts of a fluorescent x ray and the concentration of iodine contrast material. A FS x-ray tomographic image was clearly obtained with a phantom.

PET in neurology: an outline of problems, recent acquisitions and future perspectives

International Nuclear Information System (INIS)

Lenzi, G.L.; Fieschi, C.

1987-01-01

The impact of computerized neuro-imaging in the neurological sciences has been so dramatic that our approach to the individual patient has changed completely since computed tomography scan availability. Further changes may be expected from the recently born positron emission tomography (PET) in particular if the exploitation of this technique is performed in close relationship with physiopathological questions and clinical problems. Moreover, the potentials and the obvious interest of PET, particularly in neurology, yield a series of problems that have to be faced without excessive fears or restraints. The problem faced is the amount and the quality of the information. (Auth.)

Reproducibility of automated simplified voxel-based analysis of PET amyloid ligand [11C]PIB uptake using 30-min scanning data

International Nuclear Information System (INIS)

Aalto, Sargo; Scheinin, Noora M.; Naagren, Kjell; Rinne, Juha O.; Kemppainen, Nina M.; Kailajaervi, Marita; Leinonen, Mika; Scheinin, Mika

2009-01-01

Positron emission tomography (PET) with 11 C-labelled Pittsburgh compound B ([ 11 C]PIB) enables the quantitation of β-amyloid accumulation in the brain of patients with Alzheimer's disease (AD). Voxel-based image analysis techniques conducted in a standard brain space provide an objective, rapid and fully automated method to analyze [ 11 C]PIB PET data. The purpose of this study was to evaluate both region- and voxel-level reproducibility of automated and simplified [ 11 C]PIB quantitation when using only 30 min of imaging data. Six AD patients and four healthy controls were scanned twice with an average interval of 6 weeks. To evaluate the feasibility of short scanning (convenient for AD patients), [ 11 C]PIB uptake was quantitated using 30 min of imaging data (60 to 90 min after tracer injection) for region-to-cerebellum ratio calculations. To evaluate the reproducibility, a test-retest design was used to derive absolute variability (VAR) estimates and intraclass correlation coefficients at both region-of-interest (ROI) and voxel level. The reproducibility both at the region level (VAR 0.9-5.5%) and at the voxel level (VAR 4.2-6.4%) was good to excellent. Based on the variability estimates obtained, power calculations indicated that 90% power to obtain statistically significant difference can be achieved using a sample size of five subjects per group when a 15% change from baseline (increase or decrease) in [ 11 C]PIB accumulation in the frontal cortex is anticipated in one group compared to no change in another group. Our results showed that an automated analysis method based on an efficient scanning protocol provides reproducible results for [ 11 C]PIB uptake and appears suitable for PET studies aiming at the quantitation of amyloid accumulation in the brain of AD patients for the evaluation of progression and treatment effects. (orig.)

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

Energy Technology Data Exchange (ETDEWEB)

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

2005-07-01

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

Preliminary assessment of fluorine-18 fluorodeoxyglucose positron emission tomography in patients with bladder cancer

International Nuclear Information System (INIS)

Kosuda, S.; Kison, P.V.; Greenough, R.; Grossman, H.B.; Wahl, R.L.

1997-01-01

The purpose of this study was to assess the feasibility of imaging of bladder cancer with fluorine-18 fluorodeoxyglucose positron emission tomography (FDG-PET) scanning. We studied 12 patients with histologically proven bladder cancer who had undergone surgical procedures and/or radiotherapy. Retrograde irrigation of the urinary bladder with 1000-3710 ml saline was performed during nine of the studies. Dynamic and static PET images were obtained, and standardized uptake value images were reconstructed. FDG-PET scanning was true-positive in eight patients (66.7%), but false-negative in four (33.3%). Of 20 organs with tumor mass lesions confirmed pathologically or clinically, 16 (80%) were detected by FDG-PET scanning. FDG-PET scanning detected all of 17 distant metastatic lesions and two of three proven regional lymph node metastases. FDG-PET was also capable of differentiating viable recurrent bladder cancer from radiation-induced alterations in two patients. In conclusion, these preliminary data indicate the feasibility of FDG-PET imaging in patients with bladder cancer, although a major remaining pitfall is intense FDG accumulation in the urine. (orig.). With 3 figs., 1 tab

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

Energy Technology Data Exchange (ETDEWEB)

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

2002-12-01

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

Usefulness of Positron Emission Tomography in Patients with Syphilis: A Systematic Review of Observational Studies.

Science.gov (United States)

Chen, Jian-Hua; Zheng, Xin; Liu, Xiu-Qin

2017-05-05

Diagnosis of syphilis is difficult. Follow-up and therapy evaluation of syphilitic patients are poor. Little is known about positron emission tomography (PET) in syphilis. This review was to systematically review usefulness of PET for diagnosis, disease extent evaluation, follow-up, and treatment response assessment in patients with syphilis. We searched PubMed, EMBASE, SCOPUS, Cochrane Library, Web of Science, ClinicalTrials.gov, and three Chinese databases (SinoMed, Wanfang, and CNKI) for English and Chinese language articles from inception to September 2016. We also collected potentially relevant studies and reviews using a manual search. The search keywords included the combined text and MeSH terms "syphilis" and "positron emission tomography". We included studies that reporting syphilis with a PET scan before and/or after antibiotic treatment. The diagnosis of syphilis was based on serological criteria or dark field microscopy. Outcomes include pre- and post-treatment PET scan, pre- and post-treatment computed tomography, and pre- and post-treatment magnetic resonance imaging. We excluded the articles not published in English or Chinese or not involving humans. Of 258 identified articles, 34 observational studies were included. Thirty-three studies were single-patient case reports and one study was a small case series. All patients were adults. The mean age of patients was 48.3 ± 12.1 years. In primary syphilis, increased fluorodeoxyglucose (FDG) accumulation could be seen at the site of inoculation or in the regional lymph nodes. In secondary syphilis with lung, bone, gastrointestinal involvement, or generalized lymphadenopathy, increased FDG uptake was the most commonly detected changes. In tertiary syphilis, increased glucose metabolic activity, hypometabolic lesions, or normal glucose uptake might be seen on PET. There were five types of PET scans in neurosyphilis. A repeated PET scan after treatment revealed apparent or complete resolution of the

False Positive Uptake in Bilateral Gynecomastia on 68Ga-PSMA PET/CT Scan.

