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Sample records for tomography-computed tomography pet-ct

  1. 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.

  2. Prospective evaluation of fluorodeoxyglucose positron emission tomography/computed tomography scan (FDG-PET/CT) for axillary staging in breast cancer

    International Nuclear Information System (INIS)

    Yamaguchi, Masahide; Noguchi, Akinori; Tani, Naoki

    2008-01-01

    Seventy-two patients from 2005 October to 2007 February with operative breast cancer underwent fluorodeoxyglucose positron emission tomography/computed tomography scan (FDG-PET/CT) of chest and body, ultrasound scan (US) and enhanced computed tomography scan (CT) followed by sentinel lymph node biopsy (SLNB) and axillary lymph node dissection (ALND). The results of PET/CT were compared with histopathological diagnosis of SLNB and ALND. Sensitivity, specificity and accuracy of PET/CT for detection of axillary lymph node metastases were 61%, 96% and 88%, respectively. Seven false-negative and two false-positive of PET/CT results were found. In patients with false-negative of PET/CT results there are two skin-invasive breast cancer patients and axillary lymph node metastases were detected in three patients with US, in one with CT and in four with SLNB. In clinical method for diagnosis of axillary lymph node metastases SLNB should be recommended because sensitivity of PET/CT for early breast cancer patients were low and positive diagnosis of axillary lymph node metastases with PET needs more than 1 cm size of lesion. PET/CT is useful for not-early breast cancer patients. To decide the operation of axillary lymph node disection needs total diagnosis of US, CT, SLNB and clinical findings. (author)

  3. 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.

  4. [(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...

  5. Ambient radiation levels in positron emission tomography/computed tomography (PET/CT) imaging center

    Energy Technology Data Exchange (ETDEWEB)

    Santana, Priscila do Carmo; Oliveira, Paulo Marcio Campos de; Mamede, Marcelo; Silveira, Mariana de Castro; Aguiar, Polyanna; Real, Raphaela Vila, E-mail: pridili@gmail.com [Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG (Brazil); Silva, Teogenes Augusto da [Centro de Desenvolvimento da Tecnologia Nuclear (CDTN/CNEN-MG), Belo Horizonte, MG (Brazil)

    2015-01-15

    Objective: to evaluate the level of ambient radiation in a PET/CT center. Materials and methods: previously selected and calibrated TLD-100H thermoluminescent dosimeters were utilized to measure room radiation levels. During 32 days, the detectors were placed in several strategically selected points inside the PET/CT center and in adjacent buildings. After the exposure period the dosimeters were collected and processed to determine the radiation level. Results: in none of the points selected for measurements the values exceeded the radiation dose threshold for controlled area (5 mSv/ year) or free area (0.5 mSv/year) as recommended by the Brazilian regulations. Conclusion: in the present study the authors demonstrated that the whole shielding system is appropriate and, consequently, the workers are exposed to doses below the threshold established by Brazilian standards, provided the radiation protection standards are followed. (author)

  6. Ambient radiation levels in positron emission tomography/computed tomography (PET/CT) imaging center

    Science.gov (United States)

    Santana, Priscila do Carmo; de Oliveira, Paulo Marcio Campos; Mamede, Marcelo; Silveira, Mariana de Castro; Aguiar, Polyanna; Real, Raphaela Vila; da Silva, Teógenes Augusto

    2015-01-01

    Objective To evaluate the level of ambient radiation in a PET/CT center. Materials and Methods Previously selected and calibrated TLD-100H thermoluminescent dosimeters were utilized to measure room radiation levels. During 32 days, the detectors were placed in several strategically selected points inside the PET/CT center and in adjacent buildings. After the exposure period the dosimeters were collected and processed to determine the radiation level. Results In none of the points selected for measurements the values exceeded the radiation dose threshold for controlled area (5 mSv/year) or free area (0.5 mSv/year) as recommended by the Brazilian regulations. Conclusion In the present study the authors demonstrated that the whole shielding system is appropriate and, consequently, the workers are exposed to doses below the threshold established by Brazilian standards, provided the radiation protection standards are followed. PMID:25798004

  7. 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

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

    Energy Technology Data Exchange (ETDEWEB)

    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)

  9. 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)

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

    Science.gov (United States)

    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.

  11. 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.)

  12. 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

  13. Somatostatin receptor positron emission tomography/computed tomography (PET/CT) in the evaluation of opsoclonus-myoclonus ataxia syndrome

    International Nuclear Information System (INIS)

    Joshi, Prathamesh; Lele, Vikram

    2013-01-01

    Opsoclonus-myoclonus ataxia (OMA) syndrome is the most common paraneoplastic neurological syndrome of childhood, associated with occult neuroblastoma in 20%-50% of all cases. OMA is the initial presentation of neuroblastoma in 1%-3% of children. Conventional radiological imaging approaches include chest radiography and abdominal computed tomography (CT). Nuclear medicine techniques, in form of 123 I/ 131 I-metaiodobenzylguanidine (MIBG) scintigraphy have been incorporated in various diagnostic algorithms for evaluation of OMA. We describe use of somatostatin receptor PET/CT with 68 Gallium- DOTA-DPhe 1 , Tyr 3 -octreotate (DOTATATE) in diagnosis of neuroblastoma in two cases of OMA

  14. Somatostatin receptor positron emission tomography/computed tomography (PET/CT) in the evaluation of opsoclonus-myoclonus ataxia syndrome.

    Science.gov (United States)

    Joshi, Prathamesh; Lele, Vikram

    2013-04-01

    Opsoclonus-myoclonus ataxia (OMA) syndrome is the most common paraneoplastic neurological syndrome of childhood, associated with occult neuroblastoma in 20%-50% of all cases. OMA is the initial presentation of neuroblastoma in 1%-3% of children. Conventional radiological imaging approaches include chest radiography and abdominal computed tomography (CT). Nuclear medicine techniques, in form of (123)I/(131)I-metaiodobenzylguanidine (MIBG) scintigraphy have been incorporated in various diagnostic algorithms for evaluation of OMA. We describe use of somatostatin receptor PET/CT with (68)Gallium- DOTA-DPhe(1), Tyr(3)-octreotate (DOTATATE) in diagnosis of neuroblastoma in two cases of OMA.

  15. 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.)

  16. [Prognostic value of (18)F-fluorodeoxyglucose (FDG) positron emission tomography-computed tomography (PET-CT) in extensive-stage small cell lung cancer].

    Science.gov (United States)

    Ding, C Y; Guo, Z; Li, Y Y; Li, T R

    2017-11-23

    Objective: To investigated the prognostic value of (18)F-fluorodeoxyglucose (FDG) positron emission tomography-computed tomography (PET-CT) in extensive-stage small cell lung cancer (ES -SCLC). Methods: Fifty-five patients with ES-SCLC who underwent pretreatment (18)F-FDG PET-CT were retrospectively recruited in this study. The correlations of maximum standardized uptake value (SUVmax) of primary lesion, metabolic tumor volume (MTV) of primary lesion (MTVp), total lesion glycolysis (TLG) of primary lesion (TLGp), the highest SUVmax of all lesions, the sum of metabolic volume (MTV sum), the sum of total lesions glycolysis (TLGsum) and clinical factors were analyzed. Results: The SUVmax, MTVp, TLGp, the highest SUVmax, MTVsum and TLGsum of 55 patients were 11.34±7.02, 29.61 cm(3,) 207.72, 13.61±7.10, 123.57 cm(3) and 988.48, respectively. The SUVmax of primary lesion, MTVp and TLGp were correlated with tumor type and the maximal tumor length, respectively(all P CT has certain prognostic value of patients with ES-SCLC. MTVsum and TLGsum are the independent predictors of PFS, and TLGsum is also an independent predictor of OS.

  17. Combined positron emission tomography/computed tomography (PET/CT) for clinical oncology: technical aspects and acquisition protocols

    International Nuclear Information System (INIS)

    Beyer, T.

    2004-01-01

    Combined PET/CT imaging is a non-invasive means of reviewing both, the anatomy and the molecular pathways of a patient during a quasi-simultaneous examination. Since the introduction of the prototype PET/CT in 1998 a rapid development of this imaging technology is being witnessed. The incorporation of fast PET detector technology into PET/CT designs and the routine use of the CT transmission images for attenuation correction of the PET allow for anato-metabolic whole-body examinations to be completed in less than 30 min. Thus, PET/CT imaging offers a logistical advantage to both, the patient and the clinicians since the two complementary exams - whenever clinically indicated - can be performed almost at the same time and a single integrated report can be created. Nevertheless, a number of pit-falls, primarily from the use of CT-based attenuation correction, have been identified and are being addressed through optimized acquisition protocols. It is fair to say, that PET/CT has been integrated in the diagnostic imaging arena, and in many cases has led to a close collaboration between different, yet complementary diagnostic and therapeutic medical disciplines. (orig.)

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

    Energy Technology Data Exchange (ETDEWEB)

    Qi, Zhihua; Gates, Erica L.; Trout, Andrew T. [Cincinnati Children' s Hospital Medical Center, Department of Radiology, Cincinnati, OH (United States); O' Brien, Maureen M. [Cincinnati Children' s Hospital Medical Center, Division of Oncology, Cancer and Blood Disease Institute, Cincinnati, OH (United States)

    2018-02-15

    Both [F-18]2-fluoro-2-deoxyglucose positron emission tomography/computed tomography ({sup 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 (P<0.0001). Average dose savings with the combined approach was 24.8±17.8% (2.60±2.51 mSv [range: 0.32-4.72 mSv]) of total CT 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. (orig.)

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

    International Nuclear Information System (INIS)

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

    2018-01-01

    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 (P<0.0001). Average dose savings with the combined approach was 24.8±17.8% (2.60±2.51 mSv [range: 0.32-4.72 mSv]) of total CT 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. (orig.)

  20. 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.

  1. Evaluation of ambient radiation levels in positron emission tomography/computed tomography in microPET/CT laboratory

    International Nuclear Information System (INIS)

    Sarmento, Daniele Martins

    2016-01-01

    Micro PET/CT scanner is an essential tool generally used for small animal molecular imaging. Fluorine-18-labeled fluorodeoxyglucose is the most widely used radioisotope in this technique. The present study aimed to evaluate the radiation levels in a micro PET/CT research laboratory of the Radiopharmacy Center at IPEN-CNEN / SP, in order to accomplish both national standards and international recommendations. The radioprotection team has classified the laboratory as supervised area; even this laboratory does not require the adoption of specific measures for protection and safety, should be done regular re-evaluation of the conditions of occupational exposures. Workplace monitoring and individual control assessment were carried out to ensure the radiological protection of all workers directly involved in handling the scanner. Initially, there was conducted a radiometric survey, as well as measurements of the external radiation level in the workplace and its surroundings. To achieve this goal, there were placed nine thermoluminescent dosimeters of CaSO 4 :Dy in preselected locations. Monthly evaluations of the occupationally exposed individuals were carried out through the use of TL dosimeters, ported in the workers' chest. Moreover, whole body measurements were performed every six months. The study period was about two-years which started in April 2014. All tests to evaluate micro PET/CT performance were based on the standard protocol of the equipment in accordance with the standard developed by the Animal PET Standard Task Force. Present study's results demonstrated that the ambient radiation levels (ambient and effective estimated radiation dose), as well as the effective shielding equipment are both adequate. This study emphasizes that it is essential to strictly follow the principles of radioprotection in workplace, whenever researches involve radioactive unsealed sources. (author)

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

    International Nuclear Information System (INIS)

    Ueda, Shigeto; Tsuda, Hitoshi; Asakawa, Hideki

    2008-01-01

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

  3. Dynamic Contrast-Enhanced Magnetic Resonance Imaging (DCE-MRI) Combined with Positron Emission Tomography-Computed Tomography (PET-CT) and Video-Electroencephalography (VEEG) Have Excellent Diagnostic Value in Preoperative Localization of Epileptic Foci in Children with Epilepsy.

    Science.gov (United States)

    Wang, Gui-Bin; Long, Wei; Li, Xiao-Dong; Xu, Guang-Yin; Lu, Ji-Xiang

    2017-01-01

    BACKGROUND To investigate the effect that dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) has on surgical decision making relative to video-electroencephalography (VEEG) and positron emission tomography-computed tomography (PET-CT), and if the differences in these variables translates to differences in surgical outcomes. MATERIAL AND METHODS A total of 166 children with epilepsy undergoing preoperative DCE-MRI, VEEG, and PET-CT examinations, surgical resection of epileptic foci, and intraoperative electrocorticography (ECoG) monitoring were enrolled. All children were followed up for 12 months and grouped by Engles prognostic classification for epilepsy. Based on intraoperative ECoG as gold standard, the diagnostic values of DCE-MRI, VEEG, PET-CT, DCE-MRI combined with VEEG, DCE-MRI combined with PET-CT, and combined application of DCE-MRI, VEEG, and PET-CT in preoperative localization for epileptic foci were evaluated. RESULTS The sensitivity of DCE-MRI, VEEG, and PET-CT was 59.64%, 76.51%, and 93.98%, respectively; the accuracy of DCE-MRI, VEEG, PET-CT, DCE-MRI combined with VEEG, and DCE-MRI combined with PET-CT was 57.58%, 67.72%, 91.03%, 91.23%, and 96.49%, respectively. Localization accuracy rate of the combination of DCE-MRI, VEEG, and PET-CT was 98.25% (56/57), which was higher than that of DCE-MRI combined with VEEG and of DCE-MRI combined with PET-CT. No statistical difference was found in the accuracy rate of localization between these three combined techniques. During the 12-month follow-up, children were grouped into Engles grade I (n=106), II (n=31), III (n=21), and IV (n=8) according to postoperative conditions. CONCLUSIONS All DCE-MRI combined with VEEG, DCE-MRI combined with PET-CT, and DCE-MRI combined with VEEG and PET-CT examinations have excellent accuracy in preoperative localization of epileptic foci and present excellent postoperative efficiency, suggesting that these combined imaging methods are suitable for serving as the

  4. 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.)

  5. 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.)

  6. Utility of 18F-fluoro-deoxyglucose emission tomography/computed tomography fusion imaging (18F-FDG PET/CT) in combination with ultrasonography for axillary staging in primary breast cancer

    International Nuclear Information System (INIS)

    Ueda, Shigeto; Ishida, Jiro; Abe, Yoshiyuki; Mochizuki, Hidetaka; Tsuda, Hitoshi; Asakawa, Hideki; Omata, Jiro; Fukatsu, Kazuhiko; Kondo, Nobuo; Kondo, Tadaharu; Hama, Yukihiro; Tamura, Katsumi

    2008-01-01

    Accurate evaluation of axillary lymph node (ALN) involvement is mandatory before treatment of primary breast cancer. The aim of this study is to compare preoperative diagnostic accuracy between positron emission tomography/computed tomography with 18 F-fluorodeoxyglucose ( 18 F-FDG PET/CT) and axillary ultrasonography (AUS) for detecting ALN metastasis in patients having operable breast cancer, and to assess the clinical management of axillary 18 F-FDG PET/CT for therapeutic indication of sentinel node biopsy (SNB) and preoperative systemic chemotherapy (PSC). One hundred eighty-three patients with primary operable breast cancer were recruited. All patients underwent 18 F-FDG PET/CT and AUS followed by SNB and/or ALN dissection (ALND). Using 18 F-FDG PET/CT, we studied both a visual assessment of 18 F-FDG uptake and standardized uptake value (SUV) for axillary staging. In a visual assessment of 18 F-FDG PET/CT, the diagnostic accuracy of ALN metastasis was 83% with 58% in sensitivity and 95% in specificity, and when cut-off point of SUV was set at 1.8, sensitivity, specificity, and accuracy were 36, 100, and 79%, respectively. On the other hand, the diagnostic accuracy of AUS was 85% with 54% in sensitivity and 99% in specificity. By the combination of 18 F-FDG PET/CT and AUS to the axilla, the sensitivity, specificity, and accuracy were 64, 94, and 85%, respectively. If either 18 F-FDG PET uptake or AUS was positive in allixa, the probability of axillary metastasis was high; 50% (6 of 12) in 18 F-FDG PET uptake only, 80% (4 of 5) in AUS positive only, and 100% (28 of 28) in dual positive. By the combination of AUS and 18 F-FDG PET/CT, candidates of SNB were more appropriately selected. The axillary 18 F-FDG uptake was correlated with the maximum size and nuclear grade of metastatic foci (p = 0.006 and p = 0.03). The diagnostic accuracy of 18 F-FDG PET/CT was shown to be nearly equal to ultrasound, and considering their limited sensitivities, the high radiation

  7. Utility of 18F-fluoro-deoxyglucose emission tomography/computed tomography fusion imaging (18F-FDG PET/CT in combination with ultrasonography for axillary staging in primary breast cancer

    Directory of Open Access Journals (Sweden)

    Tamura Katsumi

    2008-06-01

    Full Text Available Abstract Background Accurate evaluation of axillary lymph node (ALN involvement is mandatory before treatment of primary breast cancer. The aim of this study is to compare preoperative diagnostic accuracy between positron emission tomography/computed tomography with 18F-fluorodeoxyglucose (18F-FDG PET/CT and axillary ultrasonography (AUS for detecting ALN metastasis in patients having operable breast cancer, and to assess the clinical management of axillary 18F-FDG PET/CT for therapeutic indication of sentinel node biopsy (SNB and preoperative systemic chemotherapy (PSC. Methods One hundred eighty-three patients with primary operable breast cancer were recruited. All patients underwent 18F-FDG PET/CT and AUS followed by SNB and/or ALN dissection (ALND. Using 18F-FDG PET/CT, we studied both a visual assessment of 18F-FDG uptake and standardized uptake value (SUV for axillary staging. Results In a visual assessment of 18F-FDG PET/CT, the diagnostic accuracy of ALN metastasis was 83% with 58% in sensitivity and 95% in specificity, and when cut-off point of SUV was set at 1.8, sensitivity, specificity, and accuracy were 36, 100, and 79%, respectively. On the other hand, the diagnostic accuracy of AUS was 85% with 54% in sensitivity and 99% in specificity. By the combination of 18F-FDG PET/CT and AUS to the axilla, the sensitivity, specificity, and accuracy were 64, 94, and 85%, respectively. If either 18F-FDG PET uptake or AUS was positive in allixa, the probability of axillary metastasis was high; 50% (6 of 12 in 18F-FDG PET uptake only, 80% (4 of 5 in AUS positive only, and 100% (28 of 28 in dual positive. By the combination of AUS and 18F-FDG PET/CT, candidates of SNB were more appropriately selected. The axillary 18F-FDG uptake was correlated with the maximum size and nuclear grade of metastatic foci (p = 0.006 and p = 0.03. Conclusion The diagnostic accuracy of 18F-FDG PET/CT was shown to be nearly equal to ultrasound, and considering their

  8. 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.

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

    Science.gov (United States)

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

    2012-05-02

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

  10. 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. ...

  11. Usefulness of CA125 and their kinetic parameters and positron emission tomography/computed tomography (PET/CT) with fluorodeoxyglucose ([18F] FDG) in the detection of recurrent ovarian cancer levels.

    Science.gov (United States)

    Palomar Muñoz, Azahara; Cordero García, José Manuel; Talavera Rubio, Prado; García Vicente, Ana M; González García, Beatriz; Bellón Guardia, María Emiliana; Soriano Castrejón, Ángel; Aranda Aguilar, Enrique

    2017-12-21

    To assess the usefulness of cancer antigen 125 (CA125) serum levels and kinetic values, velocity (CA125vel) and doubling time (CA125dt), as well as fluorodeoxyglucose ([ 18 F]FDG) positron emission tomography/computed tomography (PET/CT), in the detection of ovarian cancer recurrence. To assess the optimal cut-off for CA125, CA125vel and CA125dt to detect relapse with [ 18 F]FDG-PET/CT. A retrospective analysis was performed of 59 [ 18 F]FDG-PET/CT (48 patients) for suspected recurrence of ovarian cancer. Receiver operating characteristic (ROC) curves were plotted and area-under-the curve (AUC) statistics were computed for CA125, CA125vel and CA125dt. The results obtained in the group with normal and high (>35U/ml) CA125 levels were compared. Forty-four cases of recurrence were diagnosed (7 had CA125 ≤35U/ml), whereas 15 showed no disease. All of them were correctly catalogued by PET/CT. In ROC analysis, the discriminatory power of CA125 was relatively high (AUC 0.835) and the optimal cut-off point to reflect active disease was 23.9U/ml. The ROC analyses for the CA125vel and CA125dt showed an AUC of 0.849 and 0.728, respectively, with an optimal cut-off point of 1.96U/ml/month and 0.76 months, respectively. In patients with normal CA125 and recurrence of ovarian cancer, the CA125vel was significantly higher than in patients without recurrence (p=0.029). [ 18 F]FDG-PET/CT is more accurate than CA125 parameters in the detection of ovarian cancer recurrence. CA125 serum levels are essential; nevertheless, CA125 kinetic values must be considered to detect relapse. Particularly in patients with CA125 within normal values, in which a higher CA125vel is indicative of recurrence. Copyright © 2017 Elsevier España, S.L.U. All rights reserved.

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

    Science.gov (United States)

    Ayaz, Sevin; Ayaz, Ümit Yaşar

    2016-01-01

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

  13. Metabolic and clinical assessment of efficacy of cryoablation therapy on skeletal masses by 18F-FDG positron emission tomography/computed tomography (PET/CT) and visual analogue scale (VAS): initial experience

    International Nuclear Information System (INIS)

    Masala, Salvatore; Bartolucci, Alberto D.; Mammucari, Matteo; Simonetti, Giovanni; Schillaci, Orazio; Calabria, Ferdinando

    2011-01-01

    Various therapy modalities have been proposed as standard treatments in management of bone metastases. Radiation therapy remains the standard of care for patients with localized bone pain, but up to 30% of them do not experience notable pain relief. Percutaneous cryoablation is a minimally invasive technique that induces necrosis by alternately freezing and thawing a target tissue. This technique is successfully used to treat a variety of malignant and benign diseases in different sites. 18 F-FDG positron emission tomography/computed tomography ( 18 F-FDG PET/CT) is a single technique of imaging that provides in a ''single step'' both morphological and metabolic features of neoplastic lesions of the bone. The aim of this study was to evaluate the efficacy of the cryosurgical technique on secondary musculoskeletal masses according to semi-quantitative PET analysis and clinical-test evaluation with the visual analogue scale (VAS). We enrolled 20 patients with painful bone lesions (score pain that exceeded 4 on the VAS) that were non-responsive to treatment; one lesion per patient was treated. All patients underwent a PET-CT evaluation before and 8 weeks after cryotherapy; maximum standardized uptake value (SUV max ) was measured before and after treatment for metabolic assessment of response to therapy. After treatment, 18 patients (90%) showed considerable reduction in SUV max value (>50%) suggestive of response to treatment; only 2 patients did not show meaningful reduction in metabolic activity. Our preliminary study demonstrates that quantitative analysis provided by PET correlates with response to cryoablation therapy as assessed by CT data and clinical VAS evaluation. (orig.)

  14. Metabolic and clinical assessment of efficacy of cryoablation therapy on skeletal masses by {sup 18}F-FDG positron emission tomography/computed tomography (PET/CT) and visual analogue scale (VAS): initial experience

    Energy Technology Data Exchange (ETDEWEB)

    Masala, Salvatore; Bartolucci, Alberto D.; Mammucari, Matteo; Simonetti, Giovanni [University Hospital Tor Vergata, Department of Diagnostic and Molecular Imaging, Interventional Radiology and Radiotherapy, Rome (Italy); Schillaci, Orazio; Calabria, Ferdinando [University Hospital Tor Vergata, Department of Diagnostic and Molecular Imaging, Interventional Radiology and Radiotherapy, Rome (Italy); I.R.C.C.S. Neuromed, Department of Nuclear Medicine and Neuroradiology, Pozzilli (Italy); Policlinico Tor Vegata, Department of Diagnostic and Molecular Imaging, Interventional Radiology and Radiotherapy, Rome (Italy)

    2011-02-15

    Various therapy modalities have been proposed as standard treatments in management of bone metastases. Radiation therapy remains the standard of care for patients with localized bone pain, but up to 30% of them do not experience notable pain relief. Percutaneous cryoablation is a minimally invasive technique that induces necrosis by alternately freezing and thawing a target tissue. This technique is successfully used to treat a variety of malignant and benign diseases in different sites. {sup 18}F-FDG positron emission tomography/computed tomography ({sup 18}F-FDG PET/CT) is a single technique of imaging that provides in a ''single step'' both morphological and metabolic features of neoplastic lesions of the bone. The aim of this study was to evaluate the efficacy of the cryosurgical technique on secondary musculoskeletal masses according to semi-quantitative PET analysis and clinical-test evaluation with the visual analogue scale (VAS). We enrolled 20 patients with painful bone lesions (score pain that exceeded 4 on the VAS) that were non-responsive to treatment; one lesion per patient was treated. All patients underwent a PET-CT evaluation before and 8 weeks after cryotherapy; maximum standardized uptake value (SUV{sub max}) was measured before and after treatment for metabolic assessment of response to therapy. After treatment, 18 patients (90%) showed considerable reduction in SUV{sub max} value (>50%) suggestive of response to treatment; only 2 patients did not show meaningful reduction in metabolic activity. Our preliminary study demonstrates that quantitative analysis provided by PET correlates with response to cryoablation therapy as assessed by CT data and clinical VAS evaluation. (orig.)

  15. Evaluation of ambient radiation levels in positron emission tomography/computed tomography in microPET/CT laboratory; Avaliacao dos niveis de radiacao ambiental no laboratorio de tomografia por emissao de positrons acoplada a tomografia computadorizada, microPET/CT

    Energy Technology Data Exchange (ETDEWEB)

    Sarmento, Daniele Martins

    2016-11-01

    Micro PET/CT scanner is an essential tool generally used for small animal molecular imaging. Fluorine-18-labeled fluorodeoxyglucose is the most widely used radioisotope in this technique. The present study aimed to evaluate the radiation levels in a micro PET/CT research laboratory of the Radiopharmacy Center at IPEN-CNEN / SP, in order to accomplish both national standards and international recommendations. The radioprotection team has classified the laboratory as supervised area; even this laboratory does not require the adoption of specific measures for protection and safety, should be done regular re-evaluation of the conditions of occupational exposures. Workplace monitoring and individual control assessment were carried out to ensure the radiological protection of all workers directly involved in handling the scanner. Initially, there was conducted a radiometric survey, as well as measurements of the external radiation level in the workplace and its surroundings. To achieve this goal, there were placed nine thermoluminescent dosimeters of CaSO{sub 4}:Dy in preselected locations. Monthly evaluations of the occupationally exposed individuals were carried out through the use of TL dosimeters, ported in the workers' chest. Moreover, whole body measurements were performed every six months. The study period was about two-years which started in April 2014. All tests to evaluate micro PET/CT performance were based on the standard protocol of the equipment in accordance with the standard developed by the Animal PET Standard Task Force. Present study's results demonstrated that the ambient radiation levels (ambient and effective estimated radiation dose), as well as the effective shielding equipment are both adequate. This study emphasizes that it is essential to strictly follow the principles of radioprotection in workplace, whenever researches involve radioactive unsealed sources. (author)

  16. Impact of Single-Photon Emission Computed Tomography/Computed Tomography (SPECT/CT) and Positron Emission Tomography/Computed Tomography (PET/CT) in the Diagnosis of Traumatic Brain Injury (TBI): Case Report.

    Science.gov (United States)

    Molina-Vicenty, Irma L; Santiago-Sánchez, Michelaldemar; Vélez-Miró, Iván; Motta-Valencia, Keryl

    2016-09-01

    Traumatic brain injury (TBI) is defined as damage to the brain resulting from an external force. TBI, a global leading cause of death and disability, is associated with serious social, economic, and health problems. In cases of mild-to-moderate brain damage, conventional anatomical imaging modalities may or may not detect the cascade of metabolic changes that have occurred or are occurring at the intracellular level. Functional nuclear medicine imaging and neurophysiological parameters can be used to characterize brain damage, as the former provides direct visualization of brain function, even in the absence of overt behavioral manifestations or anatomical findings. We report the case of a 30-year-old Hispanic male veteran who, after 2 traumatic brain injury events, developed cognitive and neuropsychological problems with no clear etiology in the presence of negative computed tomography (CT) findings.

  17. Program standard of quality control for a system of Positron Emission Tomography-computed tomography (PET-CT) used in the Foundation Valle de Lili

    International Nuclear Information System (INIS)

    Nunez, Nathalia I.; Benavides, Sivor O.; Lopera, Wilson

    2013-01-01

    A standard protocol of quality control in the Fundacion Valle del Lili for the implementation of a multimodal scanner developed emission tomography BIOGRAPH mCT X-3R of SIEMENS ® covering routine testing, frequency, acceptance ranges necessary corrective and preventive measures to detect and correct any faults and proceed if the upper detection precision and accuracy ranges accepted deviations actions. In order to minimize errors in the planning and management of patient dose, thereby improving the quality of the diagnostic image with the dose of radiation is reasonably low as possible, consistent with the clinical use of the equipment used and the information requested diagnostic study

  18. The efficacy of preoperative positron emission tomography-computed tomography (PET-CT) for detection of lymph node metastasis in cervical and endometrial cancer: clinical and pathological factors influencing it.

    Science.gov (United States)

    Nogami, Yuya; Banno, Kouji; Irie, Haruko; Iida, Miho; Kisu, Iori; Masugi, Yohei; Tanaka, Kyoko; Tominaga, Eiichiro; Okuda, Shigeo; Murakami, Koji; Aoki, Daisuke

    2015-01-01

    We studied the diagnostic performance of (18)F-fluoro-2-deoxy-d-glucose-positron emission tomography/computed tomography in cervical and endometrial cancers with particular focus on lymph node metastases. Seventy patients with cervical cancer and 53 with endometrial cancer were imaged with (18)F-fluoro-2-deoxy-D-glucose-positron emission tomography/computed tomography before lymphadenectomy. We evaluated the diagnostic performance of (18)F-fluoro-2-deoxy-D-glucose-positron emission tomography/computed tomography using the final pathological diagnoses as the golden standard. We calculated the sensitivity, specificity, positive predictive value and negative predictive value of (18)F-fluoro-2-deoxy-D-glucose-positron emission tomography/computed tomography. In cervical cancer, the results evaluated by cases were 33.3, 92.7, 55.6 and 83.6%, respectively. When evaluated by the area of lymph nodes, the results were 30.6, 98.9, 55.0 and 97.0%, respectively. As for endometrial cancer, the results evaluated by cases were 50.0, 93.9, 40.0 and 95.8%, and by area of lymph nodes, 45.0, 99.4, 64.3 and 98.5%, respectively. The limitation of the efficacy was found out by analyzing it by the region of the lymph node, the size of metastatic node, the historical type of tumor in cervical cancer and the prevalence of lymph node metastasis. The efficacy of positron emission tomography/computed tomography regarding the detection of lymph node metastasis in cervical and endometrial cancer is not established and has limitations associated with the region of the lymph node, the size of metastasis lesion in lymph node and the pathological type of primary tumor. The indication for the imaging and the interpretation of the results requires consideration for each case by the pretest probability based on the information obtained preoperatively. © The Author 2014. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  19. 18F-Fluorodeoxyglucose-Positron Emission Tomography/Computed Tomography in Tuberculosis: Spectrum of Manifestations.

    Science.gov (United States)

    Agarwal, Krishan Kant; Behera, Abhishek; Kumar, Rakesh; Bal, Chandrasekhar

    2017-01-01

    The objective of this article is to provide an illustrative tutorial highlighting the utility of 18 F-fluorodeoxyglucose-positron emission tomography/computed tomography ( 18 F-FDG-PET/CT) imaging to detect spectrum of manifestations in patients with tuberculosis (TB). FDG-PET/CT is a powerful tool for early diagnosis, measuring the extent of disease (staging), and consequently for evaluation of response to therapy in patients with TB.

  20. 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.

  1. 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

  2. Positron emission tomography/computed tomography imaging and rheumatoid arthritis.

    Science.gov (United States)

    Wang, Shi-Cun; Xie, Qiang; Lv, Wei-Fu

    2014-03-01

    Rheumatoid arthritis (RA) is a phenotypically heterogeneous, chronic, destructive inflammatory disease of the synovial joints. A number of imaging tools are currently available for evaluation of inflammatory conditions. By targeting the upgraded glucose uptake of infiltrating granulocytes and tissue macrophages, positron emission tomography/computed tomography with fluorine-18 fluorodeoxyglucose ((18) F-FDG PET/CT) is available to delineate inflammation with high sensitivity. Recently, several studies have indicated that FDG uptake in affected joints reflects the disease activity of RA. In addition, usage of FDG PET for the sensitive detection and monitoring of the response to treatment has been reported. Combined FDG PET/CT enables the detailed assessment of disease in large joints throughout the whole body. These unique capabilities of FDG PET/CT imaging are also able to detect RA-complicated diseases. Therefore, PET/CT has become an excellent ancillary tool to assess disease activity and prognosis in RA. © 2014 Asia Pacific League of Associations for Rheumatology and Wiley Publishing Asia Pty Ltd.

  3. Comparative Oncology: Evaluation of 2-Deoxy-2-[18F]fluoro-D-glucose (FDG Positron Emission Tomography/Computed Tomography (PET/CT for the Staging of Dogs with Malignant Tumors.