Science.gov (United States)

Sasikumar, Arun; Joy, Ajith; Nair, Bindu P; Pillai, M R A; Madhavan, Jayaprakash

2017-09-01

A 66-year-old man on hormonal therapy with prostate cancer was referred for Ga-PSMA PET/CT scan for biochemical recurrence. Ga-PSMA PET/CT scan detected moderate heterogeneous tracer concentration in bilateral breast parenchyma, in addition to the abnormal tracer concentration in enlarged prostate gland, right external iliac lymph node, and sclerotic lesion in L4 vertebra. On clinical examination, he was found to have bilateral gynecomastia. Abnormal concentration of Ga-PSMA in breast cancer is now well known, and in this context, it is important to know that tracer localization can occur in gynecomastia as well, as evidenced in this case.

PET scanning of macrophages in patients with scleroderma fibrosing alveolitis

Energy Technology Data Exchange (ETDEWEB)

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

2008-11-15

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

PET scanning of macrophages in patients with scleroderma fibrosing alveolitis

International Nuclear Information System (INIS)

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

2008-01-01

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

18F-fluorodeoxyglucose positron emission tomography-positive sarcoidosis after chemoradiotherapy for Hodgkin’s disease: a case report

Directory of Open Access Journals (Sweden)

Pham Alan

2011-06-01

Full Text Available Abstract Introduction The occurrence of granulomatous disease in the setting of Hodgkin's disease is rare; however, when it occurs it can pose significant clinical and diagnostic challenges for physicians treating these patients. Case presentation We report the case of a 33-year-old Caucasian woman of Mediterranean descent with newly diagnosed 18F-fluorodeoxyglucose (18F-FDG positron emission tomography (PET/computed tomography (CT scan-positive, early-stage Hodgkin's disease involving the cervical nodes who, despite having an excellent clinical response to chemotherapy, had a persistent 18F-FDG PET scan-positive study, which was suggestive of residual or progressive disease. A subsequent biopsy of her post-chemotherapy PET-positive nodes demonstrated sarcoidosis with no evidence of Hodgkin's disease. Conclusion This case highlights the fact that abnormalities observed on posttherapy PET/CT scans in patients with Hodgkin's disease are not always due to residual or progressive disease. An association between Hodgkin's disease and/or its treatment with an increased incidence of granulomatous disease appears to exist. Certain patterns of 18F-FDG uptake observed on PET/CT scans may suggest other pathologies, such as granulomatous inflammation, and because of the significant differences in prognosis and management, clinicians should maintain a low threshold of confidence for basing their diagnosis on histopathological evaluations when PET/CT results appear to be incongruent with the patient's clinical response.

Predicting Outcome in Patients with Rhabdomyosarcoma: Role of [18F]Fluorodeoxyglucose Positron Emission Tomography

International Nuclear Information System (INIS)

Casey, Dana L.; Wexler, Leonard H.; Fox, Josef J.; Dharmarajan, Kavita V.; Schoder, Heiko; Price, Alison N.; Wolden, Suzanne L.

2014-01-01

Purpose: To evaluate whether [ 18 F]fluorodeoxyglucose positron emission tomography (FDG-PET) response of the primary tumor after induction chemotherapy predicts outcomes in rhabdomyosarcoma (RMS). Methods and Materials: After excluding those with initial tumor resection, 107 patients who underwent FDG-PET after induction chemotherapy at Memorial Sloan Kettering Cancer Center from 2002 to 2013 were reviewed. Local control (LC), progression-free survival (PFS), and overall survival (OS) were calculated according to FDG-PET response and maximum standardized uptake value (SUV) at baseline (PET1/SUV1), after induction chemotherapy (PET2/SUV2), and after local therapy (PET3/SUV3). Receiver operator characteristic curves were used to determine the optimal cutoff for dichotomization of SUV1 and SUV2 values. Results: The SUV1 (<9.5 vs ≥9.5) was predictive of PFS (P=.02) and OS (P=.02), but not LC. After 12 weeks (median) of induction chemotherapy, 45 patients had negative PET2 scans and 62 had positive scans: 3-year PFS was 72% versus 44%, respectively (P=.01). The SUV2 (<1.5 vs ≥1.5) was similarly predictive of PFS (P=.005) and was associated with LC (P=.02) and OS (P=.03). A positive PET3 scan was predictive of worse PFS (P=.0009), LC (P=.05), and OS (P=.03). Conclusions: [ 18 F]fluorodeoxyglucose positron emission tomography is an early indicator of outcomes in patients with RMS. Future prospective trials may incorporate FDG-PET response data for risk-adapted therapy and early assessment of new treatment regimens

Discordant Findings of Skeletal Metastasis Between Tc99m MDP Bone Scans and F18 FDG PET/CT Imaging for Advanced Breast and Lung Cancers—Two Case Reports and Literature Review

Directory of Open Access Journals (Sweden)

Yu-Wen Chen

2007-12-01

Full Text Available Traditionally, Tc99m methyl diphosphate (MDP bone scintigraphy provides high-sensitivity detection of skeletal metastasis from breast and lung cancers in regular follow-up. Fluorodeoxyglucose (FDG positron emission tomography/computed tomography (PET/CT, based on the glucose metabolism of malignant cells, plays a role in describing rumor growth, proliferation of neoplasm and the extent of metastasis. In general, concordant findings of skeletal metastasis are seen on both types of image, especially in cases of breast and lung cancer. However, there were extremely discordant findings of skeletal metastasis between bone scans and F18 FDG PET/CT imaging in two cases among 300 consecutive F18 FDG PET/CT follow-up exams of patients with malignancies, during the past year, in our center. Both cases, one of breast cancer and one of lung cancer, had negative bone scintigraphic findings, but a diffusely high grade of F18 FDG avid marrow infiltration in the axial spine, leading to the diagnosis of stage IV disease in both cases. Owing to variant genetic aberrance of malignance, F18 FDG PET/CT reveals direct evidence of diffuse, rapid neoplasm metabolism in the bone marrow of the spine, but not of secondary osteoblastic reactions in vivo. F18 FDG PET/CT should always be employed in the follow-up of patients with malignancies.

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

International Nuclear Information System (INIS)

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

2011-01-01

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

Variation in positron emission tomography use after colon cancer resection.

Science.gov (United States)

Bailey, Christina E; Hu, Chung-Yuan; You, Y Nancy; Kaur, Harmeet; Ernst, Randy D; Chang, George J

2015-05-01

Colon cancer surveillance guidelines do not routinely include positron emission tomography (PET) imaging; however, its use after surgical resection has been increasing. We evaluated the secular patterns of PET use after surgical resection of colon cancer among elderly patients and identified factors associated with its increasing use. We used the SEER-linked Medicare database (July 2001 through December 2009) to establish a retrospective cohort of patients age ≥ 66 years who had undergone surgical resection for colon cancer. Postoperative PET use was assessed with the test for trends. Patient, tumor, and treatment characteristics were analyzed using univariable and multivariable logistic regression analyses. Of the 39,221 patients with colon cancer, 6,326 (16.1%) had undergone a PET scan within 2 years after surgery. The use rate steadily increased over time. The majority of PET scans had been performed within 2 months after surgery. Among patients who had undergone a PET scan, 3,644 (57.6%) had also undergone preoperative imaging, and 1,977 (54.3%) of these patients had undergone reimaging with PET within 2 months after surgery. Marriage, year of diagnosis, tumor stage, preoperative imaging, postoperative visit to a medical oncologist, and adjuvant chemotherapy were significantly associated with increased PET use. PET use after colon cancer resection is steadily increasing, and further study is needed to understand the clinical value and effectiveness of PET scans and the reasons for this departure from guideline-concordant care. Copyright © 2015 by American Society of Clinical Oncology.

Function's evaluation, perfusion and metabolism by positron emission tomography associated with multislice tomography (PET/CT) in patient with previous diagnosis to myocardial necrosis

International Nuclear Information System (INIS)

Campisi, Roxana; Aramayo, Natalia; Osorio, Amilcar

2010-01-01

A 64-years-old male patient with previous diagnosis of myocardial necrosis as assessed by myocardial perfusion gated single photon emission computed tomography (gSPECT) with 3-vessel-disease, left ventricular dysfunction and symptomatic by epigastric pain. The patient was referred for myocardial viability assessment by positron emission tomography (PET) to define clinical management decision. (authors) [es

Respiratory gating in cardiac PET

DEFF Research Database (Denmark)

Lassen, Martin Lyngby; Rasmussen, Thomas; Christensen, Thomas E

2017-01-01

BACKGROUND: Respiratory motion due to breathing during cardiac positron emission tomography (PET) results in spatial blurring and erroneous tracer quantification. Respiratory gating might represent a solution by dividing the PET coincidence dataset into smaller respiratory phase subsets. The aim...... of our study was to compare the resulting imaging quality by the use of a time-based respiratory gating system in two groups administered either adenosine or dipyridamole as the pharmacological stress agent. METHODS AND RESULTS: Forty-eight patients were randomized to adenosine or dipyridamole cardiac...... stress (82)RB-PET. Respiratory rates and depths were measured by a respiratory gating system in addition to registering actual respiratory rates. Patients undergoing adenosine stress showed a decrease in measured respiratory rate from initial to later scan phase measurements [12.4 (±5.7) vs 5.6 (±4...

High-resolution dynamic imaging and quantitative analysis of lung cancer xenografts in nude mice using clinical PET/CT.

Science.gov (United States)

Wang, Ying Yi; Wang, Kai; Xu, Zuo Yu; Song, Yan; Wang, Chu Nan; Zhang, Chong Qing; Sun, Xi Lin; Shen, Bao Zhong

2017-08-08

Considering the general application of dedicated small-animal positron emission tomography/computed tomography is limited, an acceptable alternative in many situations might be clinical PET/CT. To estimate the feasibility of using clinical PET/CT with [F-18]-fluoro-2-deoxy-D-glucose for high-resolution dynamic imaging and quantitative analysis of cancer xenografts in nude mice. Dynamic clinical PET/CT scans were performed on xenografts for 60 min after injection with [F-18]-fluoro-2-deoxy-D-glucose. Scans were reconstructed with or without SharpIR method in two phases. And mice were sacrificed to extracting major organs and tumors, using ex vivo γ-counting as a reference. Strikingly, we observed that the image quality and the correlation between the all quantitive data from clinical PET/CT and the ex vivo counting was better with the SharpIR reconstructions than without. Our data demonstrate that clinical PET/CT scanner with SharpIR reconstruction is a valuable tool for imaging small animals in preclinical cancer research, offering dynamic imaging parameters, good image quality and accurate data quatification.