    Directory of Open Access Journals (Sweden)

    Stefanie M F Seiler

    Full Text Available 2-Deoxy-2-[18F]fluoro-D-glucose PET/CT is a well-established imaging method for staging, restaging and therapy-control in human medicine. In veterinary medicine, this imaging method could prove to be an attractive and innovative alternative to conventional imaging in order to improve staging and restaging. The aim of this study was both to evaluate the effectiveness of this image-guided method in canine patients with spontaneously occurring cancer as well as to illustrate the dog as a well-suited animal model for comparative oncology.Ten dogs with various malignant tumors were included in the study and underwent a whole body FDG PET/CT. One patient has a second PET-CT 5 months after the first study. Patients were diagnosed with histiocytic sarcoma (n = 1, malignant lymphoma (n = 2, mammary carcinoma (n = 4, sertoli cell tumor (n = 1, gastrointestinal stromal tumor (GIST (n = 1 and lung tumor (n = 1. PET/CT data were analyzed with the help of a 5-point scale in consideration of the patients' medical histories.In seven of the ten dogs, the treatment protocol and prognosis were significantly changed due to the results of FDG PET/CT. In the patients with lymphoma (n = 2 tumor extent could be defined on PET/CT because of increased FDG uptake in multiple lymph nodes. This led to the recommendation for a therapeutic polychemotherapy as a treatment. In one of the dogs with mammary carcinoma (n = 4 and in the patient with the lung tumor (n = 1, surgery was cancelled due to the discovery of multiple metastasis. Consequently no treatment was recommended.FDG PET/CT offers additional information in canine patients with malignant disease with a potential improvement of staging and restaging. The encouraging data of this clinical study highlights the possibility to further improve innovative diagnostic and staging methods with regard to comparative oncology. In the future, performing PET/CT not only for staging but also in therapy control could offer a

  4. Positron emission tomography-computed tomography has a clinical impact for patients with cervical cancer

    DEFF Research Database (Denmark)

    Sandvik, Rikke Mulvad; Jensen, Pernille Tine; Hendel, Helle W

    2011-01-01

    Many studies have found that positron emission tomography-computed tomography (PET-CT) has a high sensitivity and specificity in the identification of metastasis in cervical cancer. Herlev Hospital, Denmark, has been performing PET-CTs in stage I-IV cervical cancer since 1 May 2006. The present...

  5. The value of positron emission tomography/computed tomography for evaluating metastatic disease in patients with pancreatic cancer.

    Science.gov (United States)

    Kim, Mi-Jin; Lee, Kwang Hyuck; Lee, Kyu Taek; Lee, Jong Kyun; Ku, Bon-Ho; Oh, Cho-Rong; Heo, Jin Seok; Choi, Seong-Ho; Choi, Dong Wook

    2012-08-01

    Routine application of positron emission tomography/computed tomography (PET/CT) for pancreatic cancer staging remains a controversial approach. The purpose of this study was to reassess the clinical impact of PET/CT for the detection of distant metastasis of pancreatic cancer. From January 2006 to June 2009, 125 patients with histologically proven pancreatic cancer that had undergone PET/CT at our hospital were retrospectively reviewed. To evaluate the clinical efficacy of PET/CT on the management plan, the post-PET/CT management plans were compared with the pre-PET/CT management plans. After the conventional staging workup, we determined that 76 patients (60.8%) had resectable lesions, whereas 48 patients had unresectable lesions. One patient underwent explorative laparotomy due to equivocal resectability. Positron emission tomography/computed tomography diagnosed distant metastasis in only 2 (2.6%) of the 76 patients with resectable lesions, and these patients did not undergo unnecessary surgical treatment. Complete resection was not performed in 8 of the 74 operative patients because they had distant metastasis detected during the operative procedure. Positron emission tomography/computed tomography diagnosed distant metastasis in 32 of the 44 patients with metastatic lesions that were histologically shown to have sensitivity of 72.7%. Positron emission tomography/computed tomography has a limited role in the evaluation of metastatic disease from pancreatic cancer.

  6. Trails on 18F-Fluorodeoxyglucose Positron Emission Tomography/Computed Tomography Leading to Diagnosis of Testicular Adrenal Rest Tumor.

    Science.gov (United States)

    Kashyap, Raghava

    2018-01-01

    Testicular adrenal rest tumors (TARTs) are secondary to hypertrophy of adrenal rest cells in the rete testis in settings of hypersecretion of androgens. We present a case of congenital adrenal hyperplasia with TART with clues to the diagnosis on 18 F-fluorodeoxyglucose positron emission tomography/computed tomography ( 18 F-FDG PET/CT). To the best of our knowledge, this is the first reported case on the role of 18 F-FDG PET/CT in TART.

  7. Diagnostic utility of fluorodeoxyglucose positron emission tomography/computed tomography in pyrexia of unknown origin

    International Nuclear Information System (INIS)

    Singh, Nidhi; Kumar, Rakesh; Malhotra, Arun; Bhalla, Ashu Seith; Kumar, Uma; Sood, Rita

    2005-01-01

    The present study was undertaken to evaluate the diagnostic utility of fluorine-18 fluorodeoxyglucose positron emission tomography/computed tomography (F-18 FDG PET/CT) in patients presenting as pyrexia of unknown origin (PUO). Forty-seven patients (31 males and 16 females; mean age of 42.7 ± 19.96 years) presenting as PUO to the Department of Medicine at the All India Institute of Medical Sciences, New Delhi over a period of 2 years underwent F-18 FDG PET/CT. PET ⁄ CT was considered supportive when its results correlated with the final definitive diagnosis. Final diagnosis was made on the basis of combined evaluation of history, clinical findings, investigations, and response to treatment. Thirty-five PET/CT studies (74.5%) were positive. However, only 18 (38.3%) were supportive of the final diagnosis. In three patients (6.4%), PET/CT was considered diagnostic as none of the other investigations including contrast-enhanced computed tomography of chest and abdomen, and directed tissue sampling could lead to the final diagnosis. All these three patients were diagnosed as aortoarteritis. Fluorine-18 fluorodeoxyglucose positron emission tomography/computed tomography is an important emerging modality in the workup of PUO. It supported the final diagnosis in 38% of our patients and was diagnostic in 6.4% of patients. Thus, PET/CT should only be considered as second-line investigation for the diagnostic evaluation of PUO; especially in suspected noninfectious inflammatory disorders

  8. Role of positron emission tomography-computed tomography in endometrial cancer

    Science.gov (United States)

    Erdemoğlu, Evrim; Çerçi, Sevim Süreyya; Erdemoğlu, Ebru; Yalçın, Yakup; Tatar, Burak

    2017-01-01

    Objective: The efficacy of preoperative 18F-fluoro-D-glucose (18F-FDG) positron emission tomography-computed tomography (PET-CT) in endometrium cancer is controversial. We examined the efficacy of PET-CT and the association between maximum standardized uptake value (SUVmax) and prognostic factors in endometrial cancer. Materials and Methods: Thirty patients with endometrial cancer underwent preoperative 18F-FDG/PET-CT. The patients were treated with abdominal hysterectomy with bilateral salpingo-oophorectomy, and bilateral systemic pelvic lymphadenectomy was planned for all patients; paraaortic lymphadenectomy was performed in patients with intermediate and high risk. Tumor histology, grade, depth of myometrial invasion, maximum tumor diameter, lymphovascular invasion, nodal status, and ovarian/adnexal metastases were recorded. Results: The mean primary tumor diameter was reported smaller in PET-CT and the effect size of PET-CT was -0.60. The kappa value was 0.06 for myometrial invasion. Pelvic lymph node metastasis was reported in 22.2% of patients in PET-CT. However, 3.7% of patients had pelvic lymph node metastasis. The kappa value for pelvic lymph node metastasis was 0.23, and sensitivity, specificity, and positive and negative predictive values were 100%, 80.7%, 16.6%, and 100%, respectively. Paraaortic lymph node metastasis in PET-CT was suspected in 10%. However, paraaortic lymph node metastasis was found in 6.7% in histopathologic analyses. The kappa value was 0.15. The sensitivity, specificity, and positive and negative predictive values of PET-CT for detecting paraaortic lymph node metastases were 100%, 93.7%, 66.6%, and 100%, respectively. Myometrial invasion and tumor diameter were the only important prognostic factors affecting SUVmax. Conclusion: According to our results, PET-CT has a limited role and diagnostic efficacy in endometrial cancer. The indications of FDG/PET-CT in endometrium cancer should be studied further and revised. PMID:29379661

  9. 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

  10. Fluorine-18 Fluorodeoxyglucose Positron Emission Tomography/Computed Tomography Imaging in Patients With Carcinoma of the Nasopharynx: Diagnostic Accuracy and Impact on Clinical Management

    International Nuclear Information System (INIS)

    Gordin, Arie; Golz, Avishay; Daitzchman, Marcello; Keidar, Zohar; Bar-Shalom, Rachel; Kuten, Abraham; Israel, Ora

    2007-01-01

    Purpose: To assess the value of 18 F-fluorodeoxyglucose (FDG) positron emission tomography/computed tomography (PET/CT) in patients with nasopharyngeal carcinoma as compared with PET and conventional imaging (CI) alone, and to assess the impact of PET/CT on further clinical management. Methods and Materials: Thirty-three patients with nasopharyngeal carcinoma had 45 PET/CT examinations. The study was a retrospective analysis. Changes in patient care resulting from the PET/CT studies were recorded. Results: Positron emission tomography/computed tomography had sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of 92%, 90%, 90%, 90%, and 91%, respectively, as compared with 92%, 65%, 76%, 86%, and 80% for PET and 92%, 15%, 60%, 60%, and 60% for CI. Imaging with PET/CT altered further management of 19 patients (57%). Imaging with PET/CT eliminated the need for previously planned diagnostic procedures in 11 patients, induced a change in the planned therapeutic approach in 5 patients, and guided biopsy to a specific metabolically active area inside an edematous region in 3 patients, thus decreasing the chances for tissue sampling errors and avoiding damage to nonmalignant tissue. Conclusions: In cancer of the nasopharynx, the diagnostic performance of PET/CT is better than that of stand-alone PET or CI. Positron emission tomography/computed tomography had a major impact on further clinical management in 57% of patients

  11. 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)

  12. Positron Emission Tomography - Computed Tomography (PET/CT)

    Science.gov (United States)

    ... type your comment or suggestion into the following text box: Comment: E-mail: Area code: Phone no: ... Colorectal Cancer Treatment Head and Neck Cancer Treatment Brain Tumor Treatment Contrast Materials Alzheimer's ...

  13. 18F-FDG positron emission tomography/computed tomography in infective endocarditis.

    Science.gov (United States)

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

    2017-02-01

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

  14. Imaging spectrum and pitfalls of ¹⁸F-fluorodeoxyglucose positron emission tomography/computed tomography in patients with tuberculosis.

    Science.gov (United States)

    Ito, Kimiteru; Morooka, Miyako; Minamimoto, Ryogo; Miyata, Yoko; Okasaki, Momoko; Kubota, Kazuo

    2013-08-01

    Mycobacterium tuberculosis (TB) is one of the most prominant diseases frequently causing false positive lesions in oncologic surveys using (18)F-fluorodeoxyglucose (FDG) positron emission tomography/computed tomography (PET/CT), since TB granulomas are composed of activated macrophages and lymphocytes with high affinity for glucose. These pitfalls of (18)F-FDG PET/CT are important for radiologists. Being familiar with (18)F-FDG images of TB could assist in preventing unfavorable clinical results based on misdiagnoses. In addition, (18)F-FDG PET/CT has the advantage of being able to screen the whole body, and can clearly detect harboring TB lesions as high uptake foci. This article details the spectrum and pitfalls of (18)F-FDG PET/CT imaging in TB.

  15. Benign thyroid and neck lesions mimicking malignancy with false positive findings on positron emission tomography-computed tomography

    Energy Technology Data Exchange (ETDEWEB)

    Yoon, Ye Ri; Kim, Shin Young; Lee, Sang Mi [Soonchunhyang University Cheonan Hospital, Cheonan (Korea, Republic of); Lee, Deuk Young [Dept. of Surgery, Younsei Angelot Women' s Clinic, Cheonan (Korea, Republic of)

    2017-02-15

    The increasing use of positron emission tomography-computed tomography (PET/CT) has led to the frequent detection of incidental thyroid and neck lesions with increased 18F-deoxyglucose (FDG) uptake. Although lesions with increased FDG uptake are commonly assumed to be malignant, benign lesions may also exhibit increased uptake. The purpose of this pictorial essay is to demonstrate that benign thyroid and neck lesions can produce false-positive findings on PET/CT, and to identify various difficulties in interpretation. It is crucial to be aware that differentiating between benign and malignant lesions is difficult in a considerable proportion of cases, when relying only on PET/CT findings. Correlation of PET/CT findings with additional imaging modalities is essential to avoid misdiagnosis.

  16. Prostate cancer nodal oligometastasis accurately assessed using prostate-specific membrane antigen positron emission tomography-computed tomography and confirmed histologically following robotic-assisted lymph node dissection.

    Science.gov (United States)

    O'Kane, Dermot B; Lawrentschuk, Nathan; Bolton, Damien M

    2016-01-01

    We herein present a case of a 76-year-old gentleman, where prostate-specific membrane antigen positron emission tomography-computed tomography (PSMA PET-CT) was used to accurately detect prostate cancer (PCa), pelvic lymph node (LN) metastasis in the setting of biochemical recurrence following definitive treatment for PCa. The positive PSMA PET-CT result was confirmed with histological examination of the involved pelvic LNs following pelvic LN dissection.

  17. Rare case of isolated splenic metastases from gastric cancer detected with fluorine-18 fluorodeoxyglucose-positron emission tomography/computed tomography

    International Nuclear Information System (INIS)

    Kamaleshwaran, Koramadai Karuppusamy; Shibu, Deepu; Sugunan Shinto, Ajit; Sivanesan, Balasubramanian

    2013-01-01

    We report a rare case of isolated splenic metastasis from gastric cancer detected with fluorine-18 fluorodeoxyglucose-positron emission tomography/computed tomography (PET/CT). A 55-year-old man with gastric cancer 1 year post surgery, evaluated with PET/CT showed focal, intense uptake in the spleen, with no other abnormal findings. On splenectomy, the lesion was confirmed as metastasis from gastric cancer pathologically. (author)

  18. Prostate cancer nodal oligometastasis accurately assessed using prostate-specific membrane antigen positron emission tomography-computed tomography and confirmed histologically following robotic-assisted lymph node dissection

    Directory of Open Access Journals (Sweden)

    Dermot B O′Kane

    2016-01-01

    Full Text Available We herein present a case of a 76-year-old gentleman, where prostate-specific membrane antigen positron emission tomography-computed tomography (PSMA PET-CT was used to accurately detect prostate cancer (PCa, pelvic lymph node (LN metastasis in the setting of biochemical recurrence following definitive treatment for PCa. The positive PSMA PET-CT result was confirmed with histological examination of the involved pelvic LNs following pelvic LN dissection.

  19. Therapeutic impact of [18F]fluoride positron-emission tomography/computed tomography on patients with unclear foot pain

    International Nuclear Information System (INIS)

    Fischer, Dorothee Rita; Hesselmann, Rolf; Johayem, Anass; Hany, Thomas F.; Schulthess, Gustav K. von; Strobel, Klaus; Maquieira, Gerardo J.; Espinosa, Norman; Zanetti, Marco

    2010-01-01

    To evaluate the therapeutic impact of [ 18 F]fluoride positron-emission tomography/computed tomography ([ 18 F]fluoride PET/CT) imaging on patients with unclear foot pain. Twenty-eight patients were prospectively included in this study. Therapeutic management was defined by two experienced dedicated foot surgeons before and after [ 18 F]fluoride PET/CT imaging. Twenty-six patients underwent cross-sectional imaging [CT, magnetic resonance (MR)] prior to PET/CT. A retrospective analysis of the magnetic resonance imaging (MRI) diagnoses was performed when a therapy change occurred after PET/CT imaging. In 13/28 (46%) patients therapeutic management was changed due to PET/CT results. Management changes occurred in patients with the following diagnoses: os trigonum syndrome; sinus tarsi syndrome; os tibiale externum syndrome; osteoarthritis of several joints; non-consolidated fragments; calcaneo-navicular coalition; plantar fasciitis; insertional tendinopathy; suggestion of periostitis; neoarticulations between metatarsal bones. Os trigonum, os tibiale externum, subtalar osteoarthritis and plantar fasciitis were only seen to be active on PET/CT images but not on MR images. [ 18 F]fluoride PET/CT has a substantial therapeutic impact on management in patients with unclear foot pain. (orig.)

  20. Spectrum of fluorodeoxyglucose-positron emission tomography/computed tomography and magnetic resonance imaging findings of ovarian tumors.

    Science.gov (United States)

    Kitajima, Kazuhiro; Ueno, Yoshiko; Maeda, Tetsuo; Murakami, Koji; Kaji, Yasushi; Kita, Masato; Suzuki, Kayo; Sugimura, Kazuro

    2011-11-01

    The purpose of this article is to review fluorodeoxyglucose-positron emission tomography/computed tomography (FDG-PET/CT) and magnetic resonance imaging (MRI) findings in a variety of benign, malignant, and borderline malignant ovarian tumors. It is advantageous to become familiar with the wide variety of FDG-PET/CT findings of this entity. Benign ovarian tumors generally have faint uptake, whereas endometriomas, fibromas, and teratomas show mild to moderate uptake. Malignant ovarian tumors generally have intense uptake, whereas tumors with a small solid component often show minimal uptake.

  1. Positron emission tomography/computed tomography and biomarkers for early treatment response evaluation in metastatic colon cancer

    DEFF Research Database (Denmark)

    Engelmann, Bodil E.; Loft, Annika; Kjær, Andreas

    2014-01-01

    BACKGROUND: Treatment options for metastatic colon cancer (mCC) are widening. We prospectively evaluated serial 2-deoxy-2-[18F]fluoro-d-glucose positron-emission tomography/computed tomography (PET/CT) and measurements of tissue inhibitor of metalloproteinases-1 (TIMP-1), carcinoembryonic antigen...... evaluated by PET/CT before treatment, after one and four treatment series. Morphological and metabolic response was independently assessed according to Response Evaluation Criteria in Solid Tumors and European Organization for Research and Treatment of Cancer PET criteria. Plasma TIMP-1, plasma u...

  2. Contrast-enhanced 18F-fluorodeoxyglucose positron emission tomography/computed tomography in immunoglobulin G4-related retroperitoneal fibrosis

    International Nuclear Information System (INIS)

    Sharma, Punit; Chatterjee, Piyali

    2015-01-01

    Immunoglobulin G4 (IgG4)-related disease encompasses a wide variety of immune disorders previously thought be distinct. IgG4-related retroperitoneal fibrosis is one such entity. Metabolic imaging with 18 F-fluorodeoxyglucose ( 18 F-FDG) positron emission tomography/computed tomography (PET/CT) can be useful in the management of IgG4-related retroperitoneal fibrosis. We here discuss the case of 63-year-old male with IgG4-related retroperitoneal fibrosis and the role, 18 F-FDG PET/CT played in his management

  3. Program standard of quality control for a system of Positron Emission Tomography-computed tomography (PET-CT) used in the Foundation Valle de Lili; Programa estandar de control de calidad para un sistema de tomografia por emision de positrones-tomografia computadorizada (PET-CT) utilizado en la Fundacion Valle del Lili

    Energy Technology Data Exchange (ETDEWEB)

    Nunez, Nathalia I.; Benavides, Sivor O., E-mail: Nnunez@fcvl.org, E-mail: Obenavides@fcvl.org [Fundacion Valle del Lili (OFM-PR/FVL), Cali (Colombia). Dept. de Fisica Medica y Proteccion Radiologica; Lopera, Wilson, E-mail: wilson.lopera@correounivalle.edu.co [Universidad del Valle, Cali (Colombia). Dept. de Fisica

    2013-07-01

    A standard protocol of quality control in the Fundacion Valle del Lili for the implementation of a multimodal scanner developed emission tomography BIOGRAPH mCT X-3R of SIEMENS Registered-Sign covering routine testing, frequency, acceptance ranges necessary corrective and preventive measures to detect and correct any faults and proceed if the upper detection precision and accuracy ranges accepted deviations actions. In order to minimize errors in the planning and management of patient dose, thereby improving the quality of the diagnostic image with the dose of radiation is reasonably low as possible, consistent with the clinical use of the equipment used and the information requested diagnostic study.

  4. Malaria masquerading as relapse of Hodgkin's lymphoma on contrast enhanced 18F-fluorodeoxyglucose positron emission tomography/computed tomography: A diagnostic dilemma

    International Nuclear Information System (INIS)

    Jeph, Sunil; Thakur, Kamia; Shamim, Shamim Ahmed; Aggarwal, Ajay

    2014-01-01

    18 Flurodeoxyglucose ( 18 F-FDG) positron emission tomography/computed tomography (PET/CT) is nowadays routinely used in management of lymphoma patients. We here present a case of Hodgkin's lymphoma which showed 18 F-FDG avid splenomegaly on PET/CT done for clinically suspected relapse. Further evaluation by peripheral smear examination revealed malaria. The patient was then started on anti-malarial medications and follow-up PET/CT revealed resolution of hypermetabolic splenomegaly. This report highlights that in endemic regions malaria can cause 18 F-FDG avid splenomegaly and might mimic relapse of lymphoma

  5. "6"8Gallium-arginine-glycine-aspartic acid and "1"8F-fluorodeoxyglucose position emission tomography/computed tomography in chondroblastic osteosarcoma of the skull

    International Nuclear Information System (INIS)

    Orunmuyi, Akintunde; Modiselle, Moshe; Lengana, Thabo; Ebenhan, Thomas; Vorster, Mariza; Sathekge, Mike

    2017-01-01

    We report the case of a 32 year-old male with Chondroblastic Osteosarcoma of the skull, which was imaged with both "1"8[F]fluorodeoxyglucose ("1"8F-FDG) positron emission tomography/computed tomography (PET/CT) and "6"8Gallium-arginine-glycine-aspartic acid ("6"8Ga-RGD) PET/CT. The "1"8F-FDG PET/CT did not demonstrate the tumour, whereas the "6"8Ga-RGD PET/CT clearly depicted a left-sided frontal tumour. "6"8Ga-RGD PET/CT may be a clinically useful imaging modality for early detection of recurrent osteosarcoma, considering the limitations of "1"8F-FDG PET in a setting of low glycolytic activity

  6. {sup 68}Gallium-arginine-glycine-aspartic acid and {sup 18}F-fluorodeoxyglucose position emission tomography/computed tomography in chondroblastic osteosarcoma of the skull

    Energy Technology Data Exchange (ETDEWEB)

    Orunmuyi, Akintunde; Modiselle, Moshe; Lengana, Thabo; Ebenhan, Thomas; Vorster, Mariza; Sathekge, Mike [Dept. of Nuclear MedicineUniversity of Pretoria and Steve Biko Academic Hospital, Pretoria (South Africa)

    2017-09-15

    We report the case of a 32 year-old male with Chondroblastic Osteosarcoma of the skull, which was imaged with both {sup 18}[F]fluorodeoxyglucose ({sup 18}F-FDG) positron emission tomography/computed tomography (PET/CT) and {sup 68}Gallium-arginine-glycine-aspartic acid ({sup 68}Ga-RGD) PET/CT. The {sup 18}F-FDG PET/CT did not demonstrate the tumour, whereas the {sup 68}Ga-RGD PET/CT clearly depicted a left-sided frontal tumour. {sup 68}Ga-RGD PET/CT may be a clinically useful imaging modality for early detection of recurrent osteosarcoma, considering the limitations of {sup 18}F-FDG PET in a setting of low glycolytic activity.

  7. Comparison of {sup 18}F-fluorodeoxyglucose positron emission tomography/computed tomography, hydro-stomach computed tomography, and their combination for detecting primary gastric cancer

    Energy Technology Data Exchange (ETDEWEB)

    Jang, Hye Young; Chung, Woo Suk; Song, E Rang; Kim, Jin Suk [Konyang University Myunggok Medical Research Institute, Konyang University Hospital, Konyang University College of Medicine, Daejeon (Korea, Republic of)

    2015-01-15

    To retrospectively compare the diagnostic accuracy for detecting primary gastric cancer on positron emission tomography/computed tomography (PET/CT) and hydro-stomach CT (S-CT) and determine whether the combination of the two techniques improves diagnostic performance. A total of 253 patients with pathologically proven primary gastric cancer underwent PET/CT and S-CT for the preoperative evaluation. Two radiologists independently reviewed the three sets (PET/CT set, S-CT set, and the combined set) of PET/CT and S-CT in a random order. They graded the likelihood for the presence of primary gastric cancer based on a 4-point scale. The diagnostic accuracy of the PET/CT set, the S-CT set, and the combined set were determined by the area under the alternative-free receiver operating characteristic curve, and sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) were calculated. Diagnostic accuracy, sensitivity, and NPV for detecting all gastric cancers and early gastric cancers (EGCs) were significantly higher with the combined set than those with the PET/CT and S-CT sets. Specificity and PPV were significantly higher with the PET/CT set than those with the combined and S-CT set for detecting all gastric cancers and EGCs. The combination of PET/CT and S-CT is more accurate than S-CT alone, particularly for detecting EGCs.

  8. Comparison of 18F-fluorodeoxyglucose positron emission tomography/computed tomography, hydro-stomach computed tomography, and their combination for detecting primary gastric cancer

    International Nuclear Information System (INIS)

    Jang, Hye Young; Chung, Woo Suk; Song, E Rang; Kim, Jin Suk

    2015-01-01

    To retrospectively compare the diagnostic accuracy for detecting primary gastric cancer on positron emission tomography/computed tomography (PET/CT) and hydro-stomach CT (S-CT) and determine whether the combination of the two techniques improves diagnostic performance. A total of 253 patients with pathologically proven primary gastric cancer underwent PET/CT and S-CT for the preoperative evaluation. Two radiologists independently reviewed the three sets (PET/CT set, S-CT set, and the combined set) of PET/CT and S-CT in a random order. They graded the likelihood for the presence of primary gastric cancer based on a 4-point scale. The diagnostic accuracy of the PET/CT set, the S-CT set, and the combined set were determined by the area under the alternative-free receiver operating characteristic curve, and sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) were calculated. Diagnostic accuracy, sensitivity, and NPV for detecting all gastric cancers and early gastric cancers (EGCs) were significantly higher with the combined set than those with the PET/CT and S-CT sets. Specificity and PPV were significantly higher with the PET/CT set than those with the combined and S-CT set for detecting all gastric cancers and EGCs. The combination of PET/CT and S-CT is more accurate than S-CT alone, particularly for detecting EGCs.

  9. 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

  10. 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.

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

    Science.gov (United States)

    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.

  12. Utility of fluorine-18-fluorodeoxyglucose positron emission tomography/computed tomography in a child with chronic granulomatous disease

    International Nuclear Information System (INIS)

    Garg, Gunjan; DaSilva, Raphaella; Bhalakia, Avni; Milstein, David M.

    2016-01-01

    We report the fluorodeoxyglucose positron emission tomography/computed tomography (FDG - PET/CT) findings in an 11-month-old boy with suspected milk protein allergy, presented to the hospital with 2-month history of fever of unknown origin and failure to thrive. It showed FDG avid lymphadenopathy above and below the diaphragm and splenic focus, which could represent diffuse inflammatory process or lymphoma. Subsequent jejunal biopsy showed non-necrotizing granulomas

  13. (18)F-Fluorodeoxyglucose-Positron Emission Tomography/Computed Tomography in Malignancies of the Thyroid and in Head and Neck Squamous Cell Carcinoma

    DEFF Research Database (Denmark)

    Lauridsen, Jeppe Kiilerich; Rohde, Max; Thomassen, Anders

    2015-01-01

    18F-fluorodeoxyglucose positron emission tomography/computed tomography (FDG-PET/CT) is a valuable diagnostic tool in a spectrum of malignant and benign conditions, because of a high sensitivity to detect even very small lesions with increased metabolism. This review focuses on the use of FDG...

  14. Routine Bone Marrow Biopsy Has Little or No Therapeutic Consequence for Positron Emission Tomography/Computed Tomography-Staged Treatment-Naive Patients With Hodgkin Lymphoma

    DEFF Research Database (Denmark)

    El-Galaly, Tarec Christoffer; d'Amore, Francesco; Mylam, Karen Juul

    2012-01-01

    PURPOSETo investigate whether bone marrow biopsy (BMB) adds useful information to [(18)F]fluorodeoxyglucose (FDG) positron emission tomography/computed tomography (PET/CT) staging in patients with Hodgkin lymphoma (HL). PATIENTS AND METHODSNewly diagnosed patients with HL undergoing a pretherapeu...

  15. Lynch Syndrome Associated Colon Adenocarcinoma Resembling Lymphoma on Fluoro-Deoxyglucose-Positron Emission Tomography/Computed Tomography

    International Nuclear Information System (INIS)

    Aparici, Carina Mari; Win, Aung Zaw

    2015-01-01

    The patient was a 46-year-old Asian male diagnosed with lynch syndrome associated colon adenocarcinoma in the right ascending colon. A presurgical staging 18-fluoro-deoxyglucose-positron emission tomography/computed tomography (FDG-PET/CT) found increased metabolic activity in the cervical, axillary, mediastinal, supraclavicular, para-aortic and mesenteric lymph nodes. This pattern of metastasis was very unusual for lynch syndrome associated colon adenocarcinoma and the involvement of those lymph nodes resembles the pattern of spread of lymphoma. He underwent right hemicolectomy and he was subsequently treated with 12 cycles of folinic acid (leucovorin), fluorouracil (5-FU), irinotecan. A restaging FDG-PET/CT at the end of the chemotherapy showed interval decrease in size and metabolic activity in the affected lymph nodes. FDG-PET/CT is a useful imaging modality in following-up the treatment response in colon adenocarcinoma

  16. Does positron emission tomography/computed tomography aid the diagnosis of prosthetic valve infective endocarditis?

    Science.gov (United States)

    Balmforth, Damian; Chacko, Jacob; Uppal, Rakesh

    2016-10-01

    A best evidence topic was constructed according to a structured protocol. The question addressed was whether (18)F-fluorodeoxyglucose positron emission tomography/computed tomography (PET/CT) aids the diagnosis of prosthetic valve endocarditis (PVE)? A total of 107 publications were found using the reported search, of which 6 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. The reported outcome of all studies was a final diagnosis of confirmed endocarditis on follow-up. All the six studies were non-randomized, single-centre, observational studies and thus represented level 3 evidence. The diagnostic capability of PET/CT for PVE was compared with that of the modified Duke Criteria and echocardiography, and reported in terms of sensitivity, specificity and positive and negative predictive values. All studies demonstrated an increased sensitivity for the diagnosis of PVE when PET/CT was combined with the modified Duke Criteria on admission. A higher SUVmax on PET was found to be significantly associated with a confirmed diagnosis of endocarditis and an additional diagnostic benefit of PET/CT angiography over conventional PET/non-enhanced CT is reported due to improved anatomical resolution. However, PET/CT was found to be unreliable in the early postoperative period due to its inability to distinguish between infection and residual postoperative inflammatory changes. PET/CT was also found to be poor at diagnosing cases of native valve endocarditis. We conclude that PET/CT aids in the diagnosis of PVE when combined with the modified Duke Criteria on admission by increasing the diagnostic sensitivity. The diagnostic ability of PET/CT can be potentiated by the use of PET/CTA; however, its use may be unreliable in the early postoperative period or in native valve endocarditis. © The Author 2016. Published by

  17. Application of positron emission tomography-computed tomography in the diagnosis of pulmonary ground-glass nodules.

    Science.gov (United States)

    Hu, Lili; Pan, Yuanwei; Zhou, Zhigang; Gao, Jianbo

    2017-11-01

    The aim of the present study was to investigate the value of positron emission tomography-computed tomography (PET-CT) using 18 F-fluorodeoxyglucose in the clinical diagnosis of pulmonary ground-glass nodule. In total, 54 patients with pulmonary GGN that were identified by PET-CT examination were selected and confirmed by pathology and clinical diagnosis in hospital between April 2014 and April 2015. The association between PET-CT findings and pathology, and the value of PET-CT were then evaluated. In the 54 patients, solitary pulmonary GGN with a nodule diameter of between 0.6 and 2.0 cm were detected. Amongst them, the PET-CT examination of 42 patients revealed hyper metabolic nodules, and were all mixed GGN type nodules with a diameter >1 cm. The PET-CT examination of the remaining 12 patients demonstrated no evidence of metabolic abnormalities and the nodules in these patients were pure or mixed GGN with a diameter <1 cm (except 2 cases with a diameter ≥1 cm). Furthermore, the diagnoses for all patients were pathologically confirmed by CT-guided needle biopsy or thoracoscopic surgical resection. Amongst them, there were 41 cases of lung adenocarcinoma, 4 cases of fungal infection, 7 cases of inflammation and 2 cases of adenomatoid hyperplasia. Additionally, PET-CT has a lower detection rate for smaller GGN exhibits no clear advantage for pure GGN, but has a higher detection rate for larger GGN. In conclusion, to a certain extent, PET-CT makes up for the shortcomings of traditional imaging and has some clinical value for the diagnosis of GGN.

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

    DEFF Research Database (Denmark)

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

    2011-01-01

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

  19. Fluorodeoxyglucose positron emission tomography-computed tomography in evaluation of pelvic and para-aortic nodal involvement in early stage and operable cervical cancer: comparison with surgicopathological findings

    International Nuclear Information System (INIS)

    Bansal, Vandana; Damania, Kaizad; Sharma, Anshu Rajnish

    2011-01-01

    Nodal metastases in cervical cancer have prognostic implications. Imaging is used as an adjunct to clinical staging for evaluation of nodal metastases. Fluorodeoxyglucose (FDG) positron emission tomography/computed tomography (PET/CT) has an advantage of superior resolution of its CT component and detecting nodal disease based on increased glycolytic activity rather than node size. But there are limited studies describing its limitations in early stage cervical cancers. We have done meta-analysis with an objective to evaluate the efficacy of FDG PET/CT and its current clinical role in early stage and operable cervical cancer. Studies in which FDG PET/CT was performed before surgery in patients with early stage cervical cancers were included for analysis. PET findings were confirmed with histopathological diagnosis rather than clinical follow-up. The current data suggest that FDG PET/CT is suboptimal in nodal staging in early stage cervical cancer

  20. Mycosis fungoides: Positron emission tomography/computed tomography in staging and monitoring the effect of therapy

    International Nuclear Information System (INIS)

    D’Souza, Maria Mathew; D’Souza, Paschal; Sharma, Rajnish; Jaimini, Abhinav; Mondal, Anupam

    2015-01-01

    A 58-year-old woman, diagnosed as a case of mycosis fungoides (MF), underwent [18F]-fluoro-D-glucose positron emission tomography/computed tomography (FDG PET/CT) examination. The study revealed intense FDG uptake in a large ulceroproliferative right thigh lesion, indurated plaques in the chest wall and left thigh, along with multiple sites of cutaneous involvement, axillary and inguinal lymphadenopathy. The patient underwent chemotherapy with CHOP regimen, radiotherapy for the right thigh lesion, along with topical corticosteroids and emollients for the disseminated cutaneous involvement. Repeat [18F]-FDG PET/CT study performed a year later, showed near complete disease regression specifically of the ulceroproliferative lesion and indurated cutaneous plaques, no change in lymphadenopathy, and a subtle diffuse progression of the remaining cutaneous lesions. A multidisciplinary approach to the diagnosis, staging and treatment of MF has long been suggested for optimizing outcomes from management of patients with this disease. This case highlights the potential role of incorporating PET/CT as a single modality imaging technique in the staging and assessment of response to therapy

  1. ¹⁸F-fluorodeoxyglucose-positron emission tomography/computed tomography in malignancies of the thyroid and in head and neck squamous cell carcinoma: a review of the literature.