Quality assurance and radiation safety in positron emission tomography

International Nuclear Information System (INIS)

Kmetyuk, Ya.V.; Radosh, H.V.; Bezshyyko, O.A.; Golinka-Bezshyyko, L.O.; Kadenko, I.M.; Kazinova, O.A.; Nagai, A.O.

2012-01-01

Scientific studies, clinical experience and economic analysis have shown that the positron emission tomography (PET) is clinically and cost effective cancer diagnostics method. Combined PET and computed tomography (PET/CT) has proven clinical utility, particularly in the diagnosis, staging or restaging malignant disease and metastases, surgical planning, radiation therapy planning and evaluation of treatment response. The use of PET/CT has grown substantially in the past few years, with an increasing number of hospitals and installations of PET/CT imaging centers each year. In the same time combination of 2 procedures, each of which impart a radiation dose and, as a result, increases the deleterious influence for health, creates additional radiation safety issues. In these conditions the role of quality assurance (QA) and quality control (QC) programs is getting more and more important. We considered main QA and radiation safety requirements for whole PET technology chain from radio-pharmacy facilities to PET/CT scanning and patient release criteria. All these issues were considered and assessed having the example of PET facilities and technology chain of All-Ukrainian Center for Radiosurgery of the Clinical Hospital 'Feofania'

Initial clinical evaluation of PET-based ion beam therapy monitoring under consideration of organ motion.

Science.gov (United States)

Kurz, Christopher; Bauer, Julia; Unholtz, Daniel; Richter, Daniel; Herfarth, Klaus; Debus, Jürgen; Parodi, Katia

2016-02-01

Intrafractional organ motion imposes considerable challenges to scanned ion beam therapy and demands for a thorough verification of the applied treatment. At the Heidelberg Ion-Beam Therapy Center (HIT), the scanned ion beam delivery is verified by means of postirradiation positron-emission-tomography (PET) imaging. This work presents a first clinical evaluation of PET-based treatment monitoring in ion beam therapy under consideration of target motion. Three patients with mobile liver lesions underwent scanned carbon ion irradiation at HIT and postirradiation PET/CT (x-ray-computed-tomography) imaging with a commercial scanner. Respiratory motion was recorded during irradiation and subsequent image acquisition. This enabled a time-resolved (4D) calculation of the expected irradiation-induced activity pattern and, for one patient where an additional 4D CT was acquired at the PET/CT scanner after treatment, a motion-compensated PET image reconstruction. For the other patients, PET data were reconstructed statically. To verify the treatment, calculated prediction and reconstructed measurement were compared with a focus on the ion beam range. Results in the current three patients suggest that for motion amplitudes in the order of 2 mm there is no benefit from incorporating respiratory motion information into PET-based treatment monitoring. For a target motion in the order of 10 mm, motion-related effects become more severe and a time-resolved modeling of the expected activity distribution can lead to an improved data interpretation if a sufficient number of true coincidences is detected. Benefits from motion-compensated PET image reconstruction could not be shown conclusively at the current stage. The feasibility of clinical PET-based treatment verification under consideration of organ motion has been shown for the first time. Improvements in noise-robust 4D PET image reconstruction are deemed necessary to enhance the clinical potential.

Initial clinical evaluation of PET-based ion beam therapy monitoring under consideration of organ motion

International Nuclear Information System (INIS)

Kurz, Christopher; Bauer, Julia; Unholtz, Daniel; Herfarth, Klaus; Debus, Jürgen; Richter, Daniel; Parodi, Katia

2016-01-01

Purpose: Intrafractional organ motion imposes considerable challenges to scanned ion beam therapy and demands for a thorough verification of the applied treatment. At the Heidelberg Ion-Beam Therapy Center (HIT), the scanned ion beam delivery is verified by means of postirradiation positron-emission-tomography (PET) imaging. This work presents a first clinical evaluation of PET-based treatment monitoring in ion beam therapy under consideration of target motion. Methods: Three patients with mobile liver lesions underwent scanned carbon ion irradiation at HIT and postirradiation PET/CT (x-ray-computed-tomography) imaging with a commercial scanner. Respiratory motion was recorded during irradiation and subsequent image acquisition. This enabled a time-resolved (4D) calculation of the expected irradiation-induced activity pattern and, for one patient where an additional 4D CT was acquired at the PET/CT scanner after treatment, a motion-compensated PET image reconstruction. For the other patients, PET data were reconstructed statically. To verify the treatment, calculated prediction and reconstructed measurement were compared with a focus on the ion beam range. Results: Results in the current three patients suggest that for motion amplitudes in the order of 2 mm there is no benefit from incorporating respiratory motion information into PET-based treatment monitoring. For a target motion in the order of 10 mm, motion-related effects become more severe and a time-resolved modeling of the expected activity distribution can lead to an improved data interpretation if a sufficient number of true coincidences is detected. Benefits from motion-compensated PET image reconstruction could not be shown conclusively at the current stage. Conclusions: The feasibility of clinical PET-based treatment verification under consideration of organ motion has been shown for the first time. Improvements in noise-robust 4D PET image reconstruction are deemed necessary to enhance the

False positive diagnosis of malignancy in a case of cryptogenic organising pneumonia presenting as a pulmonary mass with mediastinal nodes detected on fluorodeoxyglucose-positron emission tomography: a case report

Science.gov (United States)

2009-01-01

Introduction We report the case of a patient with positive findings on a lung emission tomography/computed tomography (PET/CT) scan, with possible contra lateral mediastinal involvement, which strongly suggested an inoperable lung carcinoma. The lung mass proved to be a cryptogenic organising pneumonia. While the latter has previously been shown to be PET/CT positive, mediastinal involvement simulating malignant spread has not been previously reported. Case presentation A 50-year-old Caucasian woman presented with a history of unproductive cough and was found to have a mass in the right upper lobe as shown on chest X-ray and a computed tomography scan. A subsequent PET/CT scan showed strong uptake in the right upper lobe (maximum standard uptake values (SUVmax) 9.6) with increased uptake in the adjacent mediastinum and contralateral mediastinal nodes. Surgical resection and mediastinoscopy revealed cryptogenic organising pneumonia, with enlarged reactive mediastinal lymph nodes. Conclusion The case illustrates the limits of PET/CT scanning as a diagnostic tool, and emphasizes the importance of obtaining histological confirmation of malignant diseases whenever possible. PMID:19946541

Early Detection of Brain Pathology Suggestive of Early AD Using Objective Evaluation of FDG-PET Scans

Directory of Open Access Journals (Sweden)

James C. Patterson

2011-01-01

Full Text Available The need for early detection of AD becomes critical as disease-modifying agents near the marketplace. Here, we present results from a study focused on improvement in detection of metabolic deficits related to neurodegenerative changes consistent with possible early AD with statistical evaluation of FDG-PET brain images. We followed 31 subjects at high risk or diagnosed with MCI/AD for 3 years. 15 met criteria for diagnosis of MCI, and five met criteria for AD. FDG-PET scans were completed at initiation and termination of the study. PET scans were read clinically and also evaluated objectively using Statistical Parametric Mapping (SPM. Using standard clinical evaluation of the FDG-PET scans, 11 subjects were detected, while 18 were detected using SPM evaluation. These preliminary results indicate that objective analyses may improve detection; however, early detection in at-risk normal subjects remains tentative. Several FDA-approved software packages are available that use objective analyses, thus the capacity exists for wider use of this method for MCI/AD.

18F-FDG PET/CT compared to conventional imaging modalities in pediatric primary bone tumors

International Nuclear Information System (INIS)

London, Kevin; Stege, Claudia; Kaspers, Gertjan; Cross, Siobhan; Dalla-Pozza, Luciano; Onikul, Ella; Graf, Nicole; Howman-Giles, Robert

2012-01-01

F-Fluoro-2-deoxy-d-glucose (FDG) positron emission tomography (PET) is useful in adults with primary bone tumors. Limited published data exist in children. To compare hybrid FDG positron emission tomography/computed tomography (PET/CT) with conventional imaging (CI) modalities in detecting malignant lesions, predicting response to chemotherapy and diagnosing physeal involvement in pediatric primary bone tumors. Retrospective analysis of PET/CT and CI reports with histopathology or follow-up > 6 months as reference standard. Response parameters and physeal involvement at diagnosis were compared to histopathology. A total of 314 lesions were detected in 86 scans. Excluding lung lesions, PET/CT had higher sensitivity and specificity than CI (83%, 98% and 78%, 97%, respectively). In lung lesions, PET/CT had higher specificity than CI (96% compared to 87%) but lower sensitivity (80% compared to 93%). Higher initial SUV max and greater SUV max reduction on PET/CT after chemotherapy predicted a good response. Change in tumor size on MRI did not predict response. Both PET/CT and MRI were very sensitive but of low specificity in predicting physeal tumor involvement. PET/CT appears more accurate than CI in detecting malignant lesions in childhood primary bone tumors, excluding lung lesions. It seems better than MRI at predicting tumor response to chemotherapy. (orig.)

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

International Nuclear Information System (INIS)

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

2015-01-01

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

13N-ammonia myocardial perfusion imaging with a PET/CT scanner: impact on clinical decision making and cost-effectiveness

International Nuclear Information System (INIS)

Siegrist, Patrick T.; Husmann, Lars; Knabenhans, Martina; Gaemperli, Oliver; Valenta, Ines; Hoefflinghaus, Tobias; Scheffel, Hans; Stolzmann, Paul; Alkadhi, Hatem; Kaufmann, Philipp A.

2008-01-01

The purpose of the study is to determine the impact of 13 N-ammonia positron emission tomography (PET) myocardial perfusion imaging (MPI) on clinical decision making and its cost-effectiveness. One hundred consecutive patients (28 women, 72 men; mean age 60.9 ± 12.0 years; range 24-85 years) underwent 13 N-ammonia PET scanning (and computed tomography, used only for attenuation correction) to assess myocardial perfusion in patients with known (n = 79) or suspected (n = 8) coronary artery disease (CAD), or for suspected small-vessel disease (SVD; n = 13). Before PET, the referring physician was asked to determine patient treatment if PET would not be available. Four weeks later, PET patient management was reassessed for each patient individually. Before PET management strategies would have been: diagnostic angiography (62 of 100 patients), diagnostic angiography and percutaneous coronary intervention (PCI; 6 of 100), coronary artery bypass grafting (CABG; 3 of 100), transplantation (1 of 100), or conservative medical treatment (28 of 100). After PET scanning, treatment strategies were altered in 78 patients leading to: diagnostic angiography (0 of 100), PCI (20 of 100), CABG (3 of 100), transplantation (1 of 100), or conservative medical treatment (76 of 100). Patient management followed the recommendations of PET findings in 97% of the cases. Cost-effectiveness analysis revealed lower costs of EUR206/patient as a result of PET scanning. In a population with a high prevalence of known CAD, PET is cost-effective and has an important impact on patient management. (orig.)