    Science.gov (United States)

    Lauridsen, Jeppe Kiilerich; Rohde, Max; Thomassen, Anders

    2015-01-01

    18F-fluorodeoxyglucose positron emission tomography/computed tomography (FDG-PET/CT) is a valuable diagnostic tool in a spectrum of malignant and benign conditions, because of a high sensitivity to detect even very small lesions with increased metabolism. This review focuses on the use of FDG-PET/CT in malignancies of the thyroid gland and in head and neck squamous cell carcinoma. Copyright © 2015 Elsevier Inc. All rights reserved.

  2. Enhancement of positron emission tomography-computed tomography image quality using the principle of stochastic resonance

    International Nuclear Information System (INIS)

    Pandey, Anil Kumar; Sharma, Sanjay Kumar; Sharma, Punit; Singh, Harmandeep; Patel, Chetan; Sarkar, Kaushik; Kumar, Rakesh; Bal, Chandra Sekhar

    2014-01-01

    Acquisition of higher counts improves visual perception of positron emission tomography-computed tomography (PET-CT) image. Larger radiopharmaceutical doses (implies more radiation dose) are administered to acquire this count in a short time period. However, diagnostic information does not increase after a certain threshold of counts. This study was conducted to develop a post processing method based on principle of “stochastic resonance” to improve visual perception of the PET-CT image having a required threshold counts. PET-CT images (JPEG file format) with low, medium, and high counts in the image were included in this study. The image was corrupted with the addition of Poisson noise. The amplitude of the Poisson noise was adjusted by dividing each pixel by a constant 1, 2, 4, 8, 16, and 32. The best amplitude of the noise that gave best images quality was selected based on high value of entropy of the output image, high value of structural similarity index and feature similarity index. Visual perception of the image was evaluated by two nuclear medicine physicians. The variation in structural and feature similarity of the image was not appreciable visually, but statistically images deteriorated as the noise amplitude increases although maintaining structural (above 70%) and feature (above 80%) similarity of input images in all cases. We obtained the best image quality at noise amplitude “4” in which 88% structural and 95% feature similarity of the input images was retained. This method of stochastic resonance can be used to improve the visual perception of the PET-CT image. This can indirectly lead to reduction of radiation dose

  3. Fluorodeoxyglucose positron emission tomography/computed tomography findings in a patient with cerebellar mutism after operation in posterior fossa

    Directory of Open Access Journals (Sweden)

    Gonca Kara Gedik

    2017-03-01

    Full Text Available Cerebellar mutism is a transient period of speechlessness that evolves after posterior fossa surgery in children. Although direct cerebellar and brain stem injury and supratentorial dysfunction have been implicated in the mediation of mutism, the pathophysiological mechanisms involved in the evolution of this kind of mutism remain unclear. Magnetic resonance imaging revealed dentatothalamocortical tract injuries and single photon emission computed tomography showed cerebellar and cerebral hypoperfusion in patients with cerebellar mutism. However, findings with 18F-fluorodeoxyglucose positron emission tomography/computed tomography (FDG PET/CT in this group of patients have not been documented previously. In this clinical case, we report a patient who experienced cerebellar mutism after undergoing a posterior fossa surgery. Right cerebellar and left frontal lobe hypometabolism was shown using FDG PET/CT. The FDG metabolism of both the cerebellum and the frontal lobe returned to normal levels after the resolution of the mutism symptoms.

  4. {sup 18}F-fluorodeoxyglucose positron emission tomography-computed tomography in the management of adult multisystem Langerhans cell histiocytosis

    Energy Technology Data Exchange (ETDEWEB)

    Obert, Julie [Universite Paris Diderot, Paris (France); Assistance Publique-Hopitaux de Paris, Centre National de Reference de l' Histiocytose Langerhansienne, Service de Pneumologie, Hopital Saint-Louis, Paris (France); Vercellino, Laetitia [Assistance Publique-Hopitaux de Paris, Service de Medecine Nucleaire, Hopital Saint-Louis, Paris (France); Van der Gucht, Axel [Universite Paris Diderot, Paris (France); Assistance Publique-Hopitaux de Paris, Service de Medecine Nucleaire, Hopital Saint-Louis, Paris (France); De Margerie-Mellon, Constance [Universite Paris Diderot, Paris (France); Assistance Publique-Hopitaux de Paris, Service de Radiologie, Hopital Saint-Louis, Paris (France); Bugnet, Emmanuelle; Lorillon, Gwenael [Assistance Publique-Hopitaux de Paris, Centre National de Reference de l' Histiocytose Langerhansienne, Service de Pneumologie, Hopital Saint-Louis, Paris (France); Chevret, Sylvie [Universite Paris Diderot, Paris (France); Assistance Publique-Hopitaux de Paris, Service de Biostatistique et Information Medicale, Hopital Saint-Louis, Paris (France); Biostatistics and Clinical Epidemiology Research Team, U1153 CRESS, Paris (France); Tazi, Abdellatif [Universite Paris Diderot, Paris (France); Assistance Publique-Hopitaux de Paris, Centre National de Reference de l' Histiocytose Langerhansienne, Service de Pneumologie, Hopital Saint-Louis, Paris (France); Biostatistics and Clinical Epidemiology Research Team, U1153 CRESS, Paris (France)

    2017-04-15

    The standard evaluation of multisystem Langerhans cell histiocytosis (LCH) includes a clinical evaluation, laboratory tests and a skeleton/skull X-ray survey, with chest high-resolution computed tomography (HRCT) in the case of pulmonary involvement. Preliminary reports suggest that {sup 18}F-fluorodeoxyglucose positron emission tomography-computed tomography ({sup 18}F-FDG PET-CT) may be useful for evaluating patients with LCH. Fourteen consecutive adult patients with multisystem LCH were included in this retrospective study, and were evaluated using standard procedures and {sup 18}F-FDG PET-CT. The two sets of findings were compared both at baseline and during follow-up. Serial HRCT and pulmonary function tests were used to evaluate outcome in patients with lung involvement. At the baseline evaluation, PET-CT identified every LCH localization found with the standard evaluation (except a mild cecum infiltration). PET-CT showed additional lesions in seven patients, mostly involving bones, and differentiated inactive from active lesions. Thyroid {sup 18}F-FDG uptake was identified in three cases. No pituitary stalk {sup 18}F-FDG uptake was observed in patients with pituitary LCH. Only 3/12 (25 %) patients with pulmonary LCH displayed moderate pulmonary {sup 18}F-FDG uptake. During follow-up, variations (≥50 % of maximum standardized uptake) in bone {sup 18}F-FDG uptake intensity were correlated with disease state and response to treatment. The absence of lung {sup 18}F-FDG uptake did not preclude lung function improvement after treatment. Except for cases with pulmonary and pituitary involvement, {sup 18}F-FDG PET-CT could replace the standard evaluation for staging of adult patients with multisystem LCH. Serial PET-CT scans are useful for evaluating treatment responses, particularly in cases with bone LCH involvement. (orig.)

  5. 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.

  6. Clinical applications of 18F-fluorodeoxyglucose positron emission tomography/computed tomography in carcinoma of unknown primary

    Institute of Scientific and Technical Information of China (English)

    HU Man; YU Jin-ming; ZHAO Wei; ZHANG Pin-liang; JU Gui-fang; FU Zheng; ZHANG Guo-li; KONG Li; YANG Yan-qin; MA Yi-dong

    2011-01-01

    Background Carcinoma of unknown primary (CUP) encompasses a heterogeneous group of tumors with varying clinical features. The management of patients of CUP remains a clinical challenge. The purpose of this study was to evaluate the clinical applications of integrated 18F-fluorodeoxyglucose positron emission tomography/computed tomography (FDG PET/CT) information in patients with CUP,including detecting the occult primary tumor and effecting on disease therapy.Methods One hundred and forty-nine patients with histologically-proven metastases of CUP were included. For all patients,the conventional diagnostic work-up was unsuccessful in localizing the primary site. Whole-body PET/CT images were obtained approximately 60 minutes after intravenous injection of 350-425 MBq of 18F-FDG.Results In 24.8% of patients,FDG PET/CT detected primary tumors that were not apparent after conventional workup.In this group of patients,the overall sensitivity,specificity,and accuracy rates of FDG PET/CT in detecting unknown primary tumors were 86.0%,87.7%,and 87.2%,respectively. FDG PET/CT imaging also led to the detection of previously unrecognized metastases in 29.5% of patients. Forty-seven (31.5%,47 of 149) patients underwent a change in therapeutic management.Conclusions FDG PET/CT is a valuable tool in patients with CUP,because it assisted in detecting unknown primary tumors and previously unrecognized distant metastases,and optimized the mangement of these patients.

  7. Contrast-enhanced fluorodeoxyglucose positron emission tomography/computed tomography in solid pseudopapillary neoplasm of the pancreas

    International Nuclear Information System (INIS)

    Santhosh, Sampath; Lakshmanan, Ramesh Kumar; Sonik, Bhavay; Padmavathy, Rajagopalan; Gunaseelan, Rajamani Emmanuel

    2016-01-01

    Solid pseudopapillary neoplasm (SPN) of the pancreas is a rare pancreatic tumor with low malignant potential. It occurs characteristically more often in young women. Radiological and pathological studies have revealed that the tumor is quite different from other pancreatic tumors. Limited information is available in the literature reporting their accumulation of fluorine- 18 fluorodeoxyglucose ( 18 F-FDG) in positron emission tomography/computed tomography (PET/CT). Here, we report a case of pancreatic SPN imaged with contrast-enhanced FDG PET/CT. A percutaneous fine needle aspiration from the metabolically active lesion revealed SPN, and it was confirmed with histopathological results. Recurrence or metastasis was not found after 7 months of follow-up

  8. Fluorodeoxyglucose positron emission tomography?computed tomography in evaluation of pelvic and para-aortic nodal involvement in early stage and operable cervical cancer: Comparison with surgicopathological findings

    OpenAIRE

    Bansal, Vandana; Damania, Kaizad; Sharma, Anshu Rajnish

    2011-01-01

    Introduction: Nodal metastases in cervical cancer have prognostic implications. Imaging is used as an adjunct to clinical staging for evaluation of nodal metastases. Fluorodeoxyglucose (FDG) positron emission tomography/computed tomography (PET/CT) has an advantage of superior resolution of its CT component and detecting nodal disease based on increased glycolytic activity rather than node size. But there are limited studies describing its limitations in early stage cervical cancers. Objectiv...

  9. Brain Positron Emission Tomography-Computed Tomography Gender Differences in Tinnitus Patients.

    Science.gov (United States)

    Shlamkovich, Nathan; Gavriel, Haim; Eviatar, Ephraim; Lorberboym, Mordechay; Aviram, Eliad

    2016-10-01

    Increased metabolism in the left auditory cortex has been reported in tinnitus patients. However, gender difference has not been addressed. To assess the differences in Positron emission tomography-computed tomography (PET-CT) results between the genders in tinnitus patients. Retrospective cohort. Included were patients referred to our clinic between January 2011 and August 2013 who complained of tinnitus and underwent fluorodeoxyglucose (FDG)-PET to assess brain metabolism. Univariate and multivariate nominal logistic regressions were used to evaluate the association between upper temporal gyrus (UTG; right and left) and gender. Included were 140 patients (87 males) with an average age of 52.5 yr (median = 53.1). Bilateral tinnitus was found in 85 patients (60.7%), left sided in 30 (21.4%), and right sided in 21(15%). Increased uptake in the UTG was found in 60% of the patients on either side. Males had a statistically significant increased uptake in the UTG in those with unilateral tinnitus and in the entire population. We present the largest study reported so far on tinnitus patients who have undergone FDG-PET-CT. We found a statistically significant difference between the genders in FDG uptake by the UTG. Further investigations should be undertaken to reveal the etiologies for these differences and to assess different therapeutic protocols according to gender. American Academy of Audiology

  10. Preoperative lymph-node staging of invasive urothelial bladder cancer with 18F-fluorodeoxyglucose positron emission tomography/computed axial tomography and magnetic resonance imaging

    DEFF Research Database (Denmark)

    Jensen, Thor Knak; Holt, Per; Gerke, Oke

    2011-01-01

    OBJECTIVE: The treatment and prognosis of bladder cancer are based on the depth of primary tumour invasion and the presence of metastases. A highly accurate preoperative tumour, node, metastasis (TNM) staging is critical to proper patient management and treatment. This study retrospectively...... investigated the value of ¹⁸F-fluorodeoxyglucose (FDG) positron emission tomography/computed axial tomography (¹⁸F-FDG PET/CT) and magnetic resonance imaging (MRI) for preoperative N staging of bladder cancer. Material and methods. From June 2006 to January 2008, 48 consecutive patients diagnosed with bladder......) for MRI and ¹⁸F-FDG PET/CT, respectively. The differences in specificity and negative predictive values were not statistically significant. Conclusions. No significant statistical difference between ¹⁸F-FDG PET/CT and MRI for preoperative N staging of urothelial bladder cancer was found in the study...

  11. Infective endocarditis detected by 18F-fluoro-2-deoxy-d-glucose positron emission tomography/computed tomography in a patient with occult infection

    Directory of Open Access Journals (Sweden)

    Chia-Lu Yeh

    2011-11-01

    Full Text Available Integrated 18F-fluoro-2-deoxy-d-glucose positron emission tomography/computed tomography (FDG PET/CT has been clinically used to detect infectious lesions. We present a case with pyrexia and bacteremia of unknown origin. Whole body FDG PET/CT was arranged to look for an occult source of infection and it revealed a focal lesion with increased FDG uptake in the mitral valve area. Under suspicion of infective endocarditis, transthoracic echocardiography was repeated and then the presence of linear vegetation over the calcified mitral annulus was confirmed. Ultimately, definite infective endocarditis was diagnosed according to the Duke criteria. The patient recovered after the antibiotic therapy. In our case, FDG PET/CT can help to localize the exact site of occult infection, thereby guiding additional testing and facilitating timely definitive diagnosis and therapy.

  12. Pretreatment Staging Positron Emission Tomography/Computed Tomography in Patients With Inflammatory Breast Cancer Influences Radiation Treatment Field Designs

    International Nuclear Information System (INIS)

    Walker, Gary V.; Niikura, Naoki; Yang Wei; Rohren, Eric; Valero, Vicente; Woodward, Wendy A.; Alvarez, Ricardo H.; Lucci, Anthony; Ueno, Naoto T.; Buchholz, Thomas A.

    2012-01-01

    Purpose: Positron emission tomography/computed tomography (PET/CT) is increasingly being utilized for staging of inflammatory breast cancer (IBC). The purpose of this study was to define how pretreatment PET/CT studies affected postmastectomy radiation treatment (PMRT) planning decisions for IBC. Methods and Materials: We performed a retrospective analysis of 62 patients diagnosed with IBC between 2004 and 2009, who were treated with PMRT in our institution and who had a staging PET/CT within 3 months of diagnosis. Patients received a baseline physical examination, staging mammography, ultrasonographic examination of breast and draining lymphatics, and chest radiography; most patients also had a bone scan (55 patients), liver imaging (52 patients), breast MRI (46 patients), and chest CT (25 patients). We compared how PET/CT findings affected PMRT, assuming that standard PMRT would target the chest wall, level III axilla, supraclavicular fossa, and internal mammary chain (IMC). Any modification of target volumes, field borders, or dose prescriptions was considered a change. Results: PET/CT detected new areas of disease in 27 of the 62 patients (44%). The areas of additional disease included the breast (1 patient), ipsilateral axilla (1 patient), ipsilateral supraclavicular (4 patients), ipsilateral infraclavicular (1 patient), ipsilateral IMC (5 patients), ipsilateral subpectoral (3 patients), mediastinal (8 patients), other distant/contralateral lymph nodes (15 patients), or bone (6 patients). One patient was found to have a non-breast second primary tumor. The findings of the PET/CT led to changes in PMRT in 11 of 62 patients (17.7%). These changes included additional fields in 5 patients, adjustment of fields in 2 patients, and higher doses to the supraclavicular fossa (2 patients) and IMC (5 patients). Conclusions: For patients with newly diagnosed IBC, pretreatment PET/CT provides important information concerning involvement of locoregional lymph nodes

  13. Role and interpretation of fluorodeoxyglucose-positron emission tomography/computed tomography in HIV-infected patients with fever of unknown origin: a prospective study.

    Science.gov (United States)

    Martin, C; Castaigne, C; Tondeur, M; Flamen, P; De Wit, S

    2013-09-01

    The aim of the study was to evaluate prospectively the usefulness of fluorodeoxyglucose-positron emission tomography/computed tomography (FDG-PET/CT) in investigation of fever of unknown origin (FUO) in HIV-positive patients and to determine whether HIV viraemia impacts on FDG-PET/CT performance. The FDG-PET/CT results of 20 HIV-infected patients with FUO were analysed and compared with the FDG-PET/CT results of 10 HIV-infected viraemic patients without FUO. The performance of FDG-PET/CT for identifying the aetiology of FUO was assessed. Final diagnosis for FUO was based on histopathology, microbiological assays, or clinical and imaging follow-up. FDG-PET/CT contributed to the diagnosis or exclusion of a focal aetiology of the febrile state in 80% of patients with FUO. The presence of increased FDG uptake in the central lymph node has 100% specificity for focal aetiology of fever, even in viraemic patients. The absence of hypermetabolic central lymph nodes in FUO patients has 100% negative predictive value for focal disease. Lymph node biopsy in central hypermetabolic areas allowed, in 100% of cases, identification of underlying disease in patients with FUO. Biopsy of peripheral lymph nodes should be performed in lymph nodes with maximum standardized uptake value (SUVmax) ≥ 6-8 (sensitivity 62.5%; specificity 75%) and avoided in lymph nodes with SUVmax = 0-4 (specificity 0%). High HIV viraemia does not prevent correct interpretation of FDG-PET/CT. As in HIV-negative patients, we confirm the usefulness of FDG-PET/CT in investigation of FUO in HIV-positive patients even if they are viraemic. © 2013 British HIV Association.

  14. FDG PET/CT imaging in canine cancer patients

    DEFF Research Database (Denmark)

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

    2011-01-01

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

  15. Impact of incidental findings on integrated 2-[18F]-fluoro-2-deoxy-D-glucose positron emission tomography/computed tomography in patients with gastric cancer.

    Science.gov (United States)

    Tae, Chung Hyun; Lee, Jun Haeng; Choi, Joon Young; Min, Byung-Hoon; Rhee, Poong-Lyul; Kim, Jae J

    2015-03-01

    Since positron emission tomography/computed tomography (PET/CT) has been introduced, many incidental findings have been identified. The aim of this study was to assess the clinical significance of incidental findings on PET/CT in patients with gastric cancer. A total of 421 patients with gastric cancer underwent PET/CT for initial staging. Incidental findings on PET/CT were classified into five categories according to clinical significance--normal variant, benign, probably benign, probably malignant, and definitely malignant. We obtained information regarding follow-up examinations, additional visits, final diagnosis of incidental findings and short-term medical costs for further evaluation. Eight hundred eighty-two incidental findings were detected in 386 (91.7%) patients. Of 274 incidental findings classified as probably benign, probably malignant or definitely malignant, 130 required one or more additional investigations. Finally, 12 (9.2%) were proved to be associated with second primary malignancy or metastasis of gastric cancer. One hundred twenty-nine additional outpatient visits and 10 additional hospitalizations were needed for evaluating the incidental findings. The treatment strategy for gastric cancer was changed in one patient. The estimated cost of additional investigations was $US283 (95% CI: $US248-$US311) per patient. Incidental findings on PET/CT were common. Although the incidental findings were suspicious of malignancy, most were benign with high costs for additional investigations. © 2015 Wiley Publishing Asia Pty Ltd.

  16. F-8 sodium fluoride position emission tomography/computed tomography for detection of thyroid cancer bone metastasis compared with bone scintigraphy

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Hyun Jong; Lee, Won Woo; Park, So Yeon; Kim, Sang Eun [Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seoul (Korea, Republic of)

    2016-04-15

    The aim of the study was to compare the diagnostic performances of F-18 sodium fluoride positron emission tomography/computed tomography (bone PET/CT) and bone scintigraphy (BS) for the detection of thyroid cancer bone metastasis. We retrospectively enrolled 6 thyroid cancer patients (age = 44.7 ± 9.8 years, M:F = 1:5, papillary:follicular = 2:4) with suspected bone metastatic lesions in the whole body iodine scintigraphy or BS, who subsequently underwent bone PET/CT. Pathologic diagnosis was conducted for 4 lesions of 4 patients. Of the 17 suspected bone lesions, 10 were metastatic and 7 benign. Compared to BS, bone PET/CT exhibited superior sensitivity (10/10 = 100% vs. 2/10 = 20%, p = 0.008), and accuracy (14/17 = 82.4% vs. 7/17 = 41.2%, p < 0.025). The specificity (4/7 = 57.1%) of bone PET/CT was not significantly different from that of BS (5/7 = 71.4%, p > 0.05). Bone PET/CT may be more sensitive and accurate than BS for the detection of thyroid cancer bone metastasis.

  17. IgG4-associated multifocal systemic fibrosis detected by cancer screening with 18F-FDG positron emission tomography/computed tomography

    International Nuclear Information System (INIS)

    Soga, Shigeyoshi; Kita, Tamotsu; Hiratsuka, Miyuki; Sakaguchi, Chiharu; Shinmoto, Hiroshi; Kosuda, Shigeru; Sakata, Ikuko; Miura, Soichiro

    2010-01-01

    Serial fluorine-18 fluorodeoxyglucose positron emission tomography/computed tomography ( 18 F-FDG PET/CT) studies were performed with an interval of one year in a 62-year-old man with IgG4-associated multifocal systemic fibrosis (IMSF). He first underwent 18 F-FDG PET/CT cancer screening, which revealed multiple 18 F-FDG-avid uptakes in the pancreas, prostate, and lymph nodes in the upper mediastinum, pulmonary hila, porta hepatis, and the left iliac and inguinal regions. He was not symptomatic at this initial examination. The follow-up 18 F-FDG PET/CT study showed disappearance of 18 F-FDG-avid uptake foci in the pancreas despite no treatment having been administered, but demonstrated new lesions in the abdominal para-aortic region and more intense FDG uptake in the porta hepatis lesion. Serial 18 F-FDG PET/CT studies might be useful in monitoring patients with IMSF, as well as evaluating the state of systemic involvement. Findings of 18 F-FDG PET/CT may provide information useful for determining the optimal initiation of IMSF treatment. (author)

  18. Influence of 2-(18F) fluoro-2-deoxy-D-glucose positron emission tomography/computed tomography on recurrent ovarian cancer diagnosis and on selection of patients for secondary cytoreductive surgery

    DEFF Research Database (Denmark)

    Risum, Signe; Høgdall, Claus; Markova, Elena

    2009-01-01

    physical examination, US, or increasing cancer antigen 125 (CA125) level (>50 U/mL or >15% above baseline level). Recurrent OC was diagnosed 58 times in 52 patients. The sensitivities of US, CT, and PET/CT for diagnosing recurrence were 66% (P = 0.003), 81% (P = 0.0001), and 97% (P ...The objective of this prospective study was to compare the sensitivities and the specificities of combined 2-(F) fluoro-2-deoxy-D-glucose positron emission tomography/computed tomography (PET/CT), abdominal/transvaginal ultrasound (US), and CT for diagnosing recurrent ovarian cancer (OC......) and to evaluate the influence of PET/CT on referral of patients with solitary recurrence to secondary cytoreductive surgery. From April 2005 to November 2007, 60 patients were consecutively included to PET/CT 68 times. The inclusion criteria were remission of 3 months or longer and recurrent OC suspected from...

  19. Importance of PET/CT for imaging of colorectal cancer

    International Nuclear Information System (INIS)

    Meinel, F.G.; Schramm, N.; Graser, A.; Reiser, M.F.; Rist, C.; Haug, A.R.

    2012-01-01

    Fluorodeoxyglucose-positron emission tomography/computed tomography (FDG-PET/CT) has emerged as a very useful imaging modality in the management of colorectal carcinoma. Data from the literature regarding the role of PET/CT in the initial diagnosis, staging, radiotherapy planning, response monitoring and surveillance of colorectal carcinoma is presented. Future directions and economic aspects are discussed. Computed tomography (CT), magnetic resonance imaging (MRI) and FDG-PET for colorectal cancer and endorectal ultrasound for rectal cancer. Combined FDG-PET/CT. While other imaging modalities allow superior visualization of the extent and invasion depth of the primary tumor, PET/CT is most sensitive for the detection of distant metastases of colorectal cancer. We recommend a targeted use of PET/CT in cases of unclear M staging, prior to metastasectomy and in suspected cases of residual or recurrent colorectal carcinoma with equivocal conventional imaging. The role of PET/CT in radiotherapy planning and response monitoring needs to be determined. Currently there is no evidence to support the routine use of PET/CT for colorectal screening, staging or surveillance. To optimally exploit the synergy between morphologic and functional information, FDG-PET should generally be performed as an integrated FDG-PET/CT with a contrast-enhanced CT component in colorectal carcinoma. (orig.) [de

  20. Evaluation of dosimetric techniques in positrons emission tomography and computerized tomography (PET/CT)

    International Nuclear Information System (INIS)

    Pinto, Gabriella Montezano

    2014-01-01

    Among diagnostic techniques PET/CT is one of those with the highest dose delivery to the patient as a cause of external exposure to X-rays, and the use of a radiopharmaceutical that results in a high energy gamma emission. The dosimetry of these two components becomes important in order to optimize and justify the technique. Various dosimetric techniques are found in literature without a consensus of the best to use. With the advances in technological and consequent equipment configuration changes, upgrades and variation in methodologies, particularly in computed tomography, a standardization of these techniques is required. Previous studies show that CT is responsible for 70 % of the dose delivered to the patient in PET/CT examinations. Thus, many researchers have been focused on CT dose optimization protocols studies. This work analyzes the doses involved in a PET/CT oncology protocol by using an Alderson female anthropomorphic phantom in a public hospital of Rio de Janeiro city. The dose estimate for PET examination resulting from the use of 18 F - FDG radiopharmaceutical was conducted through dose factors published in ICRP 106; the dose for CT was estimated and compared by calculation of the absorbed doses to patients according to four methods: thermoluminescent dosimetry (TL0100) distributed in critical organs of the Alderson phantom; measurements of CTOI according to AAPM number 96; correction factor for effective diameter SSOE (AAPM Number 204); and simulation by ImPACT program For CT, the results in terms of effective dose presented (TLO, CTOI and ImPACT) ± 5 % maximum variations between methodologies. Considering medium absorbed dose (TLO, SSOE and ImPACT) the results differed in ± 7 % from each other. These findings demonstrate that parameters provided by the manufacturer on the console can be used to have a primary approach of both, absorbed and effective doses to the patient since that a quality assurance program of these parameters are adopted in

  1. Fluorodeoxyglucose Positron Emission Tomography-Computed Tomography in Disseminated Cryptococcosis.

    Science.gov (United States)

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

    2017-01-01

    Disseminated cryptococcosis without pulmonary involvement is a very rare phenomenon. Patterns of organ involvement in cryptococcosis resemble various other infective conditions as well as malignant conditions on fluorodeoxyglucose positron emission tomography-computed tomography. We present a case of a 43-year-old male patient who had disseminated cryptococcosis. The rarity of the case being noninvolvement of lungs and meninges and resembling more like lymphoma due to the diffuse involvement of the lymph nodes on both sides of the diaphragm.

  2. 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

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

    Science.gov (United States)

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

    2014-03-01

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

  4. Detection of thoracic aortic prosthetic graft infection with 18F-fluorodeoxyglucose positron emission tomography/computed tomography.

    Science.gov (United States)

    Tokuda, Yoshiyuki; Oshima, Hideki; Araki, Yoshimori; Narita, Yuji; Mutsuga, Masato; Kato, Katsuhiko; Usui, Akihiko

    2013-06-01

    To investigate the diagnostic value of (18)F-fluorodeoxyglucose positron emission tomography/computed tomography (FDG-PET/CT) in detecting thoracic aortic prosthetic graft infection. Nine patients with clinically suspected thoracic aortic graft infection underwent FDG-PET/CT scanning. In these patients, the diagnoses could not be confirmed using conventional modalities. The patients' clinical courses were retrospectively reviewed. On the basis of surgical, microbiological and clinical follow-up findings, the aortic grafts were considered infected in 4 patients and not infected in 5. All 4 patients with graft infection (root: 2 cases, arch: 1 case and descending: 1 case) eventually underwent in situ re-replacement. Two of the 4 patients also had abdominal grafts; however, only the thoracic grafts were replaced because uptake was low around the abdominal grafts. The maximal standardized uptake value (SUVmax) in the perigraft area was higher in the infected group than in the non-infected group (11.4 ± 4.5 vs 6.9 ± 6.4), although the difference was not statistically significant. According to the receiver operating characteristic analysis, SUVmax >8 appeared to be the cut-off value in distinguishing the two groups (sensitivity: 1.0 and specificity: 0.8). FDG-PET/CT is useful for confirming the presence of graft infection by detecting high uptake around grafts and excluding other causes of inflammation. An SUVmax value greater than 8 around a graft suggests the presence of graft infection. In addition, FDG-PET/CT can be used to clarify the precise extent of infection. This is especially useful if multiple separated prosthetic grafts have been implanted.

  5. 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...

  6. 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

  7. Prognostic impact of clinician-based interpretation of 18F-fluorodeoxyglucose positron emission tomography/computed tomography reports obtained in patients with newly diagnosed diffuse large B-cell lymphoma

    DEFF Research Database (Denmark)

    Mylam, Karen J; El-Galaly, Tarec C; Hutchings, Martin

    2014-01-01

    The aim of this study was to evaluate the prognostic value of clinician interpretation of positron emission tomography/computed tomography (PET/CT) reports at mid-therapy, interim PET (I-PET) and after the end of first-line therapy (E-PET) in patients with diffuse large B-cell lymphoma (DLBCL.......001) for positive, indeterminate and negative interpretation of PET/CT reports. Progression-free survival and OS did not differ significantly in patients with a negative and an indeterminate I-PET report. The use of well-defined reporting criteria, e.g. the Deauville five-point scale, is likely to reduce the number...

  8. [(18)F]Fluorodeoxyglucose - positron emission tomography/computed tomography improves staging in patients with high-risk muscle-invasive bladder cancer scheduled for radical cystectomy.

    Science.gov (United States)

    Kollberg, Petter; Almquist, Helen; Bläckberg, Mats; Cronberg, Carin; Garpered, Sabine; Gudjonsson, Sigurdur; Kleist, Jakob; Lyttkens, Kerstin; Patschan, Oliver; Liedberg, Fredrik

    2015-01-01

    The aim of this study was to evaluate the clinical use of [(18)F]fluorodeoxyglucose-positron emission tomography/computed tomography (FDG-PET/CT) in addition to conventional preoperative radiological investigations in a defined group of patients with high-risk muscle-invasive bladder cancer. In total, 103 patients with high-risk muscle-invasive bladder cancer defined as stage T3/T4 disease or as stage T2 with hydronephrosis or high-risk histological features, who were provisionally scheduled to undergo cystectomy, were prospectively recruited to the study. The patients were referred to FDG-PET/CT in addition to standard preoperative investigation with computed tomography (CT). The final treatment decision was reached at a multidisciplinary conference based on all available information including the FDG-PET/CT findings. Compared to CT alone, FDG-PET/CT provided more supplemental findings suggesting malignant manifestations in 48 (47%) of the 103 patients. The additional FDG-PET/CT findings led to an altered provisional treatment plan in 28 out of 103 patients (27%), detection of disseminated bladder cancer and subsequent cancellation of the initially intended cystectomy in 16 patients, and identification of disseminated disease and treatment with induction chemotherapy before radical cystectomy in 12 patients. Preoperative FDG-PET/CT changed the treatment plan for a considerable proportion (27%) of the present patients. Accordingly, such examination can potentially improve the preoperative staging of cystectomy patients with high-risk features, and may also reduce the number of futile operations in patients with advanced disease who are beyond cure.

  9. Diagnostic performance of fluorodeoxyglucose-positron emission tomography/computed tomography of breast cancer in detecting axillary lymph node metastasis. Comparison with ultrasonography and contrast-enhanced CT

    International Nuclear Information System (INIS)

    Monzawa, Shuichi; Adachi, Shuji; Suzuki, Kayo; Hirokaga, Koichi; Takao, Shintaro; Sakuma, Toshiko; Hanioka, Keisuke

    2009-01-01

    The purpose of this retrospective study was to evaluate the diagnostic performance of positron emission tomography/computed tomography (PET/CT) with fluorine-18-labeled 2-fluoro-2-deoxy-D-glucose (FDG) in comparison with that of ultrasonography and contrast-enhanced computed tomography (CT) in detecting axillary lymph node metastasis in patients with breast cancer. Fifty patients with invasive breast cancer were recruited. They had received no neoadjuvant chemotherapy and underwent PET/CT, ultrasonography and contrast-enhanced CT before mastectomy. The clinical stage was I in 34 patients, II in 15 patients, and III in one patient. The images of these modalities were interpreted in usual practice before surgery and the diagnostic reports were reviewed for analysis. Sensitivity, specificity, positive predictive value, and negative predictive value of each modality were obtained taking histopathological results of axillary lymph node dissection or sentinel lymph node biopsy as the reference standard. Axillary lymph node metastasis was confirmed in 15 of 50 patients by histopathological studies. PET/CT identified lymph node metastasis in three of these 15 patients. The overall sensitivity and specificity, positive predictive value, and negative predictive value of PET/CT in the diagnosis of axillary lymph node metastasis were 20, 97, 75, and 74%, and those of ultrasonography were 33, 94, 71, and 77% and those of contrast-enhanced CT were 27, 97, 80, and 76%, respectively. PET/CT showed poor sensitivity and high specificity in the detection of axillary lymph node metastasis of breast cancer. Diagnostic performance of PET/CT was not superior to that of ultrasonography and contrast-enhanced CT. (author)

  10. 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.)

  11. Predicted extracapsular invasion of hilar lymph node metastasis by fusion positron emission tomography/computed tomography in patients with lung cancer.

    Science.gov (United States)

    Makino, Takashi; Hata, Yoshinobu; Otsuka, Hajime; Koezuka, Satoshi; Isobe, Kazutoshi; Tochigi, Nobumi; Shiraga, Nobuyuki; Shibuya, Kazutoshi; Homma, Sakae; Iyoda, Akira

    2015-09-01

    Intraoperative detection of hilar lymph node metastasis, particularly with extracapsular invasion, may affect the surgical procedure in patients with lung cancer, as the preoperative estimation of hilar lymph node metastasis is unsatisfactory. The aim of this study was to investigate whether fusion positron emission tomography/computed tomography (PET/CT) is able to predict extracapsular invasion of hilar lymph node metastasis. Between April, 2007 and April, 2013, 509 patients with primary lung cancer underwent surgical resection at our institution, among whom 28 patients exhibiting hilar lymph node metastasis (at stations 10 and 11) were enrolled in this study. A maximum lymph node standardized uptake value of >2.5 in PET scans was interpreted as positive. A total of 17 patients had positive preoperative PET/CT findings in their hilar lymph nodes, while the remaining 11 had negative findings. With regard to extracapsular nodal invasion, the PET/CT findings (P=0.0005) and the histological findings (squamous cell carcinoma, P=0.05) were found to be significant predictors in the univariate analysis. In the multivariate analysis, the PET/CT findings were the only independent predictor (P=0.0004). The requirement for extensive pulmonary resection (sleeve lobectomy, bilobectomy or pneumonectomy) was significantly more frequent in the patient group with positive compared with the group with negative PET/CT findings (76 vs. 9%, respectively, P=0.01). Therefore, the PET/CT findings in the hilar lymph nodes were useful for the prediction of extracapsular invasion and, consequently, for the estimation of possible extensive pulmonary resection.

  12. The Anatomical Biological Value on Pretreatment (18)F-fluorodeoxyglucose Positron Emission Tomography Computed Tomography Predicts Response and Survival in Locally Advanced Head and Neck Cancer.

    Science.gov (United States)

    Ashamalla, Hani; Mattes, Malcolm; Guirguis, Adel; Zaidi, Arifa; Mokhtar, Bahaa; Tejwani, Ajay

    2014-05-01

    (18)F-fluorodeoxyglucose positron emission tomography/computed tomography (PET/CT) has become increasingly relevant in the staging of head and neck cancers, but its prognostic value is controversial. The objective of this study was to evaluate different PET/CT parameters for their ability to predict response to therapy and survival in patients treated for head and neck cancer. A total of 28 consecutive patients with a variety of newly diagnosed head and neck cancers underwent PET/CT scanning at our institution before initiating definitive radiation therapy. All underwent a posttreatment PET/CT to gauge tumor response. Pretreatment PET/CT parameters calculated include the standardized uptake value (SUV) and the anatomical biological value (ABV), which is the product of SUV and greatest tumor diameter. Maximum and mean values were studied for both SUV and ABV, and correlated with response rate and survival. The mean pretreatment tumor ABVmax decreased from 35.5 to 7.9 (P = 0.0001). Of the parameters tested, only pretreatment ABVmax was significantly different among those patients with a complete response (CR) and incomplete response (22.8 vs. 65, respectively, P = 0.021). This difference was maximized at a cut-off ABVmax of 30 and those patients with ABVmax < 30 were significantly more likely to have a CR compared to those with ABVmax of ≥ 30 (93.8% vs. 50%, respectively, P = 0.023). The 5-year overall survival was 80% compared to 36%, respectively, (P = 0.028). Multivariate analysis confirmed that ABVmax was an independent prognostic factor. Our data supports the use of PET/CT, and specifically ABVmax, as a prognostic factor in head and neck cancer. Patients who have an ABVmax ≥ 30 were more likely to have a poor outcome with chemoradiation alone, and a more aggressive trimodality approach may be indicated in these patients.

  13. The Impact of Positron Emission Tomography/Computed Tomography in Edge Delineation of Gross Tumor Volume for Head and Neck Cancers

    International Nuclear Information System (INIS)

    Ashamalla, Hani; Guirgius, Adel; Bieniek, Ewa; Rafla, Sameer; Evola, Alex; Goswami, Ganesh; Oldroyd, Randall; Mokhtar, Bahaa; Parikh, Kapila

    2007-01-01

    Purpose: To study anatomic biologic contouring (ABC), using a previously described distinct halo, to unify volume contouring methods in treatment planning for head and neck cancers. Methods and Materials: Twenty-five patients with head and neck cancer at various sites were planned for radiation therapy using positron emission tomography/computed tomography (PET/CT). The ABC halo was used in all PET/CT scans to contour the gross tumor volume (GTV) edge. The CT-based GTV (GTV-CT) and PET/CT-based GTV (GTV-ABC) were contoured by two independent radiation oncologists. Results: The ABC halo was observed in all patients studied. The halo had a standard unit value of 2.19 ± 0.28. The mean halo thickness was 2.02 ± 0.21 mm. Significant volume modification (≥25%) was seen in 17 of 25 patients (68%) after implementation of GTV-ABC. Concordance among observers was increased with the use of the halo as a guide for GTV determination: 6 patients (24%) had a ≤10% volume discrepancy with CT alone, compared with 22 (88%) with PET/CT (p 3 in CT-based planning to 7.2 cm 3 in PET/CT-based planning (p < 0.001). Conclusions: Using the 'anatomic biologic halo' to contour GTV in PET/CT improves consistency among observers. The distinctive appearance of the described halo and its presence in all of the studied tumors make it attractive for GTV contouring in head and neck tumors. Additional studies are needed to confirm the correlation of the halo with presence of malignant cells

  14. Role of 18F fluorodeoxyglucose positron emission tomography/computed tomography in the detection of recurrence in patients with cervical cancer

    International Nuclear Information System (INIS)

    Bhoil, Amit; Mittal, Bhagwant Rai; Bhattacharya, Anish; Santhosh, Sampath; Patel, Firuza

    2013-01-01

    Treatment of cervical cancer is usually surgery in the early stages and radiotherapy or chemoradiotherapy in more advanced stages of the disease. Recurrence may occur in multiple sites following primary treatment. Although recurrent metastatic disease is not curable, surgical treatment may be of great help if locoregional recurrence is detected early. Fluorine-18 Fluorodeoxyglucose positron emission tomography - computed tomography ( 18 F FDG PET/CT) forms an important part of investigations in the diagnosis of clinically suspicious recurrent cervical cancer. To assess the role of 18 F FDG PET/CT in diagnosing recurrence in patients with clinical suspicion of recurrent cervical cancer. We retrospectively evaluated 53 histopathologically proved patients of cervical cancer. All the patients had been treated with either surgery/radiation therapy with or without chemotherapy. The standard PET/CT acquisition protocol, with delayed post void static pelvic images, wherever required, was followed in all patients. Significant uptake of FDG in the lymph nodes was considered to be a recurrence suggestive of metastasis. Para-aortic lymph nodal involvement was considered to be distant metastasis. Any significant uptake in the lung nodule on FDG PET was evaluated either by histological confirmation, by taking fine needle aspiration cytology (FNAC), or by a follow-up chest CT done after three months. Of the 53 patients with clinically equivocal recurrence, FDG PET/CT suggested recurrence in 41 patients (local recurrence in 14 patients and distant recurrence/metastasis with or without local recurrence in 27 patients). It had a sensitivity of 97.5%, a specificity of 63.6%, positive predictive value of 90.9%, and negative predictive value of 87.5%. PET/CT appears to have an important role in detecting recurrence following primary treatment of cervical cancer. The high positive and negative predictive values of PET/CT may be helpful in planning management of recurrent cervical cancer

  15. PET/CT-guided interventions: Indications, advantages, disadvantages and the state of the art.

    Science.gov (United States)

    Cazzato, Roberto Luigi; Garnon, Julien; Shaygi, Behnam; Koch, Guillaume; Tsoumakidou, Georgia; Caudrelier, Jean; Addeo, Pietro; Bachellier, Philippe; Namer, Izzie Jacques; Gangi, Afshin

    2018-02-01

    Positron emission tomography/computed tomography (PET/CT) represents an emerging imaging guidance modality that has been applied to successfully guide percutaneous procedures such as biopsies and tumour ablations. The aim of the present narrative review is to report the indications, advantages and disadvantages of PET/CT-guided procedures in the field of interventional oncology and to briefly describe the experience gained with this new emerging technique while performing biopsies and tumor ablations.

  16. Impacts of biological and procedural factors on semiquantification uptake value of liver in fluorine-18 fluorodeoxyglucose positron emission tomography/computed tomography imaging.

    Science.gov (United States)

    Mahmud, Mohd Hafizi; Nordin, Abdul Jalil; Ahmad Saad, Fathinul Fikri; Azman, Ahmad Zaid Fattah

    2015-10-01

    Increased metabolic activity of fluorodeoxyglucose (FDG) in tissue is not only resulting of pathological uptake, but due to physiological uptake as well. This study aimed to determine the impacts of biological and procedural factors on FDG uptake of liver in whole body positron emission tomography/computed tomography (PET/CT) imaging. Whole body fluorine-18 ((18)F) FDG PET/CT scans of 51 oncology patients have been reviewed. Maximum standardized uptake value (SUVmax) of lesion-free liver was quantified in each patient. Pearson correlation was performed to determine the association between the factors of age, body mass index (BMI), blood glucose level, FDG dose and incubation period and liver SUVmax. Multivariate regression analysis was established to determine the significant factors that best predicted the liver SUVmax. Then the subjects were dichotomised into four BMI groups. Analysis of variance (ANOVA) was established for mean difference of SUVmax of liver between those BMI groups. BMI and incubation period were significantly associated with liver SUVmax. These factors were accounted for 29.6% of the liver SUVmax variance. Statistically significant differences were observed in the mean SUVmax of liver among those BMI groups (Pvalue for physiological liver SUVmax as a reference standard for different BMI of patients in PET/CT interpretation and use a standard protocol for incubation period of patient to reduce variation in physiological FDG uptake of liver in PET/CT study.

  17. F-18 Sodium Fluoride Positron Emission Tomography/Computed Tomography for Detection of Thyroid Cancer Bone Metastasis Compared with Bone Scintigraphy.

    Science.gov (United States)

    Lee, Hyunjong; Lee, Won Woo; Park, So Yeon; Kim, Sang Eun

    2016-01-01

    The aim of the study was to compare the diagnostic performances of F-18 sodium fluoride positron emission tomography/computed tomography (bone PET/CT) and bone scintigraphy (BS) for the detection of thyroid cancer bone metastasis. We retrospectively enrolled 6 thyroid cancer patients (age = 44.7 ± 9.8 years, M:F = 1:5, papillary:follicular = 2:4) with suspected bone metastatic lesions in the whole body iodine scintigraphy or BS, who subsequently underwent bone PET/CT. Pathologic diagnosis was conducted for 4 lesions of 4 patients. Of the 17 suspected bone lesions, 10 were metastatic and 7 benign. Compared to BS, bone PET/CT exhibited superior sensitivity (10/10 = 100% vs. 2/10 = 20%, p = 0.008), and accuracy (14/17 = 82.4% vs. 7/17 = 41.2%, p 0.05). Bone PET/CT may be more sensitive and accurate than BS for the detection of thyroid cancer bone metastasis.

  18. Incidental detection of prostate-specific antigen-negative metastatic prostate cancer initially presented with solitary pulmonary nodule on fluorodeoxyglucose positron emission tomography/computed tomography

    International Nuclear Information System (INIS)

    Erdogan, Ezgi Basak; Buyukpinarbasili, Nur; Ziyade, Sedat; Akman, Tolga; Turk, Haci Mehmet; Aydin, Mehmet

    2005-01-01

    A 71-year-old male patient with solitary pulmonary nodule underwent fluorodeoxyglucose positron emission tomography/computed tomography (FDG PET/CT) showing slightly increased FDG uptake in this nodule. In addition, PET/CT detected hypermetabolic sclerotic bone lesions in the right second rib and 7 th thoracic vertebrae, which were interpreted as possible metastases, and mildly increased FDG uptake in the prostate gland highly suspicious of malignancy. The patient's prostate-specific antigen (PSA) level was within normal range (3.8 ng/dL). The histopathological examination of the lung nodule and right second rib lesion proved metastases from prostate cancer, then the prostate biopsy-confirmed prostate adenocarcinoma. The unique feature of this case is to emphasize the importance of performing PET/CT for solitary pulmonary nodule in detecting PSA-negative metastatic prostate cancer. This case indicated that it should be kept in mind that, even if the PSA is negative, a lung metastasis of prostate cancer may be an underlying cause in patients evaluated for solitary pulmonary nodule by FDG PET/CT

  19. Diagnostic value of positron emission tomography/computed tomography with fluorine-18 fluorodeoxyglucose in patients with differentiated thyroid gland carcinoma, high thyroglobulin serum levels and negative iodine whole body scan; Valor diagnostico da tomografia por emissao de positrons/tomografia computadorizada (PET-CT) com fluor-18 fluordeoxiglicose (FDG-{sup 18}F) em pacientes com carcinoma diferenciado da tireoide, niveis sericos de tireoglobulina elevados e pesquisa de corpo inteiro com iodo negativa

    Energy Technology Data Exchange (ETDEWEB)

    Yamaga, Lilian Yuri Itaya; Cunha, Marcelo Livorsi da; Wagner, Jairo; Thom, Annelise Fischer; Daniel, Mauro Miguel; Funari, Marcelo B. de Gusmao [Hospital Israelita Albert Einstein, Sao Paulo, SP (Brazil). Dept. de Imagem]. E-mail: itaya@einstein.br

    2007-06-15

    Purpose: To evaluate the role of PET-CT with FDG-{sup 18}F in the detection of recurrence and/or metastasis of differentiated thyroid carcinoma (DTC) in patients with elevated levels of thyroglobulin (TG) and negative whole body scan (WBS). Patients and method: PET-CT findings of 25 patients were compared to histopathology evaluation and conventional imaging (CI). Results: PET-CT scan was positive in 16 patients finding 14 true-positive and 2 false-positive cases (positive predictive value 87.5%). Nine patients had negative PET-CT; two had decrease of TG to undetectable levels. One patient had residual disease detected by post-therapeutic WBS. Six patients had no evidence of tumor during follow-up (mean time 16 months). PET-CT was concordant with CI in 52%, partially concordant in 12% and discordant in 36% (6 false-negatives and 3 false-positive of CI). We observed a tendency of increasing proportion of positive PET-CT with increasing TG. Conclusion: PET-CT scan with FDG-{sup 18}F is useful in the detection of recurrence and/or metastases of DTC with high TG levels but negative WBS. It presents elevated positive predictive value and is superior to CI being more effective as higher the serum TG levels. (author)

  20. Simultaneous 68Ga DOTATATE Positron Emission Tomography/Magnetic Resonance Imaging in Meningioma Target Contouring: Feasibility and Impact Upon Interobserver Variability Versus Positron Emission Tomography/Computed Tomography and Computed Tomography/Magnetic Resonance Imaging.

    Science.gov (United States)

    Maclean, J; Fersht, N; Sullivan, K; Kayani, I; Bomanji, J; Dickson, J; O'Meara, C; Short, S

    2017-07-01

    The increasing use of highly conformal radiation techniques to treat meningioma confers a greater need for accurate targeting. Several groups have shown that positron emission tomography/computed tomography (PET/CT) information alters meningioma targets contoured by single observers, but whether this translates into improved accuracy has not been defined. As magnetic resonance imaging (MRI) is the cornerstone of meningioma target contouring, simultaneous PET/MRI may be superior to PET/CT. We assessed whether 68 Ga DOTATATE PET imaging (from PET/CT and PET/MRI) reduced interobserver variability (IOV) in meningioma target volume contouring. Ten patients with meningioma underwent simultaneous 68 Ga DOTATATE PET/MRI followed by PET/CT. They were selected as it was anticipated that target volume definition in their cases would be particularly challenging. Three radiation oncologists contoured target volumes according to an agreed protocol: gross tumour volume (GTV) and clinical target volume (CTV) on CT/MRI alone, CT/MRI+PET(CT) and CT/MRI+PET(MRI). GTV/CTV Kouwenhoven conformity levels (KCL), regions of contour variation and qualitative differences between PET(CT) and PET(MRI) were evaluated. There was substantial IOV in contouring. GTV mean KCL: CT/MRI 0.34, CT/MRI+PET(CT) 0.38, CT/MRI+PET(MRI) 0.39 (P = 0.06). CTV mean KCL: CT/MRI 0.31, CT/MRI+PET(CT) 0.35, CT/MRI+PET(MRI) 0.35 (P = 0.04 for all groups; P > 0.05 for individual pairs). One observer consistently contoured largest and one smallest. Observers rarely decreased volumes in relation to PET. Most IOV occurred in bone followed by dural tail, postoperative bed and venous sinuses. Tumour edges were qualitatively clearer on PET(MRI) versus PET(CT), but this did not affect contouring. IOV in contouring challenging meningioma cases was large and only slightly improved with the addition of 68 Ga DOTATATE PET. Simultaneous PET/MRI for meningioma contouring is feasible, but did not improve IOV versus PET/CT

  1. Shielding Calculations for Positron Emission Tomography - Computed Tomography Facilities

    Energy Technology Data Exchange (ETDEWEB)

    Baasandorj, Khashbayar [Korea Atomic Energy Research Institute, Daejeon (Korea, Republic of); Yang, Jeongseon [Korea Institute of Nuclear Safety, Daejeon (Korea, Republic of)

    2015-10-15

    Integrated PET-CT has been shown to be more accurate for lesion localization and characterization than PET or CT alone, and the results obtained from PET and CT separately and interpreted side by side or following software based fusion of the PET and CT datasets. At the same time, PET-CT scans can result in high patient and staff doses; therefore, careful site planning and shielding of this imaging modality have become challenging issues in the field. In Mongolia, the introduction of PET-CT facilities is currently being considered in many hospitals. Thus, additional regulatory legislation for nuclear and radiation applications is necessary, for example, in regulating licensee processes and ensuring radiation safety during the operations. This paper aims to determine appropriate PET-CT shielding designs using numerical formulas and computer code. Since presently there are no PET-CT facilities in Mongolia, contact was made with radiological staff at the Nuclear Medicine Center of the National Cancer Center of Mongolia (NCCM) to get information about facilities where the introduction of PET-CT is being considered. Well-designed facilities do not require additional shielding, which should help cut down overall costs related to PET-CT installation. According to the results of this study, building barrier thicknesses of the NCCM building is not sufficient to keep radiation dose within the limits.

  2. Ultrasound, elastography, and fluorodeoxyglucose positron emission tomography/computed tomography imaging in Riedel's thyroiditis: report of two cases.

    Science.gov (United States)

    Slman, Rouba; Monpeyssen, Hervé; Desarnaud, Serge; Haroche, Julien; Fediaevsky, Laurence Du Pasquier; Fabrice, Menegaux; Seret-Begue, Dominique; Amoura, Zahir; Aurengo, André; Leenhardt, Laurence

    2011-07-01

    Riedel's thyroiditis (RT) is a rare disease characterized by a chronic inflammatory lesion of the thyroid gland with invasion by a dense fibrosis. Publications of the imaging features of RT are scarce. To our knowledge, ultrasound elastography (USE) findings have not been previously reported. Therefore, we describe two patients with RT who were imaged with ultrasonography (US), USE, and fluorodeoxyglucose positron emission tomography/computed tomography (FDG-PET/CT). Two women were referred for a large, hard goiter with compressive symptoms (dyspnea and dysphagia); in one patient, the goiter was associated with retroperitoneal fibrosis. In both cases, RT was confirmed by surgical biopsy with pathological examination. Thyroid US imaging was performed with a US scan and a 10-13 MHz linear transducer. The hardness of the tissues was analyzed using transient USE (ShearWave, Aixplorer-SuperSonic Imagine). PET/CT scanning was performed with a Philips Gemini GXL camera (GE Medical Systems). In the first patient, US examination revealed a compressive multinodular goiter with large solid hypoechoic and poorly vascularized areas adjacent to the nodules. The predominant right nodule was hypoechoic with irregular margins. The second patient had a hypoechoic goiter with large bilateral hypoechoic areas. In both cases, an unusual feature was observed: the presence of tissue surrounding the primitive carotid artery, associated with thrombi of the internal jugular vein. Further, USE showed heterogeneity in the stiffness values of the thyroid parenchyma varying between 21 kPa and 281 kPa. FDG-PET/CT imaging showed uptake foci in the thyroid gland. In both cases, US showed a decrease in the thyroid gland volume and the disappearance of encasement of the neck vasculature in response to corticosteroid treatment. In contrast, the FDG-PET/CT features remained unchanged. US features, such as vascular encasement and improvement under corticosteroid treatment, seem to be specific to this

  3. 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...

  4. Differences in fluorodeoxyglucose positron emission tomography/computed tomography findings between elderly onset rheumatoid arthritis and polymyalgia rheumatica.

    Science.gov (United States)

    Takahashi, Hiroyuki; Yamashita, Hiroyuki; Kubota, Kazuo; Miyata, Yoko; Okasaki, Momoko; Morooka, Miyako; Takahashi, Yuko; Kaneko, Hiroshi; Kano, Toshikazu; Mimori, Akio

    2015-07-01

    To compare the fluorodeoxyglucose positron emission tomography/computed tomography (FDG-PET/CT) findings in patients with elderly-onset rheumatoid arthritis (EORA) with those in patients with polymyalgia rheumatica (PMR), two conditions with similar clinical presentations. We retrospectively analyzed the FDG-PET/CT findings in 10 patients with EORA and 27 patients with PMR admitted to our department between 2006 and 2012. No significant difference was observed in the median patient ages at the time of FDG-PET/CT scans in the EORA and PMR groups (73.5 vs. 78.0 years, respectively). Significant differences in both FDG uptake scores and standardized uptake values were observed between the two groups in the ischial tuberosities, spinous processes, and wrists. No significant differences were detected in the shoulders and hips. However, specific uptake patterns were observed in each group: circular and linear uptake patterns were observed around the humeral head in the EORA group, whereas focal and non-linear uptake patterns were observed in the PMR group. Moreover, focal uptake in front of the hip joint, indicating iliopectineal bursitis, tended to be limited to the PMR group. High sensitivity (92.6%) and specificity (90%) were observed for PMR diagnoses when at least three of the following five items were satisfied: characteristic findings of shoulder and iliopectineal bursitis, FDG uptake in ischial tuberosities and spinal spinous processes, and lack of FDG uptake in the wrists. The differences in the degree of uptake at each lesion and in uptake patterns at the shoulders and hips are potentially useful for obtaining a definitive diagnosis.

  5. 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.

  6. 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.

  7. 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...

  8. 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

    Energy Technology Data Exchange (ETDEWEB)

    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)

  9. Diagnostic and prognostic impact of 18F-FDG PET/CT in follicular lymphoma

    International Nuclear Information System (INIS)

    Le Dortz, Ludovic; Garin, Etienne; Guibert, Sophie de; Houot, Roch; Bayat, Sahar; Cuggia, Marc; Devillers, Anne; Le Jeune, Florence; Bahri, Haifa; Barge, Marie-Luce; Rolland, Yan; Lamy, Thierry

    2010-01-01

    The aim of this study was to assess the usefulness of positron emission tomography/computed tomography in staging, prognosis evaluation and restaging of patients with follicular lymphoma. A retrospective study was performed on 45 patients with untreated biopsy-proven follicular lymphoma who underwent 18 F-fluorodeoxyglucose PET/CT (FDG PET/CT) and CT before and after chemoimmunotherapy induction treatment (rituximab combined with cyclophosphamide, doxorubicin, vincristine and prednisone). PET/CT detected more nodal (+51%) and extranodal (+89%) lesions than CT. PET/CT modified Ann Arbor staging in eight patients (18%). Five patients (11%) initially considered as being early stage (I/II) were eventually treated as advanced stage (III/IV). In this study, an initial PET/CT prognostic score was significantly more accurate than the Follicular Lymphoma International Prognostic Index score in identifying patients with poor prognosis (i.e. patients with incomplete therapeutic response or early relapse). The accuracy of PET/CT for therapeutic response assessment was higher than that of CT (0.97 vs 0.64), especially due to its ability to identify inactive residual masses. In addition, post-treatment PET/CT was able to predict patients' outcomes. The median progression-free survival was 48 months in the PET/CT-negative group as compared with 17.2 months for the group with residual uptake (p -4 ). FDG PET/CT is useful for staging and assessing the prognosis and therapeutic response of patients with follicular lymphoma. (orig.)

  10. Pure ground glass nodular adenocarcinomas: Are preoperative positron emission tomography/computed tomography and brain magnetic resonance imaging useful or necessary?

    Science.gov (United States)

    Cho, Hyoun; Lee, Ho Yun; Kim, Jhingook; Kim, Hong Kwan; Choi, Joon Young; Um, Sang-Won; Lee, Kyung Soo

    2015-09-01

    The utility of (18)F-Fluorodeoxyglucose positron emission tomography/computed tomography (FDG PET/CT) scanning and brain magnetic resonance imaging (MRI) as a staging workup for lung adenocarcinoma manifesting as pure ground glass opacity (GGO) is unknown. The purpose of this study was to determine the utility of these 2 tests for preoperative staging of pure GGO nodular lung adenocarcinoma. The study included 164 patients (male:female, 73:91; mean age, 62 years) with pure GGO nodular lung adenocarcinoma who underwent PET/CT (in 136 patients) and/or brain MRI (in 109 patients) before surgery. Pathologic N staging and dedicated standard imaging or follow-up imaging findings for M staging were used as reference standards. The median follow-up time was 47.9 months. On PET/CT scan, abnormal FDG uptake of lymph nodes was found in 2 of 136 patients (1.5%); both were negative on final pathology. Abnormal FDG uptake of the liver was detected in 1 patient, which was also confirmed to be negative by dedicated abdominal CT. The sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of PET/CT in detecting metastases were not applicable, 98% (95% confidence interval [CI], 94%-100%), 0% (95% CI, 0%-71%), 100% (95% CI, 97%-100%), and 98% (95% CI, 94%-100%), respectively. No brain metastasis was found in preoperative brain MRI of 109 patients. Of 109 patients, 1 (0.9%) developed brain metastasis 30 months after surgical resection. PET/CT and brain MRI is not necessary in the staging of pure GGO nodular lung adenocarcinoma. Copyright © 2015 The American Association for Thoracic Surgery. Published by Elsevier Inc. All rights reserved.

  11. Intra-tumour 18F-FDG uptake heterogeneity decreases the reliability on target volume definition with positron emission tomography/computed tomography imaging.

    Science.gov (United States)

    Dong, Xinzhe; Wu, Peipei; Sun, Xiaorong; Li, Wenwu; Wan, Honglin; Yu, Jinming; Xing, Ligang

    2015-06-01

    This study aims to explore whether the intra-tumour (18) F-fluorodeoxyglucose (FDG) uptake heterogeneity affects the reliability of target volume definition with FDG positron emission tomography/computed tomography (PET/CT) imaging for nonsmall cell lung cancer (NSCLC) and squamous cell oesophageal cancer (SCEC). Patients with NSCLC (n = 50) or SCEC (n = 50) who received (18)F-FDG PET/CT scanning before treatments were included in this retrospective study. Intra-tumour FDG uptake heterogeneity was assessed by visual scoring, the coefficient of variation (COV) of the standardised uptake value (SUV) and the image texture feature (entropy). Tumour volumes (gross tumour volume (GTV)) were delineated on the CT images (GTV(CT)), the fused PET/CT images (GTV(PET-CT)) and the PET images, using a threshold at 40% SUV(max) (GTV(PET40%)) or the SUV cut-off value of 2.5 (GTV(PET2.5)). The correlation between the FDG uptake heterogeneity parameters and the differences in tumour volumes among GTV(CT), GTV(PET-CT), GTV(PET40%) and GTV(PET2.5) was analysed. For both NSCLC and SCEC, obvious correlations were found between uptake heterogeneity, SUV or tumour volumes. Three types of heterogeneity parameters were consistent and closely related to each other. Substantial differences between the four methods of GTV definition were found. The differences between the GTV correlated significantly with PET heterogeneity defined with the visual score, the COV or the textural feature-entropy for NSCLC and SCEC. In tumours with a high FDG uptake heterogeneity, a larger GTV delineation difference was found. Advance image segmentation algorithms dealing with tracer uptake heterogeneity should be incorporated into the treatment planning system. © 2015 The Royal Australian and New Zealand College of Radiologists.

  12. Intra-tumour 18F-FDG uptake heterogeneity decreases the reliability on target volume definition with positron emission tomography/computed tomography imaging

    International Nuclear Information System (INIS)

    Dong, Xinzhe; Wu, Peipei; Yu, Jinming; Xing, Ligang; Sun, Xiaorong; Li, Wenwu; Wan, Honglin

    2015-01-01

    This study aims to explore whether the intra-tumour 18 F-fluorodeoxyglucose (FDG) uptake heterogeneity affects the reliability of target volume definition with FDG positron emission tomography/computed tomography (PET/CT) imaging for nonsmall cell lung cancer (NSCLC) and squamous cell oesophageal cancer (SCEC). Patients with NSCLC (n = 50) or SCEC (n = 50) who received 18 F-FDG PET/CT scanning before treatments were included in this retrospective study. Intra-tumour FDG uptake heterogeneity was assessed by visual scoring, the coefficient of variation (COV) of the standardised uptake value (SUV) and the image texture feature (entropy). Tumour volumes (gross tumour volume (GTV) ) were delineated on the CT images (GTV CT ), the fused PET/CT images (GTV PET-CT ) and the PET images, using a threshold at 40% SUV max (GTV PET40% ) or the SUV cut-off value of 2.5 (GTV PET2.5 ). The correlation between the FDG uptake heterogeneity parameters and the differences in tumour volumes among GTV CT , GTV PET-CT , GTV PET40% and GTV PET2.5 was analysed. For both NSCLC and SCEC, obvious correlations were found between uptake heterogeneity, SUV or tumour volumes. Three types of heterogeneity parameters were consistent and closely related to each other. Substantial differences between the four methods of GTV definition were found. The differences between the GTV correlated significantly with PET heterogeneity defined with the visual score, the COV or the textural feature-entropy for NSCLC and SCEC. In tumours with a high FDG uptake heterogeneity, a larger GTV delineation difference was found. Advance image segmentation algorithms dealing with tracer uptake heterogeneity should be incorporated into the treatment planning system.

  13. Positron Emission Tomography/Computed Tomography Imaging of Residual Skull Base Chordoma Before Radiotherapy Using Fluoromisonidazole and Fluorodeoxyglucose: Potential Consequences for Dose Painting

    Energy Technology Data Exchange (ETDEWEB)

    Mammar, Hamid, E-mail: hamid.mammar@unice.fr [Radiation Oncology Department, Antoine Lacassagne Center, Nice (France); CNRS-UMR 6543, Institute of Developmental Biology and Cancer, University of Nice Sophia Antipolis, Nice (France); Kerrou, Khaldoun; Nataf, Valerie [Department of Nuclear Medicine and Radiopharmacy, Tenon Hospital, and University Pierre et Marie Curie, Paris (France); Pontvert, Dominique [Proton Therapy Center of Orsay, Curie Institute, Paris (France); Clemenceau, Stephane [Department of Neurosurgery, Pitie-Salpetriere Hospital, Paris (France); Lot, Guillaume [Department of Neurosurgery, Adolph De Rothschild Foundation, Paris (France); George, Bernard [Department of Neurosurgery, Lariboisiere Hospital, Paris (France); Polivka, Marc [Department of Pathology, Lariboisiere Hospital, Paris (France); Mokhtari, Karima [Department of Pathology, Pitie-Salpetriere Hospital, Paris (France); Ferrand, Regis; Feuvret, Loiec; Habrand, Jean-louis [Proton Therapy Center of Orsay, Curie Institute, Paris (France); Pouyssegur, Jacques; Mazure, Nathalie [CNRS-UMR 6543, Institute of Developmental Biology and Cancer, University of Nice Sophia Antipolis, Nice (France); Talbot, Jean-Noeel [Department of Nuclear Medicine and Radiopharmacy, Tenon Hospital, and University Pierre et Marie Curie, Paris (France)

    2012-11-01

    Purpose: To detect the presence of hypoxic tissue, which is known to increase the radioresistant phenotype, by its uptake of fluoromisonidazole (18F) (FMISO) using hybrid positron emission tomography/computed tomography (PET/CT) imaging, and to compare it with the glucose-avid tumor tissue imaged with fluorodeoxyglucose (18F) (FDG), in residual postsurgical skull base chordoma scheduled for radiotherapy. Patients and Methods: Seven patients with incompletely resected skull base chordomas were planned for high-dose radiotherapy (dose {>=}70 Gy). All 7 patients underwent FDG and FMISO PET/CT. Images were analyzed qualitatively by visual examination and semiquantitatively by computing the ratio of the maximal standardized uptake value (SUVmax) of the tumor and cerebellum (T/C R), with delineation of lesions on conventional imaging. Results: Of the eight lesion sites imaged with FDG PET/CT, only one was visible, whereas seven of nine lesions were visible on FMISO PET/CT. The median SUVmax in the tumor area was 2.8 g/mL (minimum 2.1; maximum 3.5) for FDG and 0.83 g/mL (minimum 0.3; maximum 1.2) for FMISO. The T/C R values ranged between 0.30 and 0.63 for FDG (median, 0.41) and between 0.75 and 2.20 for FMISO (median,1.59). FMISO T/C R >1 in six lesions suggested the presence of hypoxic tissue. There was no correlation between FMISO and FDG uptake in individual chordomas (r = 0.18, p = 0.7). Conclusion: FMISO PET/CT enables imaging of the hypoxic component in residual chordomas. In the future, it could help to better define boosted volumes for irradiation and to overcome the radioresistance of these lesions. No relationship was founded between hypoxia and glucose metabolism in these tumors after initial surgery.