Hypoxia positron emission tomography imaging: combining information on perfusion and tracer retention to improve hypoxia specificity

DEFF Research Database (Denmark)

Busk, Morten; Munk, Ole L; Jakobsen, Steen S

2017-01-01

BACKGROUND: Static positron emission tomography (PET) allows mapping of tumor hypoxia, but low resolution and slow tracer retention/clearance results in poor image contrast and the risk of missing areas where hypoxic cells and necrosis are intermixed. Fully dynamic PET may improve accuracy but scan...

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

Science.gov (United States)

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

2004-01-01

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

Scanning transmission ion micro-tomography (STIM-T) of biological specimens

International Nuclear Information System (INIS)

Schwertner, Michael; Sakellariou, Arthur; Reinert, Tilo; Butz, Tilman

2006-01-01

Computed tomography (CT) was applied to sets of Scanning Transmission Ion Microscopy (STIM) projections recorded at the LIPSION ion beam laboratory (Leipzig) in order to visualize the 3D-mass distribution in several specimens. Examples for a test structure (copper grid) and for biological specimens (cartilage cells, cygospore) are shown. Scanning Transmission Micro-Tomography (STIM-T) at a resolution of 260 nm was demonstrated for the first time. Sub-micron features of the Cu-grid specimen were verified by scanning electron microscopy. The ion energy loss measured during a STIM-T experiment is related to the mass density of the specimen. Typically, biological specimens can be analysed without staining. Only shock freezing and freeze-drying is required to preserve the ultra-structure of the specimen. The radiation damage to the specimen during the experiment can be neglected. This is an advantage compared to other techniques like X-ray micro-tomography. At present, the spatial resolution is limited by beam position fluctuations and specimen vibrations

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

International Nuclear Information System (INIS)

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

2016-01-01

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

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

Energy Technology Data Exchange (ETDEWEB)

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

2016-06-15

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

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

Science.gov (United States)

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

2010-04-01

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

Positron emission tomography

CERN Document Server

Paans, A M J

2006-01-01

Positron Emission Tomography (PET) is a method for measuring biochemical and physiological processes in vivo in a quantitative way by using radiopharmaceuticals labelled with positron emitting radionuclides such as 11C, 13N, 15O and 18F and by measuring the annihilation radiation using a coincidence technique. This includes also the measurement of the pharmacokinetics of labelled drugs and the measurement of the effects of drugs on metabolism. Also deviations of normal metabolism can be measured and insight into biological processes responsible for diseases can be obtained. At present the combined PET/CT scanner is the most frequently used scanner for whole-body scanning in the field of oncology.

Simultaneous fast scanning XRF, dark field, phase-, and absorption contrast tomography

Science.gov (United States)

Medjoubi, Kadda; Bonissent, Alain; Leclercq, Nicolas; Langlois, Florent; Mercère, Pascal; Somogyi, Andrea

2013-09-01

Scanning hard X-ray nanoprobe imaging provides a unique tool for probing specimens with high sensitivity and large penetration depth. Moreover, the combination of complementary techniques such as X-ray fluorescence, absorption, phase contrast and dark field imaging gives complete quantitative information on the sample structure, composition and chemistry. The multi-technique "FLYSCAN" data acquisition scheme developed at Synchrotron SOLEIL permits to perform fast continuous scanning imaging and as such makes scanning tomography techniques feasible in a time-frame well-adapted to typical user experiments. Here we present the recent results of simultaneous fast scanning multi-technique tomography performed at Soleil. This fast scanning scheme will be implemented at the Nanoscopium beamline for large field of view 2D and 3D multimodal imaging.

Test-retest variability of high resolution positron emission tomography (PET) imaging of cortical serotonin (5HT2A) receptors in older, healthy adults

International Nuclear Information System (INIS)

Chow, Tiffany W; Mamo, David C; Uchida, Hiroyuki; Graff-Guerrero, Ariel; Houle, Sylvain; Smith, Gwenn S; Pollock, Bruce G; Mulsant, Benoit H

2009-01-01

Position emission tomography (PET) imaging using [ 18 F]-setoperone to quantify cortical 5-HT 2A receptors has the potential to inform pharmacological treatments for geriatric depression and dementia. Prior reports indicate a significant normal aging effect on serotonin 5HT 2A receptor (5HT 2A R) binding potential. The purpose of this study was to assess the test-retest variability of [ 18 F]-setoperone PET with a high resolution scanner (HRRT) for measuring 5HT 2A R availability in subjects greater than 60 years old. Methods: Six healthy subjects (age range = 65–78 years) completed two [ 18 F]-setoperone PET scans on two separate occasions 5–16 weeks apart. The average difference in the binding potential (BP ND ) as measured on the two occasions in the frontal and temporal cortical regions ranged between 2 and 12%, with the lowest intraclass correlation coefficient in anterior cingulate regions. We conclude that the test-retest variability of [ 18 F]-setoperone PET in elderly subjects is comparable to that of [ 18 F]-setoperone and other 5HT 2A R radiotracers in younger subject samples

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

Science.gov (United States)

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

2009-09-01

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

3D quantification of soil structure and functioning based on PET and CT scanning techniques

DEFF Research Database (Denmark)

Garbout, Amin

This thesis explores the potential of PET and CT scanning techniques to quantify and visualize soil structure, root development, and soil/plant interactions. At the investigated scale, these non-invasive and nondestructive techniques have some obvious advantages compared with most other techniques....... The processed measurements show some expected and a few unexpected effects (or lack of effects) on different characteristics of soil structure. The combination of CT and PET scanning in an air plant soil controller system revealed some very interesting research possibilities. Interactions between soil structure...

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

Energy Technology Data Exchange (ETDEWEB)

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

2005-12-15

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

[Scans without Evidence of Dopamine Deficit (SWEDDs)].