  14. Pilot study utilizing Fluorine-18 fluorodeoxyglucose-positron emission tomography/computed tomography for glycolytic phenotyping of canine mast cell tumors.

    Science.gov (United States)

    Griffin, Lynn R; Thamm, Doug H; Selmic, Laura E; Ehrhart, E J; Randall, Elissa

    2018-03-23

    The goal of this prospective pilot study was to use naturally occurring canine mast cell tumors of various grades and stages as a model for attempting to determine how glucose uptake and markers of biologic behavior are correlated. It was hypothesized that enhanced glucose uptake, as measured by 2-[fluorine-18]fluoro-d-glucose-positron emission tomography/computed tomography (F18 FDG PET-CT), would correlate with histologic grade. Dogs were recruited for this study from a population referred for treatment of cytologically or histologically confirmed mast cell tumors. Patients were staged utilizing standard of care methods (abdominal ultrasound and three view thoracic radiographs), followed by a whole body F18 FDG PET-CT. Results of the F18 FDG PET-CT were analyzed for possible metastasis and standard uptake value maximum (SUV max ) of identified lesions. Incisional or excisional biopsies of the accessible mast cell tumors were obtained and histology performed. Results were then analyzed to look for a possible correlation between the grade of mast cell tumors and SUV max . A total of nine animals were included in the sample. Findings indicated that there was a correlation between grade of mast cell tumors and SUV max as determined by F18 FDG PET-CT (p-value = 0.073, significance ≤ 0.1). Based on the limited power of this study, it is felt that further research to examine the relationship between glucose utilization and biologic aggressiveness in canine mast cell tumors is warranted. This study was unable to show that F18 FDG PET-CT was a better staging tool than standard of care methods. © 2018 American College of Veterinary Radiology.

  15. Nonrigid Image Registration for Head and Neck Cancer Radiotherapy Treatment Planning With PET/CT

    International Nuclear Information System (INIS)

    Ireland, Rob H.; Dyker, Karen E.; Barber, David C.; Wood, Steven M.; Hanney, Michael B.; Tindale, Wendy B.; Woodhouse, Neil; Hoggard, Nigel; Conway, John; Robinson, Martin H.

    2007-01-01

    Purpose: Head and neck radiotherapy planning with positron emission tomography/computed tomography (PET/CT) requires the images to be reliably registered with treatment planning CT. Acquiring PET/CT in treatment position is problematic, and in practice for some patients it may be beneficial to use diagnostic PET/CT for radiotherapy planning. Therefore, the aim of this study was first to quantify the image registration accuracy of PET/CT to radiotherapy CT and, second, to assess whether PET/CT acquired in diagnostic position can be registered to planning CT. Methods and Materials: Positron emission tomography/CT acquired in diagnostic and treatment position for five patients with head and neck cancer was registered to radiotherapy planning CT using both rigid and nonrigid image registration. The root mean squared error for each method was calculated from a set of anatomic landmarks marked by four independent observers. Results: Nonrigid and rigid registration errors for treatment position PET/CT to planning CT were 2.77 ± 0.80 mm and 4.96 ± 2.38 mm, respectively, p = 0.001. Applying the nonrigid registration to diagnostic position PET/CT produced a more accurate match to the planning CT than rigid registration of treatment position PET/CT (3.20 ± 1.22 mm and 4.96 ± 2.38 mm, respectively, p = 0.012). Conclusions: Nonrigid registration provides a more accurate registration of head and neck PET/CT to treatment planning CT than rigid registration. In addition, nonrigid registration of PET/CT acquired with patients in a standardized, diagnostic position can provide images registered to planning CT with greater accuracy than a rigid registration of PET/CT images acquired in treatment position. This may allow greater flexibility in the timing of PET/CT for head and neck cancer patients due to undergo radiotherapy

  16. FDG PET/CT detects benign neurofibromas presenting as nodal masses: Imaging hallmarks of a diagnostic “red herring”

    International Nuclear Information System (INIS)

    Puranik, Ameya D.; Purandare, Nilendu C.; Bal, Munita M.; Agrawal, Archi; Shah, Sneha; Rangarajan, Venkatesh

    2015-01-01

    Multi-modality positron emission tomography/computed tomography (PET/CT) with 18F-fluoro-deoxy-glucose (FDG) depicts the enhancement pattern and metabolic intensity of lesions. Benign lesions with multiplicity, like neurofibromas often mimic similar appearing malignant neoplasms. We, report, a similar case where FDG PET/CT shows imaging hallmarks for diagnosing benign neurofibromas, in a patient with clinical presentation of lymphoma

  17. Detection of penile metastasis from bladder cancer using F 18 FDG PET/CT

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Dong Yun; Lee, Jong Jin [Univ. of Ulsan College of Medicine, Seoul (Korea, Republic of)

    2012-12-15

    A 74 year old man who had experienced priapism for 2 months after radical cystectomy for bladder cancer visited our hospital, and underwent metastatic work up {sup 18}F fluorodeoxyglucose (FDG) positron emission tomography/computed tomography(PET/CT)showed diffuse hypermetabolic activity along the penis shaft, which was confirmed as a penile metastasis.

  18. Impact of 18F-FDG PET/CT Staging in Newly Diagnosed Classical Hodgkin Lymphoma

    DEFF Research Database (Denmark)

    El-Galaly, Tarec Christoffer; Hutchings, Martin; Mylam, Karen Juul

    2013-01-01

    F-18-Fluorodeoxyglucose positron emission tomography/computed tomography (PET/CT) is a highly accurate staging method in classical Hodgkin lymphoma (cHL). We retrospectively compared the staging results obtained in two large cohorts of patients with cHL diagnosed before (n = 324) and after (n = 4...

  19. Prospective Evaluation of Magnetic Resonance Imaging and [18F]Fluorodeoxyglucose Positron Emission Tomography-Computed Tomography at Diagnosis and Before Maintenance Therapy in Symptomatic Patients With Multiple Myeloma Included in the IFM/DFCI 2009 Trial: Results of the IMAJEM Study.

    Science.gov (United States)

    Moreau, Philippe; Attal, Michel; Caillot, Denis; Macro, Margaret; Karlin, Lionel; Garderet, Laurent; Facon, Thierry; Benboubker, Lotfi; Escoffre-Barbe, Martine; Stoppa, Anne-Marie; Laribi, Kamel; Hulin, Cyrille; Perrot, Aurore; Marit, Gerald; Eveillard, Jean-Richard; Caillon, Florence; Bodet-Milin, Caroline; Pegourie, Brigitte; Dorvaux, Veronique; Chaleteix, Carine; Anderson, Kenneth; Richardson, Paul; Munshi, Nikhil C; Avet-Loiseau, Herve; Gaultier, Aurelie; Nguyen, Jean-Michel; Dupas, Benoit; Frampas, Eric; Kraeber-Bodere, Françoise

    2017-09-01

    Purpose Magnetic resonance imaging (MRI) and positron emission tomography-computed tomography (PET-CT) are important imaging techniques in multiple myeloma (MM). We conducted a prospective trial in patients with MM aimed at comparing MRI and PET-CT with respect to the detection of bone lesions at diagnosis and the prognostic value of the techniques. Patients and Methods One hundred thirty-four patients received a combination of lenalidomide, bortezomib, and dexamethasone (RVD) with or without autologous stem-cell transplantation, followed by lenalidomide maintenance. PET-CT and MRI were performed at diagnosis, after three cycles of RVD, and before maintenance therapy. The primary end point was the detection of bone lesions at diagnosis by MRI versus PET-CT. Secondary end points included the prognostic impact of MRI and PET-CT regarding progression-free (PFS) and overall survival (OS). Results At diagnosis, MRI results were positive in 127 of 134 patients (95%), and PET-CT results were positive in 122 of 134 patients (91%; P = .33). Normalization of MRI after three cycles of RVD and before maintenance was not predictive of PFS or OS. PET-CT became normal after three cycles of RVD in 32% of the patients with a positive evaluation at baseline, and PFS was improved in this group (30-month PFS, 78.7% v 56.8%, respectively). PET-CT normalization before maintenance was described in 62% of the patients who were positive at baseline. This was associated with better PFS and OS. Extramedullary disease at diagnosis was an independent prognostic factor for PFS and OS, whereas PET-CT normalization before maintenance was an independent prognostic factor for PFS. Conclusion There is no difference in the detection of bone lesions at diagnosis when comparing PET-CT and MRI. PET-CT is a powerful tool to evaluate the prognosis of de novo myeloma.

  20. FDG-PET/CT Imaging for Staging and Target Volume Delineation in Preoperative Conformal Radiotherapy of Rectal Cancer

    International Nuclear Information System (INIS)

    Bassi, Maria Chiara; Turri, Lucia; Sacchetti, Gianmauro; Loi, Gianfranco; Cannillo, Barbara; La Mattina, Pierdaniele; Brambilla, Marco; Inglese, Eugenio; Krengli, Marco

    2008-01-01

    Purpose: To investigate the potential impact of using 18 F-fluorodeoxyglucose positron emission tomography/computed tomography (FDG-PET/CT) on staging and target volume delineation for patients affected by rectal cancer and candidates for preoperative conformal radiotherapy. Methods and Materials: Twenty-five patients diagnosed with rectal cancer T3-4 N0-1 M0-1 and candidates for preoperative radiotherapy underwent PET/CT simulation after injection of 5.18 MBq/kg of FDG. Clinical stage was reassessed on the basis of FDG-PET/CT findings. The gross tumor volume (GTV) and the clinical target volume (CTV) were delineated first on CT and then on PET/CT images. The PET/CT-GTV and PET/CT-CTV were analyzed and compared with CT-GTV and CT-CTV, respectively. Results: In 4 of 25 cases (24%), PET/CT affected tumor staging or the treatment purpose. In 3 of 25 cases (12%) staged N0 M0, PET/CT showed FDG uptake in regional lymph nodes and in a case also in the liver. In a patient with a single liver metastasis PET/CT detected multiple lesions, changing the treatment intent from curative to palliative. The PET/CT-GTV and PET/CT-CTV were significantly greater than the CT-GTV (p = 0.00013) and CT-CTV (p = 0.00002), respectively. The mean difference between PET/CT-GTV and CT-GTV was 25.4% and between PET/CT-CTV and CT-CTV was 4.1%. Conclusions: Imaging with PET/CT for preoperative radiotherapy of rectal cancer may lead to a change in staging and target volume delineation. Stage variation was observed in 12% of cases and a change of treatment intent in 4%. The GTV and CTV changed significantly, with a mean increase in size of 25% and 4%, respectively

  1. Positron emission tomography/computed tomography and radioimmunotherapy of prostate cancer

    DEFF Research Database (Denmark)

    Bouchelouche, Kirsten; Capala, Jacek; Oehr, Peter

    2009-01-01

    of a number of diagnostic and therapeutic strategies. J591, a monoclonal antibody, which targets the extracellular domain of prostate-specific membrane antigen, shows promising results. HER2 receptors may also have a potential as target for PET/CT imaging and RIT of advanced prostate cancer. SUMMARY: PET......PURPOSE OF REVIEW: Traditional morphologically based imaging modalities are now being complemented by positron emission tomography (PET)/computed tomography (CT) in prostate cancer. Metastatic prostate cancer is an attractive target for radioimmunotherapy (RIT) as no effective therapies...... are available. This review highlights the most important achievements within the last year in PET/CT and RIT of prostate cancer. RECENT FINDINGS: Conflicting results exist on the use of choline for detection of malignant disease in the prostate gland. The role of PET/CT in N-staging remains to be elucidated...

  2. Differentiation between malignant and benign pathologic fractures with F-18-fluoro-2-deoxy-D-glucose positron emission tomography/computed tomography

    Energy Technology Data Exchange (ETDEWEB)

    Shin, D.S.; Shon, O.J.; Byun, S.J. [Yeungnam University, Department of Orthopedic Surgery College of Medicine, Daegu (Korea); Choi, J.H. [Yeungnam University, Department of Surgical Pathology, College of Medicine, Daegu (Korea); Chun, K.A.; Cho, I.H. [Yeungnam University, Department of Nuclear Medicine, College of Medicine, Daegu (Korea)

    2008-05-15

    To evaluate the efficacy of F-18-fluoro-2-deoxy-D-glucose positron emission tomography/computed tomography (FDG PET/CT) in differentiating malignant from benign pathologic fractures. F-18 FDG PET/CT was performed on 34 patients with pathologic fractures between May 2004 and June 2007. Fractures were located in tubular bones (26), in the pelvis (six), in the spine (one) and in a rib (one). The FDG uptake pattern at the fracture site was described, whether FDG uptake occurred in the marrow or cortex and soft tissue. Maximum standardized uptake values (SUVmax, the largest value at the region of interest) were measured at the fracture site, including cortical bone, bone marrow and soft tissue. As a reference standard, biopsy was used for 12 patients and clinical follow-up for 22 patients. Sensitivity, specificity and diagnostic accuracy of PET/CT were calculated. There were 19 malignant and 15 benign fractures. In the malignant fractures, PET/CT demonstrated high (mean SUVmax 12.0, range 4.3 to 45.7) F-18 FDG uptake in bone marrow in most cases (17 of 19). In benign fractures, there was low FDG uptake (mean SUVmax 2.9, range 0.6 to 5.5) within cortical bone or adjacent soft tissue around the fracture, rarely in the marrow. There were significant differences in the pattern of intramedullary FDG uptake (P < 0.001) and in the mean SUVmax (P < 0.01) between malignant and benign fractures. The sensitivity, specificity and diagnostic accuracy of F-18 FDG PET/CT were 89.5%, 86.7% and 88.2%, respectively, with a cut-off SUVmax set at 4.7. The time interval between fracture and PET/CT did not significantly influence FDG uptake at the fracture site. F-18 FDG PET/CT reliably differentiated between malignant and benign fractures based on the SUVmax and based on medullary uptake, which was characteristic for malignant fractures. (orig.)

  3. 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.

  4. 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

  5. Integrated positron emission tomography/computed tomography for ...

    African Journals Online (AJOL)

    Methods. Patients who underwent both PET-CT and lymph node tissue sampling for the investigation of suspected NSCLC were prospectively included in this observational study. Results were analysed per patient and per lymph node stage. A post-hoc analysis was performed to test the validity of a maximum standardised ...

  6. Positron emission tomography/computer tomography in gastrointestinal malignancies

    DEFF Research Database (Denmark)

    Tind, Sofie; Vestergaard, Sys; Farahani, Ziba A

    2017-01-01

    The use of FDG-PET/CT in GI-malignancies may not be as straightforward as in many other cancers, but the potential is clearly there in select clinical settings. The challenges include the relative non-specificity of FDG, the variable degrees of physiologic FDG-uptake, and the heterogeneous FDG-up...

  7. Change of Maximum Standardized Uptake Value Slope in Dynamic Triphasic [18F]-Fluorodeoxyglucose Positron Emission Tomography/Computed Tomography Distinguishes Malignancy From Postradiation Inflammation in Head-and-Neck Squamous Cell Carcinoma: A Prospective Trial

    International Nuclear Information System (INIS)

    Anderson, Carryn M.; Chang, Tangel; Graham, Michael M.; Marquardt, Michael D.; Button, Anna; Smith, Brian J.; Menda, Yusuf; Sun, Wenqing; Pagedar, Nitin A.; Buatti, John M.

    2015-01-01

    Purpose: To evaluate dynamic [ 18 F]-fluorodeoxyglucose (FDG) uptake methodology as a post–radiation therapy (RT) response assessment tool, potentially enabling accurate tumor and therapy-related inflammation differentiation, improving the posttherapy value of FDG–positron emission tomography/computed tomography (FDG-PET/CT). Methods and Materials: We prospectively enrolled head-and-neck squamous cell carcinoma patients who completed RT, with scheduled 3-month post-RT FDG-PET/CT. Patients underwent our standard whole-body PET/CT scan at 90 minutes, with the addition of head-and-neck PET/CT scans at 60 and 120 minutes. Maximum standardized uptake values (SUV max ) of regions of interest were measured at 60, 90, and 120 minutes. The SUV max slope between 60 and 120 minutes and change of SUV max slope before and after 90 minutes were calculated. Data were analyzed by primary site and nodal site disease status using the Cox regression model and Wilcoxon rank sum test. Outcomes were based on pathologic and clinical follow-up. Results: A total of 84 patients were enrolled, with 79 primary and 43 nodal evaluable sites. Twenty-eight sites were interpreted as positive or equivocal (18 primary, 8 nodal, 2 distant) on 3-month 90-minute FDG-PET/CT. Median follow-up was 13.3 months. All measured SUV endpoints predicted recurrence. Change of SUV max slope after 90 minutes more accurately identified nonrecurrence in positive or equivocal sites than our current standard of SUV max ≥2.5 (P=.02). Conclusions: The positive predictive value of post-RT FDG-PET/CT may significantly improve using novel second derivative analysis of dynamic triphasic FDG-PET/CT SUV max slope, accurately distinguishing tumor from inflammation on positive and equivocal scans

  8. Therapy response evaluation with positron emission tomography-computed tomography.

    Science.gov (United States)

    Segall, George M

    2010-12-01

    Positron emission tomography-computed tomography with F-18-fluorodeoxyglucose is widely used for evaluation of therapy response in patients with solid tumors but has not been as readily adopted in clinical trials because of the variability of acquisition and processing protocols and the absence of universal response criteria. Criteria proposed for clinical trials are difficult to apply in clinical practice, and gestalt impression is probably accurate in individual patients, especially with respect to the presence of progressive disease and complete response. Semiquantitative methods of determining tissue glucose metabolism, such as standard uptake value, can be a useful descriptor for levels of tissue glucose metabolism and changes in response to therapy if technical quality control measures are carefully maintained. The terms partial response, complete response, and progressive disease are best used in clinical trials in which the terms have specific meanings and precise definitions. In clinical practice, it may be better to use descriptive terminology agreed upon by imaging physicians and clinicians in their own practice. Copyright © 2010. Published by Elsevier Inc.

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

    International Nuclear Information System (INIS)

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

    2015-01-01

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

  10. Utility of interim and end-of-treatment PET/CT in peripheral T-cell lymphomas

    DEFF Research Database (Denmark)

    El-Galaly, Tarec Christoffer; Pedersen, Martin Bjerregård; Hutchings, Martin

    2015-01-01

    According to the updated guidelines for imaging in lymphoma, 18F-FDG positron emission tomography/computed tomography (PET/CT) is recommended for staging and evaluation of treatment response in FDG-avid lymphomas. The purpose of the study was to evaluate the utility of PET/CT in nodal peripheral T....../CT. Medical records were reviewed for baseline clinical and follow-up information. Staging, interim (I-PET), and end-of-treatment PET/CT (E-PET) studies were centrally reviewed, and reported using the Deauville 5-point score (DS). A total of 124 patients fulfilled the inclusion criteria. The median age was 58...

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2015-06-15

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

  12. The role of 18F-FDG PET/CT in pediatric lymph-node acute lymphoblastic leukemia involvement.

    Science.gov (United States)

    Cistaro, Angelina; Saglio, Francesco; Asaftei, Sebastian; Fania, Piercarlo; Berger, Massimo; Fagioli, Franca

    2011-01-01

    In pediatric oncology, positron emission tomography/computed tomography (PET/CT) is emerging as an essential diagnostic tool in characterizing suspicious neoplastic lesions and staging malignant diseases. Most studies regarding the possible role of FDG-PET/CT in the management of acute lymphoblastic leukemia (ALL) patients are limited to adults. Here we report a pediatric patient with recurrent ALL, in which FDG-PET/CT was used both to define more precisely the cause of lymphadenopathy and to assess the effect of the second-line therapy.

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

    International Nuclear Information System (INIS)

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

    2010-01-01

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

  14. Clinical PET/CT Atlas: A Casebook of Imaging in Oncology

    International Nuclear Information System (INIS)

    2015-01-01

    Integrated positron emission tomography/computed tomography (PET/CT) has evolved since its introduction into the commercial market more than a decade ago. It is now a key procedure, particularly in oncological imaging. Over the last years in routine clinical service, PET/CT has had a significant impact on diagnosis, treatment planning, staging, therapy, and monitoring of treatment response and has therefore played an important role in the care of cancer patients. The high sensitivity from the PET component and the specificity of the CT component give this hybrid imaging modality the unique characteristics that make PET/CT, even after over 10 years of clinical use, one of the fastest growing imaging modalities worldwide. This publication combines over 90 comprehensive cases covering all major indications of fluorodeoxyglucose (18F-FDG)-PET/CT as well as some cases of clinically relevant special tracers. The cases provide an overview of what the specific disease can look like in PET/CT, the typical pattern of the disease’s spread as well as likely pitfalls and teaching points. This PET/CT Atlas will allow professionals interested in PET/CT imaging to embrace the variety of oncological imaging by providing clinically relevant teaching files on the effectiveness and diagnostic quality of FDG-PET/CT imaging in routine applications

  15. Update on nodal staging in non-small cell lung cancer with integrated positron emission tomography/computed tomography: a meta-analysis.

    Science.gov (United States)

    Pak, Kyoungjune; Park, Sohyun; Cheon, Gi Jeong; Kang, Keon Wook; Kim, In-Joo; Lee, Dong Soo; Kim, E Edmund; Chung, June-Key

    2015-06-01

    Nowadays, the number of primary studies on fluorodeoxyglucose (FDG) positron emission tomography/computed tomography (PET/CT) has been increasing rapidly. Thus, we updated meta-analysis to evaluate the test performance of FDG PET/CT for nodal staging in non-small cell lung cancer (NSCLC) including the most recent studies. We performed a systematic search of MEDLINE and EMBASE for English publications using keywords "positron emission tomography", "lung cancer", and "lymph node". All searches were limited to human studies. Inclusion criteria were studies of the initial nodal staging of NSCLC with PET/CT. The reasons for exclusion are as follows: (1) studies with PET, (2) previous therapy before PET/CT, (3) nodal staging not confirmed by histology, and (4) reviews, abstracts, and editorial materials. 786 articles were identified through database searching. 28 studies including 3,255 patients and 11,887 lymph nodes (LN) were eligible for this study. The pooled sensitivity was 0.62 (95% CI 0.54-0.70), widely ranging from 0.13 to 0.98. The specificity ranged between 0.72 and 0.98 with an overall estimated specificity of 0.92 (0.88-0.95) for node-based data. The pooled sensitivity, specificity, positive and negative likelihood ratio were 0.67 (0.54-0.79), 0.87 (0.82-0.91), 5.20 (3.59-7.54), and 0.37 (0.25-0.55) for patient-based data. Studies from tuberculosis (Tb) endemic countries showed lower sensitivity (0.56 vs 0.68, p = 0.03) for node-based data and lower specificity (0.83 vs 0.89, p < 0.01) for patient-based ones. PET/CT has a high specificity, but low sensitivity for detecting LN metastasis in patients with NSCLC. Tb might be one of the main reasons for lower sensitivity of PET/CT in several countries. The primary clinicians of lung cancer should be aware of the possibility of hidden metastatic LNs in bilateral FDG uptake of mediastinal and hilar LNs, especially in the Tb endemic countries.

  16. Role of {sup 68}Ga-DOTATOC PET-CT in the diagnosis and staging of pancreatic neuroendocrine tumours

    Energy Technology Data Exchange (ETDEWEB)

    Kumar, Rakesh; Sharma, Punit; Karunanithi, Sellam; Naswa, Niraj; Lata, Sneh; Malhotra, Arun [All India Institute of Medical Sciences, Department of Nuclear Medicine, New Delhi (India); Garg, Pramod [All India Institute of Medical Sciences, Department of Gastroenterology and Human Nutrition, New Delhi (India); Sharma, Raju; Thulkar, Sanjay [All India Institute of Medical Sciences, Department of Radiodiagnosis, New Delhi (India)

    2011-11-15

    The objective of the present study was to evaluate the role of {sup 68}Ga-DOTA(0)-Phe(1)-Tyr(3)-octreotide ({sup 68}Ga-DOTATOC) positron emission tomography computed tomography (PET-CT) for detection and staging of pancreatic neuroendocrine tumours (NETs). Twenty patients with clinically suspected and/or histopathologically proven pancreatic NET underwent {sup 68}Ga-DOTATOC PET-CT imaging for staging and /or localisation of primary lesion. They also underwent contrast enhanced CT (CECT) and 8 patients underwent {sup 18}F-FDG PET-CT. SUVmax of primary and metastatic lesions were measured. Results were verified with histopathology for primary tumour and with clinical follow up/MRI and /or biopsy for metastatic disease. Results of {sup 68}Ga-DOTATOC PET-CT were compared to CECT and {sup 18}F-FDG PET-CT. {sup 68}Ga-DOTATOC PET-CT correctly localised primary in all 20, CECT in 15 and {sup 18}F-FDG PET-CT in 2 patients. {sup 68}Ga-DOTATOC PET-CT demonstrated metastases in 13 patients, CECT in 7 and {sup 18}F-FDG PET-CT in 2. {sup 68}Ga-DOTATOC PET-CT emerged as the best investigation with 100% sensitivity and PPV for detecting primary tumour and metastatic disease. The detection rate of CECT was lower than {sup 68}Ga-DOTATOC PET-CT, both for primary tumour (20vs.15) or metastatic disease (13vs.7). {sup 18}F-FDG PET-CT performed poorly for primary and metastasis. Ga-DOTATOC PET-CT is a very useful imaging investigation for diagnosing and staging pancreatic NET. (orig.)

  17. 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

  18. 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.

  19. The Role of Positron Emission Tomography/Computed Tomography Imaging in Head and Neck Cancer after Radical Chemoradiotherapy: a Single Institution Experience.

    Science.gov (United States)

    Nelissen, C; Sherriff, J; Jones, T; Guest, P; Colley, S; Sanghera, P; Hartley, A

    2017-11-01

    Positron emission tomography/computed tomography (PET/CT) is used to restage head and neck cancer 3 months after chemoradiotherapy. The purpose of this study was to determine the negative predictive value (NPV) of a scan reported as having no abnormal uptake and the positive predictive values (PPV) for different maximum standardised uptake value (SUVmax) thresholds. Patients with squamous cell carcinoma of the oro-/hypopharynx/larynx (n = 206) were included. SUVmax and subsequent locoregional recurrence were documented. The median SUVmax was 11.2 (range 4-33)/4.6 (range 2-30), respectively, in patients with/without definite primary site recurrence (P = 0.004). The median SUVmax was 4.4 (range 2.6-15.6)/3.1 (range 2.1-4.6), respectively, in patients with/without definite nodal recurrence (P = 0.003). The NPV for a scan reported as having no abnormal uptake was 92%. The PPV for the SUVmax thresholds 4, 6 and 8, respectively, were 53, 65 and 92% (primary site) and 93, 100 and 100% (nodes). The NPV of PET/CT after chemoradiation is consistent with the literature and underlines the importance of PET/CT in restaging the primary site if salvage neck dissection is considered. The overall PPV of PET/CT remains low but is high for nodal SUVmax > 4. These data could be used to design risk-stratified follow-up schedules. Copyright © 2017 The Royal College of Radiologists. Published by Elsevier Ltd. All rights reserved.

  20. Maximum standardized uptake value of fluorodeoxyglucose positron emission tomography/computed tomography is a prognostic factor in ovarian clear cell adenocarcinoma.

    Science.gov (United States)

    Konishi, Haruhisa; Takehara, Kazuhiro; Kojima, Atsumi; Okame, Shinichi; Yamamoto, Yasuko; Shiroyama, Yuko; Yokoyama, Takashi; Nogawa, Takayoshi; Sugawara, Yoshifumi

    2014-09-01

    Fluorodeoxyglucose positron emission tomography/computed tomography (FDG-PET/CT) is useful for diagnosing malignant tumors. Intracellular FDG uptake is measured as the standardized uptake value (SUV), which differs depending on tumor characteristics. This study investigated differences in maximum SUV (SUVmax) according to histologic type in ovarian epithelial cancer and the relationship of SUVmax with prognosis. This study included 80 patients with ovarian epithelial cancer based on histopathologic findings at surgery and who had undergone PET/CT before treatment. Maximum SUV on PET/CT of primary lesions and histopathology were compared based on histologic type, and the prognosis associated with different SUVmax was evaluated. Clinical tumor stage was I in 35 patients, II in 8, III in 25, and IV in 12. Histologic type was serous adenocarcinoma (AC) in 33 patients, clear cell AC in 27, endometrioid AC in 15, and mucinous AC in 5. Median SUVmax was lower in mucinous AC (2.76) and clear cell AC (4.9) than in serous AC (11.4) or endometrioid AC (11.4). Overall, median SUVmax was lower in clinical stage I (5.37) than in clinical stage ≥II (10.3). However, in both clear cell AC and endometrioid AC, when histologic evaluation was possible, no difference was seen between stage I and stage ≥II. Moreover, in clear cell AC, the 5-year survival rate was significantly higher in the low-SUVmax group (100%) than in the high-SUVmax group (43.0%, P = 0.009). Maximum SUV on preoperative FDG-PET/CT in ovarian epithelial cancer differs according to histologic type. In clear cell AC, SUVmax may represent a prognostic factor.

  1. Anticancer activity using positron emission tomography-computed tomography and pharmacokinetics of β-eudesmol in human cholangiocarcinoma xenografted nude mouse model.

    Science.gov (United States)

    Plengsuriyakarn, Tullayakorn; Karbwang, Juntra; Na-Bangchang, Kesara

    2015-03-01

    Cholangiocarcinoma (CCA) is an important public health problem in several parts of South East Asia, particularly in Thailand. The limited availability of effective diagnostic tools for early stage CCA, including chemotherapeutic options, constitutes a major problem for treatment and control of CCA. The aim of the present study was to assess the anti-CCA activity and pharmacokinetics of β-eudesmol in CCA-xenografted nude mouse model and healthy mice. Positron emission tomography-computed tomography (PET-CT) with (18)F-fluorodeoxyglucose was used for detecting and monitoring tumour development, and PET-CT with technetium-99m was used to investigate its pharmacokinetics property. Results support the role of PET-CT as a potential tool for detecting and monitoring the progress of lung metastasis. Tumour size and lung metastasis were significantly inhibited by 91.6% (of baseline) and 95% (of total lung mass), respectively, following treatment with high-dose β-eudesmol (100 mg/kg body weight for 30 days). Survival time was prolonged by 64.4% compared with untreated controls. Systemic clearance of the compound was rapid, particularly during the first 60 min. The compound was distributed to the vital organs at maximum levels 2 h after oral administration and 15 min after intravenous injection. Results from the present study suggest the potential of β-eudesmol as a promising candidate for further development as an anti-CCA drug with respect to its pharmacodynamics and pharmacokinetic properties. PET-CT, with radiotracers (18)F-fluorodeoxyglucose and technetium-99m, was shown to be a reliable tool in the investigation of anti-CCA and pharmacokinetic properties of β-eudesmol in CCA-xenografted and healthy mice. © 2014 Wiley Publishing Asia Pty Ltd.

  2. Standardized uptake value on positron emission tomography/computed tomography predicts prognosis in patients with locally advanced pancreatic cancer.

    Science.gov (United States)

    Wang, Si-Liang; Cao, Shuo; Sun, Yu-Nan; Wu, Rong; Chi, Feng; Tang, Mei-Yue; Jin, Xue-Ying; Chen, Xiao-Dong

    2015-10-01

    The aim of the present study was to investigate the use and value of maximum standardized uptake value (SUV max) on positron emission tomography/computed tomography (PET/CT) images as a prognostic marker for patients with locally advanced pancreatic cancer (LAPC). The medical records of all consecutive patients who underwent PET/CT examination in our institution were retrospectively reviewed. Inclusion criteria were histologically or cytologically proven LAPC. Patients with distant metastasis were excluded. For statistical analysis, the SUV max of primary pancreatic cancer was measured. Survival rates were calculated using the Kaplan-Meier method, and multivariable analysis was performed to determine the association of SUV max with overall survival (OS) and progression-free survival (PFS) using a Cox proportional hazards model. Between July 2006 and June 2013, 69 patients were enrolled in the present study. OS and PFS were 14.9 months [95% confidence interval (CI) 13.1-16.7] and 8.3 months (95% CI 7.1-9.5), respectively. A high SUV max (>5.5) was observed in 35 patients, who had significantly worse OS and PFS than the remaining patients with a low SUV max (P = 0.025 and P = 0.003). Univariate analysis showed that SUV max and tumor size were prognostic factors for OS, with a hazard ratio of 1.90 and 1.81, respectively. A high SUV max was an independent prognostic factor, with a hazard ratio of 1.89 (95% CI 1.015-3.519, P = 0.045). The present study suggests that increased SUV max is a predictor of poor prognosis in patients with LAPC.