Science.gov (United States)

Mukai, Yohei; Murata, Miho

2016-01-01

Dopamine transporter (DaT) single-photon emission computed tomography (SPECT) and [18F]fluoro-L-DOPA ([18F]DOPA) positron emission tomography (PET) facilitate the investigation of dopaminergic hypofunction in neurodegenerative diseases. DaT SPECT and [18F]DOPA PET have been adopted as survey tools in clinical trials. In a large study on Parkinson's disease, 4-15% of subjects clinically diagnosed with early-stage Parkinson's disease had normal dopaminergic functional imaging scans. These are called Scans without Evidence of Dopamine Deficit (SWEDDs), and are considered to represent a state different from Parkinson's disease. Neurological diseases that exhibit parkinsonism and have normal dopaminergic cells in the nigrostriatal system (e.g., essential tremor, psychogenic parkinsonism, DOPA-responsive dystonia, vascular parkinsonism, drug-induced parkinsonism, manganism, brain tumor, myoclonus-dystonia (DYT11), and fragile X syndrome) might be diagnosed with SWEDDs. True bradykinesia with fatigue or decrement may be useful for distinguishing between Parkinson's disease and SWEDDs. However, because SWEDDs encompass many diseases, their properties may not be uniform. In this review, we discuss DaT SPECT, the concept of SWEDDs, and differential diagnosis.

Imaging of the pancreas using positron emission tomography with N-13 ammonia

International Nuclear Information System (INIS)

Hayashi, N.; Tamaki, N.; Yamamoto, K.; Senda, M.; Yonekura, Y.; Saji, H.; Nishizawa, S.; Adachi, H.; Torizuka, K.

1986-01-01

A new technique for imaging the pancreas was developed using positron emission tomography (PET) with N-13 ammonia. Four healthy volunteers and 15 patients with pancreatic diseases were studied. After intravenous injection of 10-20 mCi of N-13 ammonia, serial PET scans were obtained every 150 seconds. In the healthy subjects, the pancreas was clearly visualized from the earliest scan. Scans in all ten patients with pancreatic cancer were abnormal. In five patients tumors were visualized as hot spots. When there was severe associated pancreatitis due to pancreatic duct obstruction by tumor, the radionuclide accumulation in the pancreas was remarkably low

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

International Nuclear Information System (INIS)

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

2014-01-01

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

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

Energy Technology Data Exchange (ETDEWEB)

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

2014-03-15

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

Magnetic resonance imaging-guided attenuation correction of positron emission tomography data in PET/MRI

Science.gov (United States)

Izquierdo-Garcia, David; Catana, Ciprian

2018-01-01

Synopsis Attenuation correction (AC) is one of the most important challenges in the recently introduced combined positron emission tomography/magnetic resonance imaging (PET/MR) scanners. PET/MR AC (MR-AC) approaches aim to develop methods that allow accurate estimation of the linear attenuation coefficients (LACs) of the tissues and other components located in the PET field of view (FoV). MR-AC methods can be divided into three main categories: segmentation-, atlas- and PET-based. This review aims to provide a comprehensive list of the state of the art MR-AC approaches as well as their pros and cons. The main sources of artifacts such as body-truncation, metallic implants and hardware correction will be presented. Finally, this review will discuss the current status of MR-AC approaches for clinical applications. PMID:26952727

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

Science.gov (United States)

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

2016-06-01

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

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

Science.gov (United States)

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

2018-02-01

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

TH-E-BRF-10: Interim Esophageal Cancer Response Assessment Via 18FDG-PET Scanning During Radiation Therapy

Energy Technology Data Exchange (ETDEWEB)

Higgins, K [Duke University Medical Physics Graduate Program, Durham, NC (United States); Wu, Q; Perez, B; Czito, B; Palta, M; Willett, C; Das, S [Duke University Medical Center, Durham, NC (United States)

2014-06-15

Purpose: Local failure occurs in a large proportion of esophageal cancer patients treated with chemoradiation. The treatment strategy for non-responders could potentially be modified if they are identified during therapy. This work investigates the utility of an interim 18FDG-PET scan acquired during the course of therapy as a predictor of pathological response post-therapy. Methods: Fifteen patients underwent 18FDG-PET scanning prior to radiation therapy (RT) and once during RT, after delivery of ∼32 Gy. The physician-contoured GTV on the planning CT scan was used to automatically segment a PET-based GTV on the pre-RT PET (GTV-pre-PET) as the volume with >40% of the maximum GTV PET SUV value. The pre- and intra-RT CTs were deformably registered to each other to transfer the GTV-pre-PET to the intra-RT PET (GTV-intra-PET). The fractional decrease in the maximum SUV, mean SUV and the SUV to the highest intensity 10% – 90% volumes from GTV-pre-PET to GTV-intra-PET were compared to pathological response assessed at the time of post-RT surgery. Results: Based on post-treatment pathology of 15 patients, 7 were classified as achieving favorable response (treatment effect grade ≤ 1) and 8 as unfavorable response (treatment effect grade > 1). Neither fractional decrease in maximum SUV nor mean SUV were significant between the favorable and unfavorable groups. However, the fractional decrease in SUV20% (SUV to the highest 20% volume) was significant (p = 0.02), with an area under the Receiver Operating Characteristics (ROC) curve of 0.84. An optimal cutoff value of 0.46 for this metric was able to distinguish between the two groups with 71% sensitivity (favorable) and 88% specificity (unfavorable). Conclusion: The fractional decrease in SUV to the volume with highest 20% intensity from pre- to intra-RT 18FDG-PET imaging may be used to distinguish between favorable and unfavorable responders with high sensitivity and specificity.