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

    International Nuclear Information System (INIS)

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

    2009-01-01

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

  4. Detection of internal mammary lymph node metastasis with {sup 18}F-fluorodeoxyglucose positron emission tomography/computed tomography in patients with stage III breast cancer

    Energy Technology Data Exchange (ETDEWEB)

    Seo, Min Jung; Lee, Jong Jin; Kim, Hye Ok; Chae, Sun-Young; Ryu, Jin-Sook; Moon, Dae Hyuk [University of Ulsan College of Medicine, Asan Medical Center, Department of Nuclear Medicine, Songpa-gu, Seoul (Korea, Republic of); Park, Seol Hoon [Ulsan University Hospital, Department of Nuclear Medicine, Ulsan (Korea, Republic of); Ahn, Sei Hyun; Lee, Jong Won; Son, Byung Ho [University of Ulsan College of Medicine, Asan Medical Center, Department of Surgery, Seoul (Korea, Republic of); Gong, Gyung-Yub [University of Ulsan College of Medicine, Asan Medical Center, Department of Pathology, Seoul (Korea, Republic of)

    2014-03-15

    The present study assessed the positive predictive value (PPV) of {sup 18}F-fluorodeoxyglucose (FDG) positron emission tomography/computed tomography (PET/CT) for the detection of internal mammary node (IMN) metastasis in patients with clinical stage III breast cancer. Patients who were diagnosed with clinical stage III breast cancer and underwent pretreatment {sup 18}F-FDG PET/CT were retrospectively analyzed. The {sup 18}F-FDG PET/CT scans were prospectively reviewed by two board-certified nuclear medicine physicians in a blinded manner. The intensities of IMNs were graded into four categories (no activity and lower, similar, and higher activities than that of the mediastinal blood pool). IMNs were measured from the combined CT (largest diameter of the short axis). Histologic data of the IMNs were obtained by ultrasonography-guided fine-needle aspiration biopsy or surgical excision. The PPV was calculated for pathologically confirmed IMNs. Visual grade, maximum standardized uptake values (SUV{sub max}), and sizes were analyzed according to the pathology results. There were 249 clinical stage III breast cancer patients (age 48.0 ± 10.1 years, range 26-79 years) who had undergone initial {sup 18}F-FDG PET/CT prior to treatment. Excluding 33 cases of stage IV breast cancer, 62 of 216 patients had visible IMNs on {sup 18}F-FDG PET/CT, and histologic confirmation was obtained in 31 patients. There were 27 metastatic and four nonmetastatic nodes (PPV 87.1 %). Metastatic nodes mostly presented with visual grade 3 (83.9 %), and SUV{sub max} and size were 3.5 ± 4.3 and 5.6 ± 2.0 mm, respectively. {sup 18}F-FDG PET/CT has a high PPV for IMN metastasis in clinical stage III breast cancer, indicating the possibility of metastasis in IMNs with FDG uptake similar to/lower than that of the blood pool or small-sized nodes. (orig.)

  5. Feasibility of Systematic Respiratory-Gated Acquisition in Unselected Patients Referred for 18F-Fluorodeoxyglucose Positron Emission Tomography/Computed Tomography

    Directory of Open Access Journals (Sweden)

    Philippe Robin

    2018-02-01

    Full Text Available ObjectiveRespiratory motion in 18F-fluorodeoxyglucose positron emission tomography/computed tomography (FDG PET/CT induces blurred images, leading to errors in location and quantification for lung and abdominal lesions. Various methods have been developed to correct for these artifacts, and most of current PET/CT scanners are equipped with a respiratory gating system. However, they are not routinely performed because their use is time-consuming. The aim of this study is to assess the feasibility and quantitative impact of a systematic respiratory-gated acquisition in unselected patients referred for FDG PET/CT, without increasing acquisition time.MethodsPatients referred for a FDG PET/CT examination to the nuclear medicine department of Brest University Hospital were consecutively enrolled, during a 3-month period. Cases presenting lung or liver uptakes were analyzed. Two sets of images were reconstructed from data recorded during a unique acquisition with a continuous table speed of 1 mm/s of the used Biograph mCT Flow PET/CT scanner: standard free-breathing images, and respiratory-gated images. Lesion location and quantitative parameters were recorded and compared.ResultsFrom October 1 2015 to December 31 2015, 847 patients were referred for FDG PET/CT, 741 underwent a respiratory-gated acquisition. Out of them, 213 (29% had one or more lung or liver uptake but 82 (38% had no usable respiratory-gated signal. Accordingly, 131 (62% patients with 183 lung or liver uptakes were analyzed. Considering the 183 lesions, 140 and 43 were located in the lungs and the liver, respectively. The median (IQR difference between respiratory-gated images and non-gated images was 18% (4−32 for SUVmax, increasing to 30% (14−57 in lower lobes for lung lesions, and −18% (−40 to −4 for MTV (p < 0.05. Technologists’ active personal dosimetry and mean total examinations duration were not statistically different between periods with and without

  6. Diagnostic performance of fluorodeoxyglucose positron emission tomography/magnetic resonance imaging fusion images of gynecological malignant tumors. Comparison with positron emission tomography/computed tomography

    International Nuclear Information System (INIS)

    Nakajo, Kazuya; Tatsumi, Mitsuaki; Inoue, Atsuo

    2010-01-01

    We compared the diagnostic accuracy of fluorodeoxyglucose positron emission tomography/computed tomography (FDG PET/CT) and PET/magnetic resonance imaging (MRI) fusion images for gynecological malignancies. A total of 31 patients with gynecological malignancies were enrolled. FDG-PET images were fused to CT, T1- and T2-weighted images (T1WI, T2WI). PET-MRI fusion was performed semiautomatically. We performed three types of evaluation to demonstrate the usefulness of PET/MRI fusion images in comparison with that of inline PET/CT as follows: depiction of the uterus and the ovarian lesions on CT or MRI mapping images (first evaluation); additional information for lesion localization with PET and mapping images (second evaluation); and the image quality of fusion on interpretation (third evaluation). For the first evaluation, the score for T2WI (4.68±0.65) was significantly higher than that for CT (3.54±1.02) or T1WI (3.71±0.97) (P<0.01). For the second evaluation, the scores for the localization of FDG accumulation showing that T2WI (2.74±0.57) provided significantly more additional information for the identification of anatomical sites of FDG accumulation than did CT (2.06±0.68) or T1WI (2.23±0.61) (P<0.01). For the third evaluation, the three-point rating scale for the patient group as a whole demonstrated that PET/T2WI (2.72±0.54) localized the lesion significantly more convincingly than PET/CT (2.23±0.50) or PET/T1WI (2.29±0.53) (P<0.01). PET/T2WI fusion images are superior for the detection and localization of gynecological malignancies. (author)

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

    International Nuclear Information System (INIS)

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

    2013-01-01

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

  8. Rare solitary focal tuberculous involvement of liver masquerading as hepatic metastasis on FDG PET/CT in a case of fibular round cell tumor

    International Nuclear Information System (INIS)

    Puranik, Ameya D; Purandare, Nilendu C; Sridhar, Epari; Agrawal, Archi; Shah, Sneha; Rangarajan, Venkatesh

    2015-01-01

    Finding of focal 18F-fluoro-deoxyglucose (FDG) uptake in liver on FDG positron emission tomography/computed tomography (FDG PET/CT) in a known case of malignancy is often considered to be metastases. We report a similar finding on FDG PET/CT in a case of Ewing's sarcoma of thigh, which turned out to be of tuberculous etiology, an unusual cause of false positive FDG uptake in the liver

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

    NARCIS (Netherlands)

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

    OBJECTIVE: To determine and compare the value of (18)F-fluoro-2-deoxy-D-glucose positron emission tomography/computed tomography (FDG-PET/CT) to blind bone marrow biopsy (BMB) of the posterior iliac crest in detecting metastatic bone marrow involvement in newly diagnosed Ewing sarcoma. MATERIALS AND

  10. 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.

  11. RELIABILITY OF POSITRON EMISSION TOMOGRAPHY-COMPUTED TOMOGRAPHY IN EVALUATION OF TESTICULAR CARCINOMA PATIENTS.

    Science.gov (United States)

    Nikoletić, Katarina; Mihailović, Jasna; Matovina, Emil; Žeravica, Radmila; Srbovan, Dolores

    2015-01-01

    The study was aimed at assessing the reliability of 18F-fluorodeoxyglucose positron emission tomography-computed tomography scan in evaluation of testicular carcinoma patients. The study sample consisted of 26 scans performed in 23 patients with testicular carcinoma. According to the pathohistological finding, 14 patients had seminomas, 7 had nonseminomas and 2 patients had a mixed histological type. In 17 patients, the initial treatment was orchiectomy+chemotherapy, 2 patients had orchiectomy+chemotherapy+retroperitoneal lymph node dissection, 3 patients had orchiectomy only and one patient was treated with chemotherapy only. Abnormal computed tomography was the main cause for the oncologist to refer the patient to positron emission tomography-computed tomography scan (in 19 scans), magnetic resonance imaging abnormalities in 1 scan, high level oftumor markers in 3 and 3 scans were perforned for follow-up. Positron emission tomography-computed tomography imaging results were compared with histological results, other imaging modalities or the clinical follow-up of the patients. Positron emission tomography-computed tomography scans were positive in 6 and negative in 20 patients. In two patients, positron emission tomography-computed tomography was false positive. There were 20 negative positron emission omography-computed tomography scans perforned in 18 patients, one patient was lost for data analysis. Clinically stable disease was confirmed in 18 follow-up scans performed in 16 patients. The values of sensitivty, specificity, accuracy, and positive- and negative predictive value were 60%, 95%, 75%, 88% and 90.5%, respectively. A hgh negative predictive value obtained in our study (90.5%) suggests that there is a small possibility for a patient to have future relapse after normal positron emission tomography-computed tomography study. However, since the sensitivity and positive predictive value of the study ire rather low, there are limitations of positive

  12. 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.

  13. Preliminary experience on the use of PET/CT in the management of pediatric post-transplant lymphoproliferative disorder.

    Science.gov (United States)

    Guerra-García, Pilar; Hirsch, Steffen; Levine, Daniel S; Taj, Mary M

    2017-12-01

    Post-transplant lymphoproliferative disorder (PTLD) is a well-known complication following prolonged immunosuppression. Contrary to other lymphomas, there is no standardized imaging approach to assess PTLD either at staging or for response to therapy. Positron emission tomography/computed tomography (PET/CT) is an imaging modality that has proven to be useful in lymphoma. However, there is still limited data concerning its use in pediatric PTLD. Our study evaluates the use of PET/CT in pediatric PTLD at our institution. To assess the role of PET/CT in pediatric PTLD, we reviewed the pediatric patients with PTLD who had undergone PET/CT at our institution between 2000 and 2016. Nine patients were identified. Six had PET/CT at diagnosis. All lesions seen on CT were identified with PET/CT. Fourteen PET/CTs were done during treatment. Eight PET/CTs were negative, including three where CT showed areas of uncertain significance. In these cases, PET/CT helped us to stop treatment and the patients remain in remission after a long follow-up (mean 74.3 months; range 12.4-180.9 months). PET/CT revealed additional disease in two cases, therefore treatment was intensified. Six biopsies and close follow-up was done to confirm PET/CT results. In one case, PET/CT did not identify central nervous system involvement demonstrated on magnetic resonance imaging. PET/CT may have an important role in the staging and follow-up of pediatric PTLD. In our cohort, PET/CT was helpful in staging and assessing treatment response and in clarifying equivocal findings on other imaging modalities. © 2017 Wiley Periodicals, Inc.

  14. Role of [18F]fluorodeoxyglucose positron emission tomography-computed tomography, sonography, and sonographically guided fine-needle aspiration biopsy in the diagnosis of axillary lymph nodes in patients with breast cancer: comparison of diagnostic performance.

    Science.gov (United States)

    Sohn, Yu-Mee; Hong, Il Ki; Han, Kyunghwa

    2014-06-01

    The aim of this study was to compare the diagnostic performance of [(18)F]fluorodeoxyglucose (FDG) positron emission tomography-computed tomography (PET-CT) with that of sonography and sonographically guided fine-needle aspiration (FNA) for determining the preoperative axillary lymph node (ALN) status and to evaluate the factors related to false-negative PET-CT, sonographic, and FNA results in ALN staging of invasive ductal carcinoma. From March 2009 to July 2012, 226 patients had a diagnosis of primary breast cancer. Among these patients, 107 constituted the study population after exclusion of transferred patients and patients with breast cancer other than invasive ductal carcinoma. The diagnostic performance of the modalities was compared with pathologic reports. Univariate and multivariate analyses were used to evaluate the relationship between clinicopathologic factors (symptoms, T stage, hormone receptors, and histologic grade), false-negative results, and true-negative results on PET-CT, sonography, and FNA. Of the 107 patients, 45 (42.1%) had positive results on final pathologic analysis of ALNs. Sonographically guided FNA had a significantly higher specificity, positive predictive value, accuracy, and area under the receiver operating characteristic curve than sonography and PET-CT (P < .01). When sonography and PET-CT were combined, the sensitivity was significantly improved (P = .019) compared with sonography alone. When FNA and PET-CT were combined, the sensitivity and negative predictive value were significantly increased compared with each modality (P < .01). Sonographically guided FNA was found to be an excellent diagnostic tool for preoperative evaluation of the ALN status. To obviate the step of sentinel lymph node biopsy for determining the ALN status, combined evaluation of ALNs by these modalities may be more complementary than the use of a single modality. © 2014 by the American Institute of Ultrasound in Medicine.

  15. 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.

  16. 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.

  17. Primary central nervous system lymphoma in an human immunodeficiency virus-infected patient mimicking bilateral eye sign in brain seen in fluorine-18 fluorodeoxyglucose-positron emission tomography/computed tomography.

    Science.gov (United States)

    Kamaleshwaran, Koramadai Karuppusany; Thirugnanam, Rajasekar; Shibu, Deepu; Kalarikal, Radhakrishnan Edathurthy; Shinto, Ajit Sugunan

    2014-04-01

    Fluorodeoxyglucose-positron emission tomography/computed tomography (FDG PET/CT) has proven useful in the diagnosis, staging, and detection of metastasis and posttreatment monitoring of several malignancies in human immunodeficiency virus (HIV)-infected patients. It also has the ability to make the important distinction between malignancy and infection in the evaluation of central nervous system (CNS) lesions, leading to the initiation of the appropriate treatment and precluding the need for invasive biopsy. We report an interesting case of HIV positive 35-year-old woman presented with headache, disorientation, and decreased level of consciousness. She underwent whole body PET/CT which showed multiple lesions in the cerebrum which mimics bilateral eye in brain. A diagnosis of a primary CNS lymphoma was made and patient was started on chemotherapy.

  18. Primary central nervous system lymphoma in an human immunodeficiency virus-infected patient mimicking bilateral eye sign in brain seen in fluorine-18 fluorodeoxyglucose-positron emission tomography/computed tomography

    International Nuclear Information System (INIS)

    Kamaleshwaran, Koramadai Karuppusany; Thirugnanam, Rajasekar; Shibu, Deepu; Kalarikal, Radhakrishnan Edathurthy; Shinto, Ajit Sugunan

    2014-01-01

    Fluorodeoxyglucose-positron emission tomography/computed tomography (FDG PET/CT) has proven useful in the diagnosis, staging, and detection of metastasis and posttreatment monitoring of several malignancies in human immunodeficiency virus (HIV)-infected patients. It also has the ability to make the important distinction between malignancy and infection in the evaluation of central nervous system (CNS) lesions, leading to the initiation of the appropriate treatment and precluding the need for invasive biopsy. We report an interesting case of HIV positive 35-year-old woman presented with headache, disorientation, and decreased level of consciousness. She underwent whole body PET/CT which showed multiple lesions in the cerebrum which mimics bilateral eye in brain. A diagnosis of a primary CNS lymphoma was made and patient was started on chemotherapy

  19. Role of fluorine-18-labeled 2-fluoro-2-deoxy-D-glucose positron emission tomography-computed tomography in the evaluation of axillary lymph node involvement in operable breast cancer in comparison with sentinel lymph node biopsy

    International Nuclear Information System (INIS)

    Challa, Vasu Reddy; Srivastava, Anurag; Dhar, Anita; Parshad, Rajinder; Bal, Chandrasekhar; Gona, Rama Mohan Reddy; Kumar, Rakesh; Sharma, Punit; Gupta, Siddhartha Datta

    2013-01-01

    Role of (18(F)fluorine-18-labeled 2-fluoro-2-deoxy-D-glucose (FDG) positron emission tomography-computed tomography (PET-CT) in the evaluation of axillary lymph node involvement in T1T2N0 breast cancer and compare results with sentinel lymph node biopsy (SLNB). SLN was identified in 32 of 37 patients with an identification rate of 86.48% (32/37). With combined technique SLN identification rate was 100% (6/6) while with blue dye alone; it was 83.8% (26/31). Among 37 patients, 16 had axillary metastases of which 12 had macrometastases and four had micrometastases detected by immunohistochemistry (IHC). Of 12 patients with axillary macrometastases, skip metastases were present in two patients in whom SLN was negative and in two patients SLN was not identified, but axillary dissection showed metastases. PET-CT had shown sensitivity, specificity, negative predictive value and positive predictive value of 56%, 90%, 73%, and 81.8%, respectively. IHC of SLN detected four patients with micrometastases upstaging the disease by 11% (4/37). Because FDG PET-CT has a high specificity in the evaluation of axillary lymph node involvement in T1T2N0 breast cancer patients according to the results of this study if FDG PET-CT is positive in axillary lymph nodes, axillary lymph node dissection may be considered instead of SLNB

  20. Cervical Lymph Node Metastases of Unknown Origin: Primary Tumor Detection with Whole-Body Positron Emission Tomography/Computed Tomography

    International Nuclear Information System (INIS)

    Nassenstein, K.; Veit-Haibach, P.; Stergar, H.; Gutzeit, A.; Freudenberg, L.; Kuehl, H.; Fischer, M.; Barkhausen, J.; Bockisch, A.; Antoch, G.

    2007-01-01

    Background: Identification of primary tumor in patients with cervical lymph node metastasis of unknown primary (MUO) has a great impact on therapy approach and potentially on patient prognosis. Purpose: To assess the diagnostic accuracy of combined positron emission tomography (PET)/computer tomography (CT) for primary tumor detection in cervical metastases of unknown origin compared to PET, CT, and PET+CT side-by-side evaluation. Material and Methods: 39 consecutive patients (eight women, 31 men; mean age 59.9±11.2 years) with MUO were enrolled in this study. PET/CT images were obtained 1 hour after injection of 350 MBq of fluorodeoxyglucose. Oral and intravenous contrast agents were administered in all patients to ensure diagnostic CT data. Fused PET/CT data were evaluated for primary tumor detection. Diagnostic accuracy was calculated and compared with CT alone, PET alone, and side-by-side PET+CT evaluation. Statistical analysis of differences in diagnostic performance between the different imaging procedures was based on the McNemar test. Results: Fused PET/CT depicted the primary tumor in 11 of 39 (28%) patients. In 28 (72%) patients, the primary tumor remained occult. CT revealed the primary in five (13%), PET alone in 10 (26%), and side-by-side evaluation of PET+CT in 10 (26%) of 39 patients. Statistical analysis showed no significant differences between the imaging modalities. Conclusion: PET, side-by-side PET+CT, and PET/CT revealed similar detection rates for primary tumors in cervical MUO patients. Therefore, cervical metastases of an unknown primary may be assessed with either of these imaging modalities. Detection rates with CT were substantially lower. Thus, inclusion of functional data for assessment of cervical MUO patients must be recommended

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

    Science.gov (United States)

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

    2014-04-01

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

  2. Use of computed tomography and positron emission tomography/computed tomography for staging of local extent in patients with malignant pleural mesothelioma.

    Science.gov (United States)

    Frauenfelder, Thomas; Kestenholz, Peter; Hunziker, Roger; Nguyen, Thi Dan Linh; Fries, Martina; Veit-Haibach, Patrick; Husmann, Lars; Stahel, Rolf; Weder, Walter; Opitz, Isabelle

    2015-01-01

    The objective of this study was to determine the diagnostic value of computed tomography (CT) and positron emission tomography (PET)/CT for staging of malignant pleural mesothelioma (MPM) in patients undergoing induction chemotherapy. Sixty-two patients (median age, 61 years; female: n = 9) with proven MPM underwent CT after induction chemotherapy. Of these, 28 underwent additional PET/CT. Extrapleural pneumonectomy was performed for pathological TNM staging. Clinical TNM stage was assessed by 3 independent readers. Relative and absolute underestimation and overestimation were compared with pathological tumor stage. Sensitivity, specificity, and accuracy for differentiation between stages T2 and T3 were assessed. Interobserver agreement between the readers was analyzed (κ). Positron emission tomography/CT and CT underestimated T stage in up to 30% of the cases. Positron emission tomography/CT had a higher accuracy for tumor extent compared with CT (PET/CT: 0.92; CT: 0.84). The accuracy for nodal staging was higher for CT than for PET/CT (PET/CT: 0.78; CT: 0.87). Concerning International Mesothelioma Interest Group classification, PET/CT improved the accuracy of preoperative staging compared with CT (PET/CT: 0.91; CT: 0.82). Interobserver agreement was moderate for CT (0.48-0.62) and good for PET/CT (0.64-0.83) for T staging. For nodal staging, interobserver agreement was fair to moderate for CT and good for PET/CT (CT: 0.37-0.51; PET/CT: 0.73-0.76). Positron emission tomography/CT is more accurate and has a lower interobserver variability for clinical intrathoracic staging of MPM compared with CT. Nevertheless PET/CT underestimated tumor stage in a substantial number of cases, showing the need for a more accurate imaging technology or approach.

  3. Solitary pulmonary nodule evaluation in regions endemic for infectious diseases: Do regional variations impact the effectiveness of fluorodeoxyglucose positron emission tomography/computed tomography.

    Science.gov (United States)

    Purandare, N C; Pramesh, C S; Agarwal, J P; Agrawal, A; Shah, S; Prabhash, K; Karimundackal, G; Jiwnani, S; Tandon, S; Rangarajan, V

    2017-01-01

    Fluorodeoxyglucose positron emission tomography/computed tomography (FDG-PET/CT) has become a preferred imaging modality for the evaluation of solitary pulmonary nodule (SPN), particularly in the developed world. Since FDG can concentrate in infective/inflammatory lesions, the diagnostic utility of FDG-PET can be questioned, particularly in regions endemic for infectious decisions. To evaluate the accuracy of FDG-PET/CT in evaluation of SPNs in a population endemic for infectious disease and to assess if regional variations have an impact on its effectiveness. All patients who underwent an FDG/PET-CT with a clinico-radiological diagnosis of SPN categorized as indeterminate were included. Based on a maximum standardized uptake values (SUVmax) cut-off of 2.5, lesions were classified as benign (2.5) and compared with gold standard histopathology. The diagnostic accuracy of PET-CT to detect malignancy was calculated. On the basis of final histopathology, lesions were grouped as (a) malignant nodules (b) infective/granulomatous nodules with a specific diagnosis and (c) nonspecific inflammatory nodules. The SUVmaxbetween these groups was compared using nonparametric statistical tests. A total of 191 patients (129 males, 62 females) with a median age of 64 years (range: 36-83) were included. Totally, 144 nodules (75.3%) were malignant and 47 were benign (24.7%). Adenocarcinoma (n = 84) was the most common malignancy. Tuberculosis (n = 16) and nonspecific infections (n = 24) were the two most common benign pathologies. There was a significant overlap in the metabolic uptake of malignant (median SUVmax-11.2, range: 3.3-34.6) and tuberculous nodules (median SUVmax-10.3, range: 2.7-22.5) with no statistically difference between their SUVmaxvalues (P = 0.43). The false-positive rate was 65.2% and the false-negative rate was 5.5%. The sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of FDG-PET/CT for detecting malignancy were 94

  4. [18F]-Fluoromisonidazole Positron Emission Tomography/Computed Tomography Visualization of Tumor Hypoxia in Patients With Chordoma of the Mobile and Sacrococcygeal Spine

    Energy Technology Data Exchange (ETDEWEB)

    Cheney, Matthew D., E-mail: mcheney@lroc.harvard.edu [Harvard Radiation Oncology Program, Boston, Massachusetts (United States); Chen, Yen-Lin [Department of Radiation Oncology, Massachusetts General Hospital, Boston, Massachusetts (United States); Lim, Ruth [Department of Diagnostic Radiology, Massachusetts General Hospital, Boston, Massachusetts (United States); Winrich, Barbara K.; Grosu, Anca L.; Trofimov, Alexei V. [Department of Radiation Oncology, Massachusetts General Hospital, Boston, Massachusetts (United States); Depauw, Nicolas [Department of Radiation Oncology, Massachusetts General Hospital, Boston, Massachusetts (United States); Centre of Medical Radiation Physics, University of Wollongong, Wollongong, NSW (Australia); Shih, Helen A. [Department of Radiation Oncology, Massachusetts General Hospital, Boston, Massachusetts (United States); Schwab, Joseph H.; Hornicek, Francis J. [Department of Orthopedic Oncology, Massachusetts General Hospital, Boston, Massachusetts (United States); DeLaney, Thomas F. [Department of Radiation Oncology, Massachusetts General Hospital, Boston, Massachusetts (United States)

    2014-12-01

    Purpose: To investigate [18F]-fluoromisonidazole positron emission tomography/computed tomography (FMISO-PET/CT) detection of targetable hypoxic subvolumes (HSVs) in chordoma of the mobile or sacrococcygeal spine. Methods and Materials: A prospective, pilot study of 20 patients with primary or locally recurrent chordoma of the mobile or sacrococcygeal spine treated with proton or combined proton/photon radiation therapy (RT) with or without surgery was completed. The FMISO-PET/CT was performed before RT and after 19.8-34.2 GyRBE (relative biologic effectiveness). Gross tumor volumes were delineated and HSVs defined including voxels with standardized uptake values ≥1.4 times the muscle mean. Clinical characteristics and treatments received were compared between patients with and without HSVs. Results: The FMISO-PET/CT detected HSVs in 12 of 20 patients (60%). Baseline and interval HSV spatial concordance varied (0%-94%). Eight HSVs were sufficiently large (≥5 cm{sup 3}) to potentially allow an intensity modulated proton therapy boost. Patients with HSVs had significantly larger gross tumor volumes (median 410.0 cm{sup 3} vs 63.4 cm{sup 3}; P=.02) and were significantly more likely to have stage T2 tumors (5 of 12 vs 0 of 8; P=.04). After a median follow-up of 1.8 years (range, 0.2-4.4 years), a local recurrence has yet to be observed. Three patients developed metastatic disease, 2 with HSVs. Conclusions: Detection of targetable HSVs by FMISO-PET/CT within patients undergoing RT with or without surgery for treatment of chordoma of the mobile and sacrococcygeal spine is feasible. The study's inability to attribute interval HSV changes to treatment, rapidly changing hypoxic physiology, or imaging inconsistencies is a limitation. Further study of double-baseline FMISO-PET/CT and hypoxia-directed RT dose escalation, particularly in patients at high risk for local recurrence, is warranted.

  5. Prognostic significance of metabolic tumor burden by positron emission tomography/computed tomography in patients with relapsed/refractory diffuse large B-cell lymphoma.

    Science.gov (United States)

    Tateishi, Ukihide; Tatsumi, Mitsuaki; Terauchi, Takashi; Ando, Kiyoshi; Niitsu, Nozomi; Kim, Won Seog; Suh, Cheolwon; Ogura, Michinori; Tobinai, Kensei

    2015-02-01

    The aim of the present study was to investigate the feasibility of measuring metabolic tumor burden using [F-18] fluorodeoxyglucose ((18) F-FDG) positron emission tomography/computed tomography (PET/CT) in patients with relapsed or refractory diffuse large B-cell lymphoma (DLBCL) treated with bendamustine-rituximab. Because the standardized uptake value is a critical parameter of tumor characterization, we carried out a phantom study of (18) F-FDG PET/CT to ensure quality control for 28 machines in the 24 institutions (Japan, 17 institutions; Korea, 7 institutions) participating in our clinical study. Fifty-five patients with relapsed or refractory DLBCL were enrolled. The (18) F-FDG PET/CT was acquired before treatment, after two cycles, and after the last treatment cycle. Treatment response was assessed after two cycles and after the last cycle using the Lugano classification. Using this classification, remission was complete in 15 patients (27%) and incomplete in 40 patients (73%) after two cycles of therapy, and remission was complete in 32 patients (58%) and incomplete in 23 patients (42%) after the last treatment cycle. The percentage change in all PET/CT parameters except for the area under the curve of the cumulative standardized uptake value-volume histogram was significantly greater in complete response patients than in non-complete response patients after two cycles and the last cycle. The Cox proportional hazard model and best subset selection method revealed that the percentage change of the sum of total lesion glycolysis after the last cycle (relative risk, 5.24; P = 0.003) was an independent predictor of progression-free survival. The percent change of sum of total lesion glycolysis, calculated from PET/CT, can be used to quantify the response to treatment and can predict progression-free survival after the last treatment cycle in patients with relapsed or refractory DLBCL treated with bendamustine-rituximab. © 2014 The Authors. Cancer Science

  6. 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

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

    Energy Technology Data Exchange (ETDEWEB)

    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

  8. Cowden syndrome detected by FDG PET/CT in an endometrial cancer patient

    International Nuclear Information System (INIS)

    Kang, Yun Hee; Lee, Hye Kyung; Park, Geon

    2016-01-01

    Cowden syndrome (CS) is a rare autosomal dominant disorder characterized by multiple hamartomas in various tissues and cancers (breast, thyroid, and endometrium). We report CS of the esophagus and gastrointestinal tract that was incidentally detected by positron emission tomography/computed tomography (PET/CT) at postoperative surveillance in an endometrial cancer patient. PET/CT showed mildly increased FDG uptake along the entire esophagus and stomach. Upper GI endoscopy and histologic examination revealed glycogenic acanthosis of the esophagus and several hundred gastric polyps. In our case, increased FDG uptake of the esophageal wall contributed to the diagnosis of CS

  9. Cowden syndrome detected by FDG PET/CT in an endometrial cancer patient

    Energy Technology Data Exchange (ETDEWEB)

    Kang, Yun Hee; Lee, Hye Kyung [Eulji University Hospital, Daejeon (Korea, Republic of); Park, Geon [Dept. of Radiology, The Catholic University of Korea, Daejeon Saint Mary' s Hospital, Daejeon (Korea, Republic of)

    2016-09-15

    Cowden syndrome (CS) is a rare autosomal dominant disorder characterized by multiple hamartomas in various tissues and cancers (breast, thyroid, and endometrium). We report CS of the esophagus and gastrointestinal tract that was incidentally detected by positron emission tomography/computed tomography (PET/CT) at postoperative surveillance in an endometrial cancer patient. PET/CT showed mildly increased FDG uptake along the entire esophagus and stomach. Upper GI endoscopy and histologic examination revealed glycogenic acanthosis of the esophagus and several hundred gastric polyps. In our case, increased FDG uptake of the esophageal wall contributed to the diagnosis of CS.

  10. Bone formation rather than inflammation reflects Ankylosing Spondylitis activity on PET-CT: a pilot study

    OpenAIRE

    Bruijnen, Stefan TG; van der Weijden, Mignon AC; Klein, Joannes P; Hoekstra, Otto S; Boellaard, Ronald; van Denderen, J Christiaan; Dijkmans, Ben AC; Voskuyl, Alexandre E; van der Horst-Bruinsma, Irene E; van der Laken, Conny J

    2012-01-01

    Introduction Positron Emission Tomography - Computer Tomography (PET-CT) is an interesting imaging technique to visualize Ankylosing Spondylitis (AS) activity using specific PET tracers. Previous studies have shown that the PET tracers [18F]FDG and [11C](R)PK11195 can target inflammation (synovitis) in rheumatoid arthritis (RA) and may therefore be useful in AS. Another interesting tracer for AS is [18F]Fluoride, which targets bone formation. In a pilot setting, the potential of PET-CT in ima...

  11. Ambient radiation levels in a microPET/CT research laboratory

    Energy Technology Data Exchange (ETDEWEB)

    Sarmento, D.M.; Rodrigues, D.L.; Sanches, M.P.; Carneiro, J.C.G.G., E-mail: janetegc@ipen.br [Instituto de Pesquisas Energeticas e Nucleres (IPEN/CNEN-SP), Sao Paulo, SP (Brazil)

    2015-07-01

    This study focuses on initial radiological evaluation and the exposure situation related to the worker task in a micro-positron emission tomography/computed tomography laboratory (microPET/CT). Selected and calibrated thermoluminescent dosimeters, TLD, of CaSO{sub 4}:Dy were used to measure room radiation levels. The detectors were placed in several selected points inside the microPET/CT laboratory and adjacent rooms. In addition, the occupationally exposed workers were monthly evaluated for external and internal exposures. In none of the selected points the dose values exceeded the radiation dose limit established for supervised area, as well as the values obtained in individual monitoring. (author)

  12. Ambient radiation levels in a microPET/CT research laboratory

    International Nuclear Information System (INIS)

    Sarmento, D.M.; Rodrigues, D.L.; Sanches, M.P.; Carneiro, J.C.G.G.

    2015-01-01

    This study focuses on initial radiological evaluation and the exposure situation related to the worker task in a micro-positron emission tomography/computed tomography laboratory (microPET/CT). Selected and calibrated thermoluminescent dosimeters, TLD, of CaSO 4 :Dy were used to measure room radiation levels. The detectors were placed in several selected points inside the microPET/CT laboratory and adjacent rooms. In addition, the occupationally exposed workers were monthly evaluated for external and internal exposures. In none of the selected points the dose values exceeded the radiation dose limit established for supervised area, as well as the values obtained in individual monitoring. (author)

  13. Use of Positron Emission Tomography/Computed Tomography in Radiation Treatment Planning for Lung Cancer

    Directory of Open Access Journals (Sweden)

    Kezban Berberoğlu

    2016-06-01

    Full Text Available Radiotherapy (RT plays an important role in the treatment of lung cancer. Accurate diagnosis and staging are crucial in the delivery of RT with curative intent. Target miss can be prevented by accurate determination of tumor contours during RT planning. Currently, tumor contours are determined manually by computed tomography (CT during RT planning. This method leads to differences in delineation of tumor volume between users. Given the change in RT tools and methods due to rapidly developing technology, it is now more significant to accurately delineate the tumor tissue. F18 fluorodeoxyglucose positron emission tomography/CT (F18 FDG PET/CT has been established as an accurate method in correctly staging and detecting tumor dissemination in lung cancer. Since it provides both anatomic and biologic information, F18 FDG PET decreases interuser variability in tumor delineation. For instance, tumor volumes may be decreased as atelectasis and malignant tissue can be more accurately differentiated, as well as better evaluation of benign and malignant lymph nodes given the difference in FDG uptake. Using F18 FDG PET/CT, the radiation dose can be escalated without serious adverse effects in lung cancer. In this study, we evaluated the contribution of F18 FDG PET/CT for RT planning in lung cancer.