TH-E-BRF-10: Interim Esophageal Cancer Response Assessment Via 18FDG-PET Scanning During Radiation Therapy

International Nuclear Information System (INIS)

Higgins, K; Wu, Q; Perez, B; Czito, B; Palta, M; Willett, C; Das, S

2014-01-01

Purpose: Local failure occurs in a large proportion of esophageal cancer patients treated with chemoradiation. The treatment strategy for non-responders could potentially be modified if they are identified during therapy. This work investigates the utility of an interim 18FDG-PET scan acquired during the course of therapy as a predictor of pathological response post-therapy. Methods: Fifteen patients underwent 18FDG-PET scanning prior to radiation therapy (RT) and once during RT, after delivery of ∼32 Gy. The physician-contoured GTV on the planning CT scan was used to automatically segment a PET-based GTV on the pre-RT PET (GTV-pre-PET) as the volume with >40% of the maximum GTV PET SUV value. The pre- and intra-RT CTs were deformably registered to each other to transfer the GTV-pre-PET to the intra-RT PET (GTV-intra-PET). The fractional decrease in the maximum SUV, mean SUV and the SUV to the highest intensity 10% – 90% volumes from GTV-pre-PET to GTV-intra-PET were compared to pathological response assessed at the time of post-RT surgery. Results: Based on post-treatment pathology of 15 patients, 7 were classified as achieving favorable response (treatment effect grade ≤ 1) and 8 as unfavorable response (treatment effect grade > 1). Neither fractional decrease in maximum SUV nor mean SUV were significant between the favorable and unfavorable groups. However, the fractional decrease in SUV20% (SUV to the highest 20% volume) was significant (p = 0.02), with an area under the Receiver Operating Characteristics (ROC) curve of 0.84. An optimal cutoff value of 0.46 for this metric was able to distinguish between the two groups with 71% sensitivity (favorable) and 88% specificity (unfavorable). Conclusion: The fractional decrease in SUV to the volume with highest 20% intensity from pre- to intra-RT 18FDG-PET imaging may be used to distinguish between favorable and unfavorable responders with high sensitivity and specificity

PET imaging of inflammation

International Nuclear Information System (INIS)

Buscombe, J. R.

2014-01-01

Inflammatory diseases are common place and often chronic. Most inflammatory cells have increased uptake of glucose which is enhanced in the presence of local cytokines. Therefore, imaging glucose metabolism by the means of 18F-fluoro-deoxy-glucose (FDG) positron emission tomography (PET) holds significant promise in imaging focal inflammation. Most of the work published involved small series of patients with either vasculitis, sarcoid or rheumatoid arthritis. It would appear that FDG PET is a simple and effective technique to identify inflammatory tissue in these conditions. There is even some work to suggest that by comparing baseline and early post therapy scans clinical outcome can be predicted. This would appear to be true with vasculitis as well as retroperitoneal fibrosis. The number of patients in each study is small but the evidence is compelling enough to recommend FDG PET imaging in the routine care of these patients.

Binary classification of ¹⁸F-flutemetamol PET using machine learning

DEFF Research Database (Denmark)

Vandenberghe, Rik; Nelissen, Natalie; Salmon, Eric

2013-01-01

(18)F-flutemetamol is a positron emission tomography (PET) tracer for in vivo amyloid imaging. The ability to classify amyloid scans in a binary manner as 'normal' versus 'Alzheimer-like', is of high clinical relevance. We evaluated whether a supervised machine learning technique, support vector ...

{sup 18}F-FDG PET/CT compared to conventional imaging modalities in pediatric primary bone tumors

Energy Technology Data Exchange (ETDEWEB)

London, Kevin [The Children' s Hospital at Westmead, Department of Nuclear Medicine, Sydney, NSW (Australia); University of Sydney, Discipline of Paediatrics and Child Health, Sydney Medical School, Sydney, NSW (Australia); Stege, Claudia; Kaspers, Gertjan [VU Medical Centre, Divisions of Paediatric Oncology/Haematology, Amsterdam (Netherlands); Cross, Siobhan; Dalla-Pozza, Luciano [The Children' s Hospital at Westmead, Department of Oncology, Sydney (Australia); Onikul, Ella [The Children' s Hospital at Westmead, Department of Medical Imaging, Sydney (Australia); Graf, Nicole [The Children' s Hospital at Westmead, Department of Pathology, Sydney (Australia); Howman-Giles, Robert [The Children' s Hospital at Westmead, Department of Nuclear Medicine, Sydney, NSW (Australia); University of Sydney, Discipline of Imaging, Sydney Medical School, Sydney, NSW (Australia)

2012-04-15

F-Fluoro-2-deoxy-d-glucose (FDG) positron emission tomography (PET) is useful in adults with primary bone tumors. Limited published data exist in children. To compare hybrid FDG positron emission tomography/computed tomography (PET/CT) with conventional imaging (CI) modalities in detecting malignant lesions, predicting response to chemotherapy and diagnosing physeal involvement in pediatric primary bone tumors. Retrospective analysis of PET/CT and CI reports with histopathology or follow-up > 6 months as reference standard. Response parameters and physeal involvement at diagnosis were compared to histopathology. A total of 314 lesions were detected in 86 scans. Excluding lung lesions, PET/CT had higher sensitivity and specificity than CI (83%, 98% and 78%, 97%, respectively). In lung lesions, PET/CT had higher specificity than CI (96% compared to 87%) but lower sensitivity (80% compared to 93%). Higher initial SUV{sub max} and greater SUV{sub max} reduction on PET/CT after chemotherapy predicted a good response. Change in tumor size on MRI did not predict response. Both PET/CT and MRI were very sensitive but of low specificity in predicting physeal tumor involvement. PET/CT appears more accurate than CI in detecting malignant lesions in childhood primary bone tumors, excluding lung lesions. It seems better than MRI at predicting tumor response to chemotherapy. (orig.)