  14. Metastasis in urothelial carcinoma mimicking prostate cancer metastasis in Ga-68 prostate-specific membrane antigen positron emission tomography-computed tomography in a case of synchronous malignancy

    International Nuclear Information System (INIS)

    Gupta, Manoj; Choudhury, Partha Sarathi; Gupta, Gurudutt; Gandhi, Jatin

    2016-01-01

    Prostate cancer is the second most common cancer in man. It commonly presents with urinary symptoms, bone pain, or diagnosed with elevated prostate-specific antigen.(PSA) levels. Correct staging and early diagnosis of recurrence by a precise imaging tool are the keys for optimum management. Molecular imaging of prostate cancer with Ga-68 prostate-specific membrane antigen.(PSMA), positron emission tomography-computed tomography.(PET-CT) has recently received significant attention and frequently used with a signature to prostate cancer-specific remark. However, this case will highlight the more cautious use of it. A-72-year-old male treated earlier for synchronous double malignancy.(invasive papillary urothelial carcinoma right ureter and carcinoma prostate) presented with rising PSA.(0.51.ng/ml) and referred for Ga-68 PSMA PET-CT, which showed a positive enlarged left supraclavicular lymph node. Lymph node biopsy microscopic and immunohistochemistry examination revealed metastatic carcinoma favoring urothelial origin. Specificity of PSMA scan to prostate cancer has been seen to be compromised in a certain situation mostly due to neoangiogenesis, and false positives emerged in renal cell cancer, differentiated thyroid cancer, glioblastoma, breast cancer brain metastasis, and paravertebral schwannomas. Understanding the causes of false positive will further enhance the confidence of interpretating PSMA scans

  15. Predictive value of pretreatment positron emission tomography/computed tomography in patients with newly diagnosed extranodal natural killer/T-cell lymphoma.

    Science.gov (United States)

    Bai, Bing; Huang, Hui-Qiang; Cai, Qi-Chun; Fan, Wei; Wang, Xiao-Xiao; Zhang, Xu; Lin, Ze-Xiao; Gao, Yan; Xia, Yun-Fei; Guo, Ying; Cai, Qing-Qing; Jiang, Wen-Qi; Lin, Tong-Yu

    2013-03-01

    The role of (18)Fluorodeoxyglucose positron emission tomography/computed tomography (PET/CT) in extranodal natural killer/T-cell lymphoma (ENKL) is not well established. This study aimed to investigate the prognostic role of the pretreatment maximum standardized uptake value (SUV(max)) on PET/CT in patients with newly diagnosed ENKL. Among 364 consecutive patients with newly diagnosed ENKL, 81 patients were included and reviewed. The impact of SUV(max) on survival and the relationship between SUV(max) and other clinicopathological parameters were analyzed. The median SUV(max) was 14.6 (range 2.0-45.4). The optimal cutoff value of SUV(max) to predict overall survival (OS) was 15. Patients with high SUV(max) (SUVmax >15) were associated with bulky disease (P KPI, P = 0.046), resistance to primary treatment (P = 0.014), poor OS (P 60 years (P = 0.001), stage III-IV (P = 0.023), SUV(max) >15 (P = 0.020), and bulky disease (>5 cm) (P = 0.002). By using the SUV(max), patients in most subgroups stratified by the KPI or the International Prognostic Index (IPI) were further discriminated in OS with significant statistical difference. Our results suggest the pretreatment SUV(max) is predictive of prognosis in patients with newly diagnosed ENKL. The SUV(max) may provide additional prognostic information for IPI and KPI.

  16. 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

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

    International Nuclear Information System (INIS)

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

    2018-01-01

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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2018-03-15

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

  19. Risk Stratification of Thyroid Incidentalomas Found on PET/CT: The Value of Iodine Content on Noncontrast Computed Tomography.

    Science.gov (United States)

    Kim, Dongwoo; Hwang, Sang Hyun; Cha, Jongtae; Jo, Kwanhyeong; Lee, Narae; Yun, Mijin

    2015-11-01

    The Hounsfield unit (HU) ratio of thyroid nodules was assessed compared to the contralateral thyroid lobe on noncontrast computed tomography (CT) to stratify further the risk of malignancy in thyroid incidentalomas found on 18F-fluorodeoxyglucose ((18)F-FDG) positron emission tomography/CT (PET/CT). This retrospective analysis included 82 patients who had thyroid incidentalomas on PET/CT in 2011. On PET/CT, the maximal standardized uptake value ratios of the thyroid nodule compared to liver (T/BSUV) and the HU ratios of the thyroid nodule compared to contralateral thyroid lobe (T/BHU) were calculated. Diagnostic performances of the T/BSUV and T/BHU were compared. The area under the curve of T/BHU was higher than that of T/BSUV (0.941 vs. 0.689, p risk of malignancy was much higher (71.1%) in nodules with a T/BHU cutoff value ≤0.68, whereas it was 0% in nodules with a T/BHU of >0.68. In this study, there were 18 nodules with nondiagnostic (n = 7) or atypia of undetermined significance or follicular lesion of undetermined significance cytologies (n = 11) after fine-needle aspiration biopsy (FNAB). When the T/BHU cutoff value was applied, three (60%) of the five nodules with a T/BHU of ≤0.68 were found to be papillary carcinomas. The remaining 13 nodules with a T/BHU of >0.68 were all benign with a risk of malignancy of 0%. T/BHU is a simple and effective parameter to stratify the risk of malignancy in thyroid incidentalomas found on PET/CT. This may be of clinical relevance in those nodules with nondiagnostic or undetermined significance cytologies upon FNAB in the scheme of current clinical practice.

  20. 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...

  1. 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

  2. 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

  3. 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

  4. Outcomes of Modestly Hypofractionated Radiation for Lung Tumors: Pre- and Mid-Treatment Positron Emission Tomography-Computed Tomography Metrics as Prognostic Factors.

    Science.gov (United States)

    Harris, Jeremy P; Chang-Halpenny, Christine N; Maxim, Peter G; Quon, Andrew; Graves, Edward E; Diehn, Maximilian; Loo, Billy W

    2015-11-01

    Many patients with lung tumors have tumors too large for stereotactic ablative radiotherapy and comorbidities precluding concurrent chemotherapy. We report the outcomes of 29 patients treated with hypofractionated radiotherapy (RT) to 60 to 66 Gy in 3-Gy fractions. We also report an exploratory analysis of the prognostic value of the pre- and mid-RT positron emission tomography-computed tomography. Modestly hypofractionated radiation therapy (HypoRT; 60-66 Gy in 3-Gy fractions) allows patients with locally advanced thoracic tumors and poor performance status to complete treatment within a shorter period without concurrent chemotherapy. We evaluated the outcomes and imaging prognostic factors of HypoRT. We retrospectively reviewed the data from all patients with primary and metastatic intrathoracic tumors treated with HypoRT from 2006 to 2012. We analyzed the survival and toxicity outcomes, including overall survival (OS), progression-free survival (PFS), local recurrence (LR), and distant metastasis. We also evaluated the following tumor metrics in an exploratory analysis: gross tumor volume (GTV), maximum standardized uptake value (SUVMax), and metabolic tumor volume using a threshold of ≥ 50% of the SUVMax (MTV50%) or the maximum gradient of fluorine-18 fluorodeoxyglucose uptake (MTVEdge). We assessed the association of these metrics and their changes from before to mid-RT using positron emission tomography-computed tomography (PET-CT) with OS and PFS. We identified 29 patients, all with pre-RT and 20 with mid-RT PET-CT scans. The median follow-up period was 15 months. The 2-year overall and non-small-cell lung cancer-only rate for OS, PFS, and LR, was 59% and 59%, 52% and 41%, and 27% and 32%, respectively. No grade ≥ 3 toxicities developed. The median decrease in GTV, SUVMax, and MTVEdge was 11%, 24%, and 18%, respectively. Inferior OS was associated with a larger pre-RT MTVEdge (P = .005) and pre-RT MTV50% (P = .007). Inferior PFS was associated with a

  5. Contrast-enhanced fluorodeoxyglucose positron emission tomography/contrast-enhanced computed tomography in mediastinal T-cell lymphoma with superior vena cava syndrome

    International Nuclear Information System (INIS)

    Santhosh, Sampath; Gorla, Arun Kumar Reddy; Bhattacharya, Anish; Varma, Subhash Chander; Mittal, Bhagwant Rai

    2016-01-01

    Positron emission tomography-computed tomography (PET/CT) is a routine investigation for the staging of lymphomas. Contrast-enhanced computed tomography is mandatory whenever parenchymal lesions, especially in the liver and spleen are suspected. We report a rare case of primary mediastinal T-cell lymphoma evaluated with contrast-enhanced PET/CT that showed features of superior vena cava syndrome

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2017-03-15

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

  7. Detection of synchronous parathyroid adenoma and breast cancer with {sup 18}F-fluorocholine PET-CT

    Energy Technology Data Exchange (ETDEWEB)

    Vorselaars, Wessel MCM; Kluijfthout, Wiuter P.; Vriens, Menno R; Van der Pol, Carmen C.; Rinkes, Inne HM Borel; Valk, Gerlof D.; De Keizer, Bart [University Medical Center Utrecht, Utrecht (Netherlands)

    2016-06-15

    A 71-year-old woman was referred to our tertiary care center for evaluation of asymptomatic recurrence of primary hyperparathyroidism. As per our protocol, the patient underwent neck/mediastinum {sup 18}F-fluorocholine (FCH) positron emission tomography-computed tomography (PET-CT) for localization. In our institution, FCH PET-CT is performed in patients with hyperparathyroidism and negative conventional imaging. FCH PET-CT is a promising new imaging modality for detection of hyperfunctioning parathyroid glands. As can be seen in the case presented, high FCH uptake was seen in a small breast cancer. Due to its favorable half-life and wide availability by its use as a localization technique for patients with prostate cancer and complicated hyperparathyroidism, FCH PET-CT may be a new promising modality in the imaging of breast cancer.

  8. 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

  9. Diagnostic Accuracy of 64Copper Prostate-specific Membrane Antigen Positron Emission Tomography/Computed Tomography for Primary Lymph Node Staging of Intermediate- to High-risk Prostate Cancer: Our Preliminary Experience.

    Science.gov (United States)

    Cantiello, Francesco; Gangemi, Vincenzo; Cascini, Giuseppe Lucio; Calabria, Ferdinando; Moschini, Marco; Ferro, Matteo; Musi, Gennaro; Butticè, Salvatore; Salonia, Andrea; Briganti, Alberto; Damiano, Rocco

    2017-08-01

    To assess the diagnostic accuracy of 64 Copper prostate-specific membrane antigen ( 64 Cu-PSMA) positron emission tomography/computed tomography (PET/CT) in the primary lymph node (LN) staging of a selected cohort of intermediate- to high-risk prostate cancer (PCa) patients. An observational prospective study was performed in 23 patients with intermediate- to high-risk PCa, who underwent 64 Cu-PSMA PET/CT for local and lymph nodal staging before laparoscopic radical prostatectomy with an extended pelvic LN dissection. The sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) for LN status of 64 Cu-PSMA PET/CT were calculated using the final pathological findings as reference. Furthermore, we evaluated the correlation of intraprostatic tumor extent and grading with 64 Cu-PSMA intraprostatic distribution. Pathological analysis of LN involvement in 413 LNs harvested from our study cohort identified a total of 22 LN metastases in 8 (5%) of the 23 (35%) PCa patients. Imaging-based LN staging in a per-patient analysis showed that 64 Cu-PSMA PET/CT was positive in 7 of 8 LN-positive patients (22%) with a sensitivity of 87.5%, specificity of 100%, PPV of 100%, and NPV of 93.7%, considering the maximum standardized uptake value (SUV max ) at 4 hours as our reference. Receiver operating characteristic curve was characterized by an area under the curve of 0.938. A significant positive association was observed between SUV max at 4 hours with Gleason score, index, and cumulative tumor volume. In our intermediate- to high-risk PCa patients study cohort, we showed the high diagnostic accuracy of 64 Cu-PSMA PET/CT for primary LN staging before radical prostatectomy. Copyright © 2017 Elsevier Inc. All rights reserved.

  10. Simultaneous whole body (18)F-fluorodeoxyglucose positron emission tomography magnetic resonance imaging for evaluation of pediatric cancer: Preliminary experience and comparison with (18)F-fluorodeoxyglucose positron emission tomography computed tomography.

    Science.gov (United States)

    Pugmire, Brian S; Guimaraes, Alexander R; Lim, Ruth; Friedmann, Alison M; Huang, Mary; Ebb, David; Weinstein, Howard; Catalano, Onofrio A; Mahmood, Umar; Catana, Ciprian; Gee, Michael S

    2016-03-28

    To describe our preliminary experience with simultaneous whole body (18)F-fluorodeoxyglucose ((18)F-FDG) positron emission tomography and magnetic resonance imaging (PET-MRI) in the evaluation of pediatric oncology patients. This prospective, observational, single-center study was Health Insurance Portability and Accountability Act-compliant, and institutional review board approved. To be eligible, a patient was required to: (1) have a known or suspected cancer diagnosis; (2) be under the care of a pediatric hematologist/oncologist; and (3) be scheduled for clinically indicated (18)F-FDG positron emission tomography-computed tomography (PET-CT) examination at our institution. Patients underwent PET-CT followed by PET-MRI on the same day. PET-CT examinations were performed using standard department protocols. PET-MRI studies were acquired with an integrated 3 Tesla PET-MRI scanner using whole body T1 Dixon, T2 HASTE, EPI diffusion-weighted imaging (DWI) and STIR sequences. No additional radiotracer was given for the PET-MRI examination. Both PET-CT and PET-MRI examinations were reviewed by consensus by two study personnel. Test performance characteristics of PET-MRI, for the detection of malignant lesions, including FDG maximum standardized uptake value (SUVmax) and minimum apparent diffusion coefficient (ADCmin), were calculated on a per lesion basis using PET-CT as a reference standard. A total of 10 whole body PET-MRI exams were performed in 7 pediatric oncology patients. The mean patient age was 16.1 years (range 12-19 years) including 6 males and 1 female. A total of 20 malignant and 21 benign lesions were identified on PET-CT. PET-MRI SUVmax had excellent correlation with PET-CT SUVmax for both benign and malignant lesions (R = 0.93). PET-MRI SUVmax > 2.5 had 100% accuracy for discriminating benign from malignant lesions using PET-CT reference. Whole body DWI was also evaluated: the mean ADCmin of malignant lesions (780.2 + 326.6) was significantly lower than

  11. Simultaneous whole body 18F-fluorodeoxyglucose positron emission tomography magnetic resonance imaging for evaluation of pediatric cancer: Preliminary experience and comparison with 18F-fluorodeoxyglucose positron emission tomography computed tomography

    Science.gov (United States)

    Pugmire, Brian S; Guimaraes, Alexander R; Lim, Ruth; Friedmann, Alison M; Huang, Mary; Ebb, David; Weinstein, Howard; Catalano, Onofrio A; Mahmood, Umar; Catana, Ciprian; Gee, Michael S

    2016-01-01

    AIM: To describe our preliminary experience with simultaneous whole body 18F-fluorodeoxyglucose (18F-FDG) positron emission tomography and magnetic resonance imaging (PET-MRI) in the evaluation of pediatric oncology patients. METHODS: This prospective, observational, single-center study was Health Insurance Portability and Accountability Act-compliant, and institutional review board approved. To be eligible, a patient was required to: (1) have a known or suspected cancer diagnosis; (2) be under the care of a pediatric hematologist/oncologist; and (3) be scheduled for clinically indicated 18F-FDG positron emission tomography-computed tomography (PET-CT) examination at our institution. Patients underwent PET-CT followed by PET-MRI on the same day. PET-CT examinations were performed using standard department protocols. PET-MRI studies were acquired with an integrated 3 Tesla PET-MRI scanner using whole body T1 Dixon, T2 HASTE, EPI diffusion-weighted imaging (DWI) and STIR sequences. No additional radiotracer was given for the PET-MRI examination. Both PET-CT and PET-MRI examinations were reviewed by consensus by two study personnel. Test performance characteristics of PET-MRI, for the detection of malignant lesions, including FDG maximum standardized uptake value (SUVmax) and minimum apparent diffusion coefficient (ADCmin), were calculated on a per lesion basis using PET-CT as a reference standard. RESULTS: A total of 10 whole body PET-MRI exams were performed in 7 pediatric oncology patients. The mean patient age was 16.1 years (range 12-19 years) including 6 males and 1 female. A total of 20 malignant and 21 benign lesions were identified on PET-CT. PET-MRI SUVmax had excellent correlation with PET-CT SUVmax for both benign and malignant lesions (R = 0.93). PET-MRI SUVmax > 2.5 had 100% accuracy for discriminating benign from malignant lesions using PET-CT reference. Whole body DWI was also evaluated: the mean ADCmin of malignant lesions (780.2 + 326.6) was

  12. Impact of EBUS-TBNA on PET-CT Imaging of Mediastinal Nodes

    DEFF Research Database (Denmark)

    Sivapalan, Pradeesh; Naur, Therese Maria Henriette; Colella, Sara

    2017-01-01

    BACKGROUND: Positron emission tomography-computed tomography (PET-CT) with fluorine-18-fluorodeoxyglucose has a high sensitivity in detecting malignancy in patients suspected of lung cancer but a low specificity as inflammatory reactions can also result in metabolic activity. Furthermore, it is a......BACKGROUND: Positron emission tomography-computed tomography (PET-CT) with fluorine-18-fluorodeoxyglucose has a high sensitivity in detecting malignancy in patients suspected of lung cancer but a low specificity as inflammatory reactions can also result in metabolic activity. Furthermore......, it is assumed that invasive pulmonary procedures with biopsies from benign lesions can induce metabolic activity resulting in false-positive results. However, this hypothesis lacks solid evidence. We aimed to evaluate how often endobronchial ultrasound (EBUS) with biopsies from benign lesions are followed...

  13. {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.)

  14. 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.)

  15. Usefulness of F-18 FDG PET/CT in the Evaluation of Early Treatment Response After Inverventional Therapy for Hepatocellular Carcinoma

    International Nuclear Information System (INIS)

    Kim Sung Hoon; Won Kyoung Sook; Choi Byung Wook; Jo Il; Zeon Seok Kil; Chung Woo Jin; Kwon Jung Hyeok

    2012-01-01

    This retrospective study investigated the usefulness of F-18 fluorodeoxyglucose (FDG) positron emission tomography/computed tomography (PET/CT) after inter-ventional therapy for hepatocellular carcinoma (HCC). Between March 2007 and November 2010, 31 Patients (24 men, 7 women; mean age, 61.8±11.0 -5-

  16. Fluorine-18 fluorodeoxyglucose positron emission tomography-computed tomography in evaluation of residual intramuscular myxoma

    International Nuclear Information System (INIS)

    Zade, Anand; Ahire, Archana; Shetty, Shishir; Rai, Sujith; Bokka, Rajashekharrao; Velumani, Arokiaswamy; Kabnurkar, Rasika

    2015-01-01

    Intramuscular myxoma (IM) is a rare benign neoplasm. In a patient diagnosed with IM of left thigh, we report the utility of a postoperative fluorine-18 fluorodeoxyglucose positron emission tomography-computed tomography scan in assessing the efficacy of surgical excision

  17. Regulatory requirements for designing PET-CT facility in India

    International Nuclear Information System (INIS)

    Tandon, Pankaj

    2010-01-01

    In India, cyclotron-produced radionuclides are gaining importance in molecular imaging in Nuclear Medicine (NM) departments. The importance of this modality among others is due to the fact that it provides valuable clinical information, which was lacking in other available modalities. Presently, every well-established hospital would like to procure Medical Cyclotron or positron emission tomography-computed tomography (PET-CT) facility in their NM department. Because cyclotron-produced radionuclides have higher energy than the other routinely used radionuclides for diagnosis, it becomes essential for the user to know about the regulatory requirement and radiation safety precautions that one has to take for the installation of this new modality in their premises. The various stages of approval of PET-CT facility by the Atomic Energy Regulatory Board (AERB) and important steps that one has to know/follow before planning for this new facility are summarized

  18. The Comparison of Computed Tomography Perfusion, Contrast-Enhanced Computed Tomography and Positron-Emission Tomography/Computed Tomography for the Detection of Primary Esophageal Carcinoma.

    Science.gov (United States)

    Genc, Berhan; Kantarci, Mecit; Sade, Recep; Orsal, Ebru; Ogul, Hayri; Okur, Aylin; Aydin, Yener; Karaca, Leyla; Eroğlu, Atilla

    2016-01-01

    The purpose of this study was to investigate the efficiency of computed tomography perfusion (CTP), contrast-enhanced computed tomography (CECT) and 18F-fluoro-2-deoxy-D-glucose (18F-FDG) positron-emission tomography (PET/CT) in the diagnosis of esophageal cancer. This prospective study consisted of 33 patients with pathologically confirmed esophageal cancer, 2 of whom had an esophageal abscess. All the patients underwent CTP, CECT and PET/CT imaging and the imaging findings were evaluated. Sensitivity, specificity and positive and negative predictive values were calculated for each of the 3 imaging modalities relative to the histological diagnosis. Thirty-three tumors were visualized on CTP, 29 on CECT and 27 on PET/CT. Six tumors were stage 1, and 2 and 4 of these tumors were missed on CECT and PET/CT, respectively. Significant differences between CTP and CECT (p = 0.02), and between CTP and PET/CT (p = 0.04) were found for stage 1 tumors. Values for the sensitivity, specificity and positive and negative predictive values on CTP were 100, 100, 100 and 100%, respectively. Corresponding values on CECT were 93.94, 0, 93.94 and 0%, respectively, and those on PET/CT were 87.88, 0, 93.55 and 0%, respectively. Hence, the sensitivity, specificity and positive and negative predictive values of CTP were better than those of CECT and PET/CT. CTP had an advantage over CECT and PET/CT in detecting small lesions. CTP was valuable, especially in detecting stage 1 tumors. © 2016 S. Karger AG, Basel.

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

    OpenAIRE

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

    2017-01-01

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

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

    OpenAIRE

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

    2015-01-01

    Brain Positron Emission Tomography/Computed Tomography with 18F-fluorodeoxyglucose (FDG PET/CT) was performed in a 44-year-old woman with marked cognitive impairment, diffuse myalgias, sensory, memory and visual disorders, and chronic fatigue, presenting with histopathological features of macrophagic myofasciitis (MMF) at deltoid muscle biopsy. Cerebromedullary Magnetic Resonance Imaging (MRI), electromyography, ophthalmic examination, and cerebrospinal fluid analysis were normal. Visual anal...

  1. MR imaging versus PET/CT for evaluation of pancreatic lesions

    Energy Technology Data Exchange (ETDEWEB)

    Belião, Sara, E-mail: sara.beliao@clix.pt [Department of Radiology Hospital S. Francisco Xavier, Estrada do Forte do Alto do Duque, 1495-005 Lisbon (Portugal); Ferreira, Alexandra, E-mail: alexandratavaresferreira@gmail.com [Department of Radiology, Hospital D. Estefânia, Rua Jacinta Marto, 1169-045 Lisbon (Portugal); Vierasu, Irina, E-mail: Ortansa-Irina.Vierasu@ulb.ac.be [Service de Médecine Nucléaire, Route de Lennik 808, 1070 Brussels (Belgium); Blocklet, Didier, E-mail: dblockle@ulb.ac.be [Service de Médecine Nucléaire, Route de Lennik 808, 1070 Brussels (Belgium); Goldman, Serge, E-mail: petscan@ulb.ac.be [Service de Médecine Nucléaire, Route de Lennik 808, 1070 Brussels (Belgium); Metens, Thierry, E-mail: tmetens@ulb.ac.be [Service de Radiologie – Imagerie par Resonance Magnétique, Route de Lennik 808, 1070 Brussels (Belgium); Matos, Celso, E-mail: cmatos@ulb.ac.be [Service de Radiologie – Imagerie par Resonance Magnétique, Route de Lennik 808, 1070 Brussels (Belgium)

    2012-10-15

    Purpose: To retrospectively determine the diagnostic accuracy of magnetic resonance imaging (MRI) and combined positron emission tomography/computed tomography (PET/CT) in the differential diagnosis of benign and malignant pancreatic lesions. Materials and methods: Twenty-seven patients (15 women/12 men, mean age 56.5 years) with MR imaging and PET/CT studies performed to differentiate benign and malignant pancreatic lesions were identified between October 2008 and October 2010. Both MR and PET/CT data sets were retrospectively and blindly evaluated by two independent readers (4 readers total) with different degrees of experience, using a visual five-point score system. The results were correlated with final diagnosis obtained by histopathology. Results: 17 patients had malignant diseases and 10 patients had benign diseases. Depending on the observer, the sensitivity, specificity, positive predictive value and negative predictive value of MRI varied between 88–94%, 50–80%, 75–89% and 71–89% respectively. Sensitivities, specificities, positive predictive values and negative predictive values of PET/CT were 73%, 56%, 73% and 56% respectively. The diagnostic accuracy of MR for the differential diagnosis of pancreatic lesions was 74–89%, compared with 67% for PET/CT. The weighted Cohen's kappa coefficient was 0.47 at MR and 0.53 at PET/CT. Conclusion: MRI achieved higher sensitivity and specificity in the differential diagnosis of pancreatic lesions.

  2. Use of Computed Tomography and Positron Emission Tomography/Computed Tomography for Staging of Local Extent in Patients With Malignant Pleural Mesothelioma

    OpenAIRE

    Frauenfelder, Thomas; Kestenholz, Peter; Hunziker, Roger; Nguyen, Thi Dan Linh; Fries, Martina; Veit-Haibach, Patrick; Husmann, Lars; Stahel, Rolf; Weder, Walter; Opitz, Isabelle

    2015-01-01

    PURPOSE The objective of this study was to determine the diagnostic value of computed tomography (CT) and positron emission tomography (PET)/CT for staging of malignant pleural mesothelioma (MPM) in patients undergoing induction chemotherapy. METHODS Sixty-two patients (median age, 61 years; female: n = 9) with proven MPM underwent CT after induction chemotherapy. Of these, 28 underwent additional PET/CT. Extrapleural pneumonectomy was performed for pathological TNM staging. Clinical TNM s...

  3. Roles of computed tomography and [18F]fluorodeoxyglucose-positron emission tomography/computed tomography in the characterization of multiple solitary solid lung nodules

    OpenAIRE

    Travaini, LL; Trifirò, G; Vigna, PD; Veronesi, G; De Pas, TM; Spaggiari, L; Paganelli, G; Bellomi, M

    2012-01-01

    The purpose of this study is to compare the performance of multidetector computed tomography (CT) and positron emission tomography/CT (PET/CT) with [18F]fluorodeoxyglucose in the diagnosis of multiple solitary lung nodules in 14 consecutive patients with suspicious lung cancer. CT and PET/CT findings were reviewed by a radiologist and nuclear medicine physician, respectively, blinded to the pathological diagnoses of lung cancer, considering nodule size, shape, and location (CT) and maximum st...

  4. Value of {sup 18}F-fluorodeoxyglucose uptake in positron emission tomography/computed tomography in predicting survival in multiple myeloma

    Energy Technology Data Exchange (ETDEWEB)

    Haznedar, Rauf; Aki, Sahika Z.; Oezkurt, Zuebeyde N.; Yagci, Muenci; Sucak, Gulsan T. [Gazi University Faculty of Medicine, Department of Hematology, Ankara (Turkey); Akdemir, Oezguer U. [Gazi University Faculty of Medicine, Department of Nuclear Medicine, Ankara (Turkey); Ceneli, Oezcan [Kirikkale University Sueleyman Demirel Hospital, Department of Hematology, Kirikkale (Turkey); Uenlue, Mustafa [Gazi University Faculty of Medicine, Department of Nuclear Medicine, Ankara (Turkey); Gazi University Faculty of Medicine, Ankara (Turkey)

    2011-06-15

    We assessed the role of the maximum standardized uptake value (SUV{sub max}) of bone marrow and the extramedullary lesion with the highest SUV{sub max} in positron emission tomography/computed tomography (PET/CT) of newly diagnosed multiple myeloma (MM) patients in predicting overall survival (OS). A total of 61 newly diagnosed patients (55 MM and 6 plasmacytoma) were enrolled in the study [37 men and 24 women with a median age of 57 years (range 28-80 years)]. The SUV{sub max} of bone marrow and the extramedullary lesion in PET/CT was correlated with the levels of {beta}{sub 2}-microglobulin, C-reactive protein (CRP), albumin, creatinine, per cent of bone marrow plasma cells, serum free light chain (FLC) ratio, International Staging System (ISS) score and Durie-Salmon stage. The extramedullary lesion with the highest SUV{sub max} showed significant correlation with bone marrow fluorodeoxyglucose (FDG) uptake (p = 0.027) and near significant correlation with ISS (p = 0.048). Bone marrow SUV{sub max} correlated significantly with the per cent of bone marrow plasma cell count (p = 0.024), CRP (p = 0.012) and ISS (p = 0.013). In stage III MM the mean values of SUV{sub max} in extramedullary lesions were significantly higher than stages I and II (6.23 {+-} 6.32 vs 2.85 {+-} 3.44, p = 0.023). The serum FLC ratio did not show any correlation with SUV{sub max} of lesions and bone marrow (p > 0.05). Forty-four MM patients with FDG-positive lesions in PET/CT showed inferior 5-year estimated survival (61.73%) when compared to 11 patients without FDG-positive lesions, all of whom were alive (p = 0.01). In multivariate analysis an extramedullary lesion with the highest SUV{sub max} was the only independent predictor of OS (p = 0.03). PET/CT allows identification of high-risk myeloma patients, and extramedullary lesions with the highest SUV{sub max} independently predict inferior OS. (orig.)

  5. 18F-FDG-PET/CT in staging, restaging, and treatment response assessment of male breast cancer

    International Nuclear Information System (INIS)

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

    2014-01-01

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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2014-10-15

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

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

    Science.gov (United States)

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

    2018-05-01

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

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

    International Nuclear Information System (INIS)

    Kwee, Thomas C.; Kwee, Robert M.

    2009-01-01

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

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

    Science.gov (United States)

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

    2017-01-01

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

  10. Efficacy of 3D-positron emission tomography/computed tomography for upper abdomen.

    Science.gov (United States)

    Murakami, Koji; Nakahara, Tadaki

    2014-04-01

    Recent advancement in computed tomography (CT) enables us to obtain high spatial resolution image and made it possible to construct extensive high-definition three-dimensional (3D) images. But a lack of contrast resolution in CT alone is still remained problem. Meanwhile, as fluorodeoxyglucose-positron emission tomography (PET) can visualize tumors in high contrast, we can create 3D images fusing the accumulation in tumors on PET/CT images. Such images can play the role of a "map of body" which makes it easy to understand the anatomical information before surgery. We also try to evaluate segmental liver function by using PET/CT fusion images. By using (11) C-methionine PET/contrast-enhanced CT, superior image quality compared to single photon emission computed tomography/CT can be obtained. CT, especially with contrast enhancement for obtaining anatomical imaging information plus PET for obtaining functional imaging information is a highly compatible combination, and adding these two types information will further increase clinical usefulness. © 2014 Japanese Society of Hepato-Biliary-Pancreatic Surgery.

  11. 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/CT

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2010-07-15

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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2012-06-15

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

  14. Acute Calculous Cholecystitis Missed on Computed Tomography and Ultrasound but Diagnosed with Fluorodeoxyglucose-Positron Emission Tomography/Computed Tomography

    Directory of Open Access Journals (Sweden)

    Carina Mari Aparici

    2016-01-01

    Full Text Available We present a case of a 69-year-old patient who underwent ascending aortic aneurysm repair with aortic valve replacement. On postsurgical day 12, he developed leukocytosis and low-grade fevers. The chest computed tomography (CT showed a periaortic hematoma which represents a postsurgical change from aortic aneurysm repair, and a small pericardial effusion. The abdominal ultrasound showed cholelithiasis without any sign of cholecystitis. Finally, a fluorodeoxyglucose (FDG-positron emission tomography (PET/CT examination was ordered to find the cause of fever of unknown origin, and it showed increased FDG uptake in the gallbladder wall, with no uptake in the lumen. FDG-PET/CT can diagnose acute cholecystitis in patients with nonspecific clinical symptoms and laboratory results.

  15. Budget impact from the incorporation of positron emission tomography - computed tomography for staging lung cancers.

    Science.gov (United States)

    Biz, Aline Navega; Caetano, Rosângela

    2015-01-01

    To estimate the budget impact from the incorporation of positron emission tomography (PET) in mediastinal and distant staging of non-small cell lung cancer. The estimates were calculated by the epidemiological method for years 2014 to 2018. Nation-wide data were used about the incidence; data on distribution of the disease's prevalence and on the technologies' accuracy were from the literature; data regarding involved costs were taken from a micro-costing study and from Brazilian Unified Health System (SUS) database. Two strategies for using PET were analyzed: the offer to all newly-diagnosed patients, and the restricted offer to the ones who had negative results in previous computed tomography (CT) exams. Univariate and extreme scenarios sensitivity analyses were conducted to evaluate the influence from sources of uncertainties in the parameters used. The incorporation of PET-CT in SUS would imply the need for additional resources of 158.1 BRL (98.2 USD) million for the restricted offer and 202.7 BRL (125.9 USD) million for the inclusive offer in five years, with a difference of 44.6 BRL (27.7 USD) million between the two offer strategies within that period. In absolute terms, the total budget impact from its incorporation in SUS, in five years, would be 555 BRL (345 USD) and 600 BRL (372.8 USD) million, respectively. The costs from the PET-CT procedure were the most influential parameter in the results. In the most optimistic scenario, the additional budget impact would be reduced to 86.9 BRL (54 USD) and 103.8 BRL (64.5 USD) million, considering PET-CT for negative CT and PET-CT for all, respectively. The incorporation of PET in the clinical staging of non-small cell lung cancer seems to be financially feasible considering the high budget of the Brazilian Ministry of Health. The potential reduction in the number of unnecessary surgeries may cause the available resources to be more efficiently allocated.

  16. Technical aspects of positron emission tomography/computed tomography in radiotherapy treatment planning.

    Science.gov (United States)

    Scripes, Paola G; Yaparpalvi, Ravindra

    2012-09-01

    The usage of functional data in radiation therapy (RT) treatment planning (RTP) process is currently the focus of significant technical, scientific, and clinical development. Positron emission tomography (PET) using ((18)F) fluorodeoxyglucose is being increasingly used in RT planning in recent years. Fluorodeoxyglucose is the most commonly used radiotracer for diagnosis, staging, recurrent disease detection, and monitoring of tumor response to therapy (Lung Cancer 2012;76:344-349; Lung Cancer 2009;64:301-307; J Nucl Med 2008;49:532-540; J Nucl Med 2007;48:58S-67S). All the efforts to improve both PET and computed tomography (CT) image quality and, consequently, lesion detectability have a common objective to increase the accuracy in functional imaging and thus of coregistration into RT planning systems. In radiotherapy, improvement in target localization permits reduction of tumor margins, consequently reducing volume of normal tissue irradiated. Furthermore, smaller treated target volumes create the possibility of dose escalation, leading to increased chances of tumor cure and control. This article focuses on the technical aspects of PET/CT image acquisition, fusion, usage, and impact on the physics of RTP. The authors review the basic elements of RTP, modern radiation delivery, and the technical parameters of coregistration of PET/CT into RT computerized planning systems. Copyright © 2012 Elsevier Inc. All rights reserved.

  17. Positron emission tomography/computed tomography scanning for ...

    African Journals Online (AJOL)

    Background: Although the site of nosocomial sepsis in the critically ill ventilated patient is usually identifiable, it may remain occult, despite numerous investigations. The rapid results and precise anatomical location of the septic source using positron emission tomography (PET) scanning, in combination with computed ...

  18. 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)

    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...

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

    Science.gov (United States)

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

    2016-01-01

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

  20. Clinical utility of F-18 FDG PET-CT in the initial evaluation of lung cancer.

    Science.gov (United States)

    Madsen, Poul Henning; Holdgaard, Paw Christian; Christensen, Janne Buck; Høilund-Carlsen, Poul Flemming

    2016-10-01

    Positron emission tomography-computed tomography (PET-CT) is a resource-demanding imaging modality with increasing popularity in the workup of patients with suspected or proven lung cancer. To review the clinical usefulness of this imaging modality in the diagnosis, staging, and pre-operative evaluation, we conducted a systematic literature search, review, and quality assessment using the rapid evidence assessment toolkit and the Oxford Centre for Evidence-Based Medicine methodology. The literature search resulted in 4,208 records including 918 reviews, of which 139 met the predefined criteria and were read in full to identify relevant original articles on F-18 FDG PET-CT (1) in the evaluation of solitary pulmonary nodules (n = 14), (2) in curative-intent treatment trials (n = 9), and (3) in planning of invasive procedures (n = 18). We found the following important results from the literature review: 1) PET-CT can rule out malignancy in most solitary pulmonary nodules due to high sensitivity (recommendation level A). 2) PET-CT reduces the number of futile treatment trials (recommendation level A). 3) The sensitivity of PET-CT in general is insufficient to rule out mediastinal lymph node metastasis (recommendation level A). ᅟ 1) With few exceptions, solitary pulmonary nodules can safely be considered benign if the PET-CT scan is negative. Exceptions consist of small (PET-CT scan has excluded occult distant metastases. 3) In general, lymph node metastasis in the mediastinum cannot be ruled out on the basis of a negative PET-CT, and confirmative invasive staging should be performed in most patients before mediastinal metastasis is confirmed or ruled out.

  1. Clinical utility of F-18 FDG PET-CT in the initial evaluation of lung cancer

    Energy Technology Data Exchange (ETDEWEB)

    Madsen, Poul Henning [Vejle Hospital, Department of Medicine, Division of Respiratory Medicine, Vejle (Denmark); Holdgaard, Paw Christian [Vejle Hospital, Department of Nuclear Medicine, Vejle (Denmark); Christensen, Janne Buck [Odense University Hospital/University of Southern Denmark, Department of Quality and Research/HTA, Odense University Hospital and Medical Research Library, Odense (Denmark); Hoeilund-Carlsen, Poul Flemming [Odense University Hospital, Department of Nuclear Medicine, Odense (Denmark)

    2016-10-15

    Positron emission tomography-computed tomography (PET-CT) is a resource-demanding imaging modality with increasing popularity in the workup of patients with suspected or proven lung cancer. To review the clinical usefulness of this imaging modality in the diagnosis, staging, and pre-operative evaluation, we conducted a systematic literature search, review, and quality assessment using the rapid evidence assessment toolkit and the Oxford Centre for Evidence-Based Medicine methodology. The literature search resulted in 4,208 records including 918 reviews, of which 139 met the predefined criteria and were read in full to identify relevant original articles on F-18 FDG PET-CT (1) in the evaluation of solitary pulmonary nodules (n = 14), (2) in curative-intent treatment trials (n = 9), and (3) in planning of invasive procedures (n = 18). We found the following important results from the literature review: (1) PET-CT can rule out malignancy in most solitary pulmonary nodules due to high sensitivity (recommendation level A). (2) PET-CT reduces the number of futile treatment trials (recommendation level A). (3) The sensitivity of PET-CT in general is insufficient to rule out mediastinal lymph node metastasis (recommendation level A). (1) With few exceptions, solitary pulmonary nodules can safely be considered benign if the PET-CT scan is negative. Exceptions consist of small (<1 cm) and non-solid, solitary pulmonary nodules. These abnormalities should be followed up by CT in a structured programme. (2) No curative-intent treatment should be commenced until a PET-CT scan has excluded occult distant metastases. (3) In general, lymph node metastasis in the mediastinum cannot be ruled out on the basis of a negative PET-CT, and confirmative invasive staging should be performed in most patients before mediastinal metastasis is confirmed or ruled out. (orig.)

  2. Clinical utility of F-18 FDG PET-CT in the initial evaluation of lung cancer

    International Nuclear Information System (INIS)

    Madsen, Poul Henning; Holdgaard, Paw Christian; Christensen, Janne Buck; Hoeilund-Carlsen, Poul Flemming

    2016-01-01

    Positron emission tomography-computed tomography (PET-CT) is a resource-demanding imaging modality with increasing popularity in the workup of patients with suspected or proven lung cancer. To review the clinical usefulness of this imaging modality in the diagnosis, staging, and pre-operative evaluation, we conducted a systematic literature search, review, and quality assessment using the rapid evidence assessment toolkit and the Oxford Centre for Evidence-Based Medicine methodology. The literature search resulted in 4,208 records including 918 reviews, of which 139 met the predefined criteria and were read in full to identify relevant original articles on F-18 FDG PET-CT (1) in the evaluation of solitary pulmonary nodules (n = 14), (2) in curative-intent treatment trials (n = 9), and (3) in planning of invasive procedures (n = 18). We found the following important results from the literature review: (1) PET-CT can rule out malignancy in most solitary pulmonary nodules due to high sensitivity (recommendation level A). (2) PET-CT reduces the number of futile treatment trials (recommendation level A). (3) The sensitivity of PET-CT in general is insufficient to rule out mediastinal lymph node metastasis (recommendation level A). (1) With few exceptions, solitary pulmonary nodules can safely be considered benign if the PET-CT scan is negative. Exceptions consist of small (<1 cm) and non-solid, solitary pulmonary nodules. These abnormalities should be followed up by CT in a structured programme. (2) No curative-intent treatment should be commenced until a PET-CT scan has excluded occult distant metastases. (3) In general, lymph node metastasis in the mediastinum cannot be ruled out on the basis of a negative PET-CT, and confirmative invasive staging should be performed in most patients before mediastinal metastasis is confirmed or ruled out. (orig.)

  3. Additional benefit of 18F-fluorodeoxyglucose integrated positron emission tomography/computed tomography in the staging of oesophageal cancer

    International Nuclear Information System (INIS)

    Gillies, R.S.; Middleton, M.R.; Maynard, N.D.; Bradley, K.M.; Gleeson, F.V.

    2011-01-01

    18 F-fluorodeoxyglucose positron emission tomography (FDG PET) has been shown to improve the accuracy of staging in oesophageal cancer. We assessed the benefit of PET/CT over conventional staging and determined if tumour histology had any significant impact on PET/CT findings. A retrospective cohort study, reviewing the results from 200 consecutive patients considered suitable for radical treatment, undergoing routine PET/CT staging comparing the results from CT and endoscopic ultrasound, as well as multi-disciplinary team records. Adenocarcinoma and squamous cell carcinoma were compared for maximum Standardised Uptake Value (SUV max ), involvement of local lymph nodes and distant metastases. PET/CT provided additional information in 37 patients (18.5%) and directly altered management in 34 (17%): 22 (11%) were upstaged; 15 (7.5%) were downstaged, 12 of whom (6%) received radical treatment. There were 11 false negatives (5.5%) and 1 false positive (0.5%). SUV max was significantly lower for adenocarcinoma than squamous cell carcinoma (median 9.1 versus 13.5, p = 0.003). Staging with PET/CT offers additional benefit over conventional imaging and should form part of routine staging for oesophageal cancer. Adenocarcinoma and squamous cell carcinoma display significantly different FDG-avidity. (orig.)

  4. Change of Maximum Standardized Uptake Value Slope in Dynamic Triphasic [{sup 18}F]-Fluorodeoxyglucose Positron Emission Tomography/Computed Tomography Distinguishes Malignancy From Postradiation Inflammation in Head-and-Neck Squamous Cell Carcinoma: A Prospective Trial

    Energy Technology Data Exchange (ETDEWEB)

    Anderson, Carryn M., E-mail: carryn-anderson@uiowa.edu [Department of Radiation Oncology, University of Iowa, Iowa City, Iowa (United States); Chang, Tangel [Department of Radiation Oncology, University of Iowa, Iowa City, Iowa (United States); Graham, Michael M. [Department of Nuclear Medicine, University of Iowa, Iowa City, Iowa (United States); Marquardt, Michael D. [Department of Radiation Oncology, University of Iowa, Iowa City, Iowa (United States); Button, Anna; Smith, Brian J. [Department of Biostatistics, University of Iowa, Iowa City, Iowa (United States); Menda, Yusuf [Department of Nuclear Medicine, University of Iowa, Iowa City, Iowa (United States); Sun, Wenqing [Department of Radiation Oncology, University of Iowa, Iowa City, Iowa (United States); Pagedar, Nitin A. [Department of Otolaryngology—Head and Neck Surgery, University of Iowa, Iowa City, Iowa (United States); Buatti, John M. [Department of Radiation Oncology, University of Iowa, Iowa City, Iowa (United States)

    2015-03-01

    Purpose: To evaluate dynamic [{sup 18}F]-fluorodeoxyglucose (FDG) uptake methodology as a post–radiation therapy (RT) response assessment tool, potentially enabling accurate tumor and therapy-related inflammation differentiation, improving the posttherapy value of FDG–positron emission tomography/computed tomography (FDG-PET/CT). Methods and Materials: We prospectively enrolled head-and-neck squamous cell carcinoma patients who completed RT, with scheduled 3-month post-RT FDG-PET/CT. Patients underwent our standard whole-body PET/CT scan at 90 minutes, with the addition of head-and-neck PET/CT scans at 60 and 120 minutes. Maximum standardized uptake values (SUV{sub max}) of regions of interest were measured at 60, 90, and 120 minutes. The SUV{sub max} slope between 60 and 120 minutes and change of SUV{sub max} slope before and after 90 minutes were calculated. Data were analyzed by primary site and nodal site disease status using the Cox regression model and Wilcoxon rank sum test. Outcomes were based on pathologic and clinical follow-up. Results: A total of 84 patients were enrolled, with 79 primary and 43 nodal evaluable sites. Twenty-eight sites were interpreted as positive or equivocal (18 primary, 8 nodal, 2 distant) on 3-month 90-minute FDG-PET/CT. Median follow-up was 13.3 months. All measured SUV endpoints predicted recurrence. Change of SUV{sub max} slope after 90 minutes more accurately identified nonrecurrence in positive or equivocal sites than our current standard of SUV{sub max} ≥2.5 (P=.02). Conclusions: The positive predictive value of post-RT FDG-PET/CT may significantly improve using novel second derivative analysis of dynamic triphasic FDG-PET/CT SUV{sub max} slope, accurately distinguishing tumor from inflammation on positive and equivocal scans.

  5. Diagnostic accuracy of (18) F-methylcholine positron emission tomography/computed tomography for intra- and extrahepatic hepatocellular carcinoma.

    Science.gov (United States)

    Bieze, Matthanja; Klümpen, Heinz-Josef; Verheij, Joanne; Beuers, Ulrich; Phoa, Saffire S K S; van Gulik, Thomas M; Bennink, Roelof J

    2014-03-01

    Diagnosis of hepatocellular carcinoma (HCC) primarily involves imaging. The aim of this study was to assess the accuracy of (18) F-fluorocholine ((18) F-FCH) positron emission tomography (PET) for detection of HCC and evaluation of extent of disease. Patients with HCC >1 cm were included between 2009 and July 2011, and follow-up closed in February 2013. Diagnosis was based on American Association for the Study of Liver Diseases criteria, and all patients underwent (18) F-FCH PET/computed tomography (CT) at baseline before treatment, 6 underwent a second PET/CT posttreatment, and 1 a third during follow-up. Whole-body PET and low-dose CT imaging were performed 15 minutes after (18) F-FCH injection. Evaluation of imaging was done with standardized uptake value (SUV) ratios: SUV maximum of the lesion divided by the SUV mean of surrounding tissue. Statistical analyses included descriptive analyses, receiver operating characteristic curve, McNemar's test, and Kaplan-Meier's test at 5% level of significance. Twenty-nine patients revealed 53 intrahepatic lesions. In 48 of 53 lesions, (18) F-FCH PET was positive (SUVratio , 1.95 ± 0.66; sensitivity, 88%; specificity, 100%). PET/CT showed uptake in 18 extrahepatic lesions and no uptake in 3 lesions affirmed non-HCC lesions; all lesions were confirmed with additional investigation (accuracy, 100%). In 17 of 29 patients, additional lesions were found on PET/CT imaging, with implications for treatment in 15 patients. Posttreatment PET/CT showed identical results, compared with standard treatment evaluation. This study shows additional value of (18) F-FCH PET/CT for patients with HCC. (18) F-FCH PET/CT has implications for staging, management, and treatment evaluation because of accurate assessment of extrahepatic disease. © 2014 by the American Association for the Study of Liver Diseases.

  6. 18F-Fluorodeoxyglucose Positron Emission Tomography/Computed Tomography Accuracy in the Staging of Non-Small Cell Lung Cancer: Review and Cost-Effectiveness

    International Nuclear Information System (INIS)

    Gómez León, Nieves; Escalona, Sofía; Bandrés, Beatriz; Belda, Cristobal; Callejo, Daniel; Blasco, Juan Antonio

    2014-01-01

    Aim of the performed clinical study was to compare the accuracy and cost-effectiveness of PET/CT in the staging of non-small cell lung cancer (NSCLC). Material and Methods. Cross-sectional and prospective study including 103 patients with histologically confirmed NSCLC. All patients were examined using PET/CT with intravenous contrast medium. Those with disease stage ≤IIB underwent surgery (n = 40). Disease stage was confirmed based on histology results, which were compared with those of PET/CT and positron emission tomography (PET) and computed tomography (CT) separately. 63 patients classified with ≥IIIA disease stage by PET/CT did not undergo surgery. The cost-effectiveness of PET/CT for disease classification was examined using a decision tree analysis. Results. Compared with histology, the accuracy of PET/CT for disease staging has a positive predictive value of 80%, a negative predictive value of 95%, a sensitivity of 94%, and a specificity of 82%. For PET alone, these values are 53%, 66%, 60%, and 50%, whereas for CT alone they are 68%, 86%, 76%, and 72%, respectively. Incremental cost-effectiveness of PET/CT over CT alone was €17,412 quality-adjusted life-year (QALY). Conclusion. In our clinical study, PET/CT using intravenous contrast medium was an accurate and cost-effective method for staging of patients with NSCLC

  7. 18F-Fluorodeoxyglucose Positron Emission Tomography/Computed Tomography Accuracy in the Staging of Non-Small Cell Lung Cancer: Review and Cost-Effectiveness

    International Nuclear Information System (INIS)

    Leon, N.G.; Bandrs, B.; Escalona, S.; Callejo, D.; Blasco, J.A.; Belda, C.; Blasco, J.A.

    2014-01-01

    Aim of the performed clinical study was to compare the accuracy and cost-effectiveness of PET/CT in the staging of non-small cell lung cancer (NSCLC). Material and Methods. Cross-sectional and prospective study including 103 patients with histologically confirmed NSCLC. All patients were examined using PET/CT with intravenous contrast medium. Those with disease stage ≤IIB underwent surgery (η=40). Disease stage was confirmed based on histology results, which were compared with those of PET/CT and positron emission tomography (PET) and computed tomography (CT) separately. 63 patients classified with ≥IIIA disease stage by PET/CT did not undergo surgery. The cost-effectiveness of PET/CT for disease classification was examined using a decision tree analysis. Results. Compared with histology, the accuracy of PET/CT for disease staging has a positive predictive value of 80%, a negative predictive value of 95%, a sensitivity of 94%, and a specificity of 82%. For PET alone, these values are 53%, 66%, 60%, and 50%, whereas for CT alone they are 68%, 86%, 76%, and 72%, respectively. Incremental cost-effectiveness of PET/CT over CT alone was €17,412 quality-adjusted life-year (QALY). Conclusion. In our clinical study, PET/CT using intravenous contrast medium was an accurate and cost-effective method for staging of patients with NSCLC

  8. 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

  9. Evaluation of diffuse large B-cell lymphoma patients with 64-slice multidetector computed tomography versus 18FDG positron emission tomography/computed tomography in initial staging and restaging after treatment.

    Science.gov (United States)

    Gómez León, Nieves; Vega, Gema; Rodríguez-Vigil Junco, Beatriz; Suevos Ballesteros, Carlos

    2018-04-25

    To prospectively compare the accuracy in initial staging and end-of-treatment restaging of diffuse large B-cell lymphoma (DLBCL) between 64-slice multidetector computed tomography (64MDCT) and 18FDG positron emission tomography/computed tomography (18FGD PET/CT) with intravenous contrast injection. Randomised and blind controlled clinical multicentric trial that included biopsy-proven DLBCL patients. Seventy-two patients from five different hospitals in the region of Madrid, Spain, were enrolled in the study between January 2012 and June 2015. Thirty-six were randomly allocated to 18FDG PET/TC and the other 36 to 64MDCT for initial staging and end-of-treatment restaging. A nuclear medicine physician and a radiologist independently analysed 18FDG PET/TC images and reached an agreement post-hoc. 64MDCT images were separately evaluated by a different radiologist. Every set of images was compared to the reference standard that included clinical data, complementary tests and follow-up. The study was approved by participating centres' ethics committees and written informed consent was obtained from all the participants. A good agreement was observed between both diagnostic techniques and the reference standard in initial staging [18FDG PET/CT (k=0.5) and 64MDCT (k=0.6)], although only the 18FDG PET/TC showed a good agreement with the reference standard for the end-of-treatment restaging (k=0.7). In DLBCL, both 18FDG PET/TC and 64MDCT have shown good agreement with the reference standard in initial staging. Nevertheless, 18FDG PET/CT has shown to be superior to 64MDCT in end-of-treatment response assessment. Copyright © 2018 Elsevier España, S.L.U. All rights reserved.

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

    International Nuclear Information System (INIS)

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

    2013-01-01

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

  11. PET/CT versus bone marrow biopsy in the initial evaluation of bone marrow infiltration in various pediatric malignancies.

    Science.gov (United States)

    Zapata, Claudia P; Cuglievan, Branko; Zapata, Catalina M; Olavarrieta, Raquel; Raskin, Scott; Desai, Kavita; De Angulo, Guillermo

    2018-02-01

    Accurate staging is essential in the prognosis and management of pediatric malignancies. Current protocols require screening for marrow infiltration with bone marrow biopsy (BMB) as the gold standard. Positron emission tomography-computed tomography (PET-CT) is commonly used to complete the staging process and can also be used to evaluate marrow infiltration. To compare PET-CT and BMB in the initial evaluation of bone marrow infiltration in pediatric cancers. We retrospectively reviewed new cases of EWS, rhabdomyosarcoma, neuroblastoma, and lymphoma diagnosed between January 2009 and October 2014. Each case had undergone both PET-CT and BMB within 4 weeks without treatment in the interval between screening modalities. We reviewed 69 cases. Bone marrow infiltration was demonstrated in 34 cases by PET-CT and in 18 cases by BMB. The sensitivity and negative predictive value of PET-CT were both 100%. Interestingly, the cases in which infiltration was not detected on BMB had an abnormal marrow signal on PET-CT focal or distant to iliac crest. PET-CT has a high sensitivity when assessing marrow infiltration in pediatric malignancies. Advances in radiologic modalities may obviate the use of invasive, painful, and costly procedures like BMB. Furthermore, biopsy results are limited by insufficient tissue or the degree of marrow infiltration (diffuse vs. focal disease). PET-CT can improve the precision of biopsy when used as a guiding tool. This study proposes the use of PET-CT as first-line screening for bone marrow infiltration to improve the accuracy of staging in new diagnoses. © 2017 Wiley Periodicals, Inc.

  12. Evaluation of hypoxia in a feline model of head and neck cancer using 64Cu-ATSM positron emission tomography/computed tomography

    International Nuclear Information System (INIS)

    Ballegeer, Elizabeth A; Madrill, Nicole J; Berger, Kevin L; Agnew, Dalen W; McNiel, Elizabeth A

    2013-01-01

    Human and feline head and neck squamous cell carcinoma (HNSCC) share histology, certain molecular features, as well as locally aggressive and highly recurrent clinical behavior. In human HNSCC, the presence of significant hypoxia within these tumors is considered an important factor in the development of a more aggressive phenotype and poor response to therapy. We hypothesized that feline head and neck tumors, particularly HNSCC, would exhibit hypoxia and that 64 Cu-diacetyl-bis(N4-methylthiosemicarbazone) (Cu-ATSM) positron emission tomography/computed tomography (PET/CT) would permit detection of intratumoral hypoxia. 12 cats with measureable head and neck tumors were given 64 Cu-ATSM and iodinated contrast for PET/CT scan. The presence or absence of hypoxia was also assessed using an intratumoral fluorescent life-time probe to quantitate pO 2 and pimonidazole immunohistochemical staining in biopsy specimens. In two cats, intratumoral O 2 and 64 Cu-ATSM uptake was measured before and after treatment with anti-angiogenic agents to determine the effect of these agents on hypoxia. Eleven of twelve feline tumors demonstrated significant 64 Cu-ATSM uptake, regardless of malignant or benign etiology. The presence (and absence) of hypoxia was confirmed using the fluorescent O 2 detection probe in nine tumors, and using pimonidazole staining in three tumors. Squamous cell carcinomas (HNSCC) demonstrated the highest degree of hypoxia, with T max /M ratios ranging from 4.3 to 21.8. Additional non-neoplastic tissues exhibited 64 Cu-ATSM uptake suggestive of hypoxia including reactive draining lymph nodes, non-malignant thyroid pathology, a tooth root abscess, and otitis media. In two cats with HNSCC that received anti-vascular agents, the pattern of 64 Cu-ATSM uptake was altered after treatment, demonstrating the potential of the feline model to study the modulation of tumor oxygenation. Feline HNSCC serves as a clinically relevant model for the investigation of

  13. FDG-PET/CT in a patient with poor-risk non-seminoma testis with mature teratoma and secondary gliosarcoma: Multimodality imaging for guiding multimodality treatment

    Energy Technology Data Exchange (ETDEWEB)

    Quak, Elske; Kovacs, Iringo; Oyen, Wim J. G.; Van der Graaf, Winette T. A. [Radboud University Nijmegen Medical Centre, Nijmegen (Nauru)

    2015-09-15

    The value of F-18-fluorodeoxyglucose positron emission tomography/computed tomography (FDG-PET/CT) in detecting viable tumours in patients with metastasised non-seminomatous testicular cancer and residual and new masses post chemotherapy remains to be determined. We describe the case of a 41-year-old patient with metastasised non-seminomatous testicular cancer, with both retroperitoneal and extra-retroperitoneal residual masses post chemotherapy, for whom FDG-PET/CT guided major treatment decisions. FDG-PET/CT correctly identified the locations of viable tumour, as was proved by histology, and successfully guided surgery. In conclusion, in selected cases surveillance of patients with non-seminomatous testicular cancer with FDG-PET/CT can guide major treatment decisions when considering surgery for metastatic disease.

  14. {sup 18}F-Choline Positron Emission Tomography/Computed Tomography and Multiparametric Magnetic Resonance Imaging for the Detection of Early Local Recurrence of Prostate Cancer Initially Treated by Radiation Therapy: Comparison With Systematic 3-Dimensional Transperineal Mapping Biopsy

    Energy Technology Data Exchange (ETDEWEB)

    Kanoun, Salim, E-mail: Salim.kanoun@gmail.com [Department of Nuclear Medicine, Centre Georges-François Leclerc, Dijon (France); LE2I UMR6306, Centre national de la recherche scientifique, Arts et Métiers, Université Bourgogne Franche-Comté, Dijon (France); MRI Unit, Centre Hospitalier Régional Universitaire, Hôpital François Mitterrand, Dijon (France); Walker, Paul [LE2I UMR6306, Centre national de la recherche scientifique, Arts et Métiers, Université Bourgogne Franche-Comté, Dijon (France); MRI Unit, Centre Hospitalier Régional Universitaire, Hôpital François Mitterrand, Dijon (France); Vrigneaud, Jean-Marc; Depardon, Edouard [Department of Nuclear Medicine, Centre Georges-François Leclerc, Dijon (France); Barbier, Vincent [Department of Urology, Centre Hospitalier Régional Universitaire, Hôpital François Mitterrand, Dijon (France); Humbert, Olivier [Department of Nuclear Medicine, Centre Georges-François Leclerc, Dijon (France); Moulin, Morgan [Department of Urology, Centre Hospitalier Régional Universitaire, Hôpital François Mitterrand, Dijon (France); and others

    2017-04-01

    Purpose: To compare the diagnostic performance of {sup 18}F-fluorocholine positron emission tomography/computed tomography (FCH-PET/CT), multiparametric prostate magnetic resonance imaging (mpMRI), and a combination of both techniques for the detection of local recurrence of prostate cancer initially treated by radiation therapy. Methods and Materials: This was a retrospective, single-institution study of 32 patients with suspected prostate cancer recurrence who underwent both FCH-PET/CT and 3T mpMRI within 3 months of one another for the detection of recurrence. All included patients had to be cleared for metastatic recurrence. The reference procedure was systematic 3-dimensional (3D)-transperineal prostate biopsy for the final assessment of local recurrence. Both imaging modalities were analyzed by 2 experienced readers blinded to clinical data. The analysis was made per-patient and per-segment using a 4-segment model. Results: The median prostate-specific antigen value at the time of imaging was 2.92 ng/mL. The mean prostate-specific antigen doubling time was 14 months. Of the 32 patients, 31 had a positive 3D-transperineal mapping biopsy for a local relapse. On a patient-based analysis, the detection rate was 71% (22 of 31) for mpMRI and 74% (23 of 31) for FCH-PET/CT. On a segment-based analysis, the sensitivity and specificity were, respectively, 32% and 87% for mpMRI, 34% and 87% for FCH-PET/CT, and 43% and 83% for the combined analysis of both techniques. Accuracy was 64%, 65%, and 66%, respectively. The interobserver agreement was κ = 0.92 for FCH-PET/CT and κ = 0.74 for mpMRI. Conclusions: Both mpMRI and FCH-PET/CT show limited sensitivity but good specificity for the detection of local cancer recurrence after radiation therapy, when compared with 3D-transperineal mapping biopsy. Prostate biopsy still seems to be mandatory to diagnose local relapse and select patients who could benefit from local salvage therapy.

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

    International Nuclear Information System (INIS)

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

    2007-01-01

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

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

    International Nuclear Information System (INIS)

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

    2013-01-01

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

  17. 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

  18. Positron Emission Tomography/Computed Tomography in the Staging and Treatment of Anal Cancer

    DEFF Research Database (Denmark)

    Sveistrup, Joen; Loft, Annika; Berthelsen, Anne Kiil

    2012-01-01

    PURPOSE: This study was intended to determine the role of PET/CT in the staging of anal cancer as a supplement to three-dimensional transanal ultrasound (TAUS) and inguinal ultrasound (US). The impact of the PET/CT on the initial stage and treatment plan proposed by TAUS/US was assessed. METHODS......-88 years). Six (6%) of the patients were HIV positive. All patients were staged with TAUS/US and PET/CT. RESULTS: Twenty-eight (28) patients were diagnosed with suspicious perirectal node metastases. TAUS visualized 24 of these, whereas PET/CT detected 15. Suspicious inguinal nodes were visualized...... on either US or PET/CT in 41 patients. Seventeen (17) of these had confirmed malignant disease on biopsy, and 15 had confirmed benign disease. All 17 patients (100%) with malignant inguinal nodes were diagnosed by PET/CT, whereas US identified 16 (94%). Ten patients were diagnosed with suspicious inguinal...

  19. 18F-FDG PET/CT in Neurolymphomatosis: Report of 3 Cases

    International Nuclear Information System (INIS)

    Canh, Nguyen Xuan; Tan, Ngo Van; Tung, Tran Thanh; Son, Nguyen Truong; Maurea, Simone

    2014-01-01

    Neurolymphomatosis is a rare manifestation of non-Hodgkin lymphoma characterized by infiltration of peripheral nerves, nerve roots, plexus and cranial nerves by malignant lymphocytes. This report presents positron emission tomography/computed tomography (PET/CT)imaging with 2-deoxy-2- 18 F-fluoro-D-glucose ( 18 F-FDG) in 3 cases of non-Hodgkin lymphoma with nerve infiltration, including one newly diagnosed lymphoma, one recurrent lymphoma in previous nerve lesions and one newly recurrent lymphoma. PET/CT could reveal the affected neural structures including cranial nerves, spinal nerve roots, brachial plexus, cervicothoracic ganglion, intercostal nerves, branches of the vagus nerve, lumbosacral plexus and sciatic nerves. There was relative concordance between PET/CT and MRI in detection of affected cranial nerves. PET/CT seemed to be better than MRI in detection of affected peripheral nerves. 18 F-FDG PET/CT was a whole-body imaging technique with the ability to reveal the affected cranial nerves, peripheral nerves, nerve roots and plexus in non-Hodgkin lymphoma. A thorough understanding of disease and use of advanced imaging modalities will increasingly detect neurolymphomatosis

  20. Prognostic value of PET/CT in lung cancer. Study of survival and tumor metabolic characterization

    International Nuclear Information System (INIS)

    Ladron de Guevara, David; Fuentes Anibal; Farina, Ciro; Corral, Camilo; Pefaur, Raul

    2013-01-01

    PET/CT (Positron emission tomography/computed tomography) is a hybrid image modality widely used in oncology, for staging, therapy evaluation or follow up. Aim: To evaluate the prognostic value of PET/CT in lung cancer. Material and Methods: Retrospective review of PET/CT records, selecting 51 patients with a lung malignancy, mass or nodule referred for PET/CT between December 2008 and December 2010. All had pathological confirmation of malignancy and had not been treated previously. Age, gender, body mass index, radiological features of lung tumor and metastases, and lung tumor 18 F-fluoro-2-deoxy-d-glucose uptake using the SUV (Standardized uptake value) index were recorded. Survival was analyzed using Kaplan-Meier curves and a Cox proportional regression analysis. Results: Pathology confirmed the presence of lung cancer in 47 patients aged 30 to 88 years. Four patients (7.8%) had other type of tumors such as carcinoid or lymphoma. Fifty percent of lung cancer patients died during a mean observation lapse of 18 months (range: 2-34 months). Patients with metastases, local lymph node involvement, a lung tumor size ≥ 3 cm and high tumor uptake (SUVmax > 6) had significantly lower survival. Occurrence of metastases was the only independent prognostic factor in the Cox regression. A lung lesion with a SUVmax ≥ 12 was always associated to hilar/mediastinal lymph node involvement. Conclusions: PET/CT imaging gives important prognostic information in lung cancer patients

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

    International Nuclear Information System (INIS)

    Liu, Y.

    2011-01-01

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

  2. Correlation between PET/CT results and histological and immunohistochemical findings in breast carcinomas

    Directory of Open Access Journals (Sweden)

    Almir Galvão Vieira Bitencourt

    2014-04-01

    Full Text Available Objective To correlate the results of 18F-fluoro-2-deoxy-D-glucose (18F-FDG positron emission tomography/computed tomography (PET/CT performed with a specific protocol for assessment of breasts with histological/immunohistochemical findings in breast carcinoma patients. Materials and Methods Cross-sectional study with prospective data collection, where patients with biopsy-confirmed breast carcinomas were studied. The patients underwent PET/CT examination in prone position, with a specific protocol for assessment of breasts. PET/CT findings were compared with histological and immunohistochemical data. Results The authors identified 59 malignant breast lesions in 50 patients. The maximum diameter of the lesions ranged from 6 to 80 mm (mean: 32.2 mm. Invasive ductal carcinoma was the most common histological type (n = 47; 79.7%. At PET/CT, 53 (89.8% of the lesions demonstrated anomalous concentrations of 18F-FDG, with maximum SUV ranging from 0.8 to 23.1 (mean: 5.5. A statistically significant association was observed between higher values of maximum SUV and histological type, histological grade, molecular subtype, tumor diameter, mitotic index and Ki-67 expression. Conclusion PET/CT performed with specific protocol for assessment of breasts has demonstrated good sensitivity and was associated with relevant histological/immunohistochemical factors related to aggressiveness and prognosis of breast carcinomas.

  3. Correlation between PET/CT results and histological and immunohistochemical findings in breast carcinomas

    International Nuclear Information System (INIS)

    Bitencourt, Almir Galvao Vieira; Lima, Eduardo Nobrega Pereira; Chojniak, Rubens; Marques, Elvira Ferreira; Souza, Juliana Alves de; Graziano, Luciana; Andrade, Wesley Pereira; Osorio, Cynthia Aparecida Bueno de Toledo

    2014-01-01

    Objective: to correlate the results of 18 F-fluoro-2-deoxy-D-glucose ( 18 F-FDG) positron emission tomography/computed tomography (PET/CT) performed with a specific protocol for assessment of breasts with histological/immunohistochemical findings in breast carcinoma patients. Materials and methods: cross-sectional study with prospective data collection, where patients with biopsy-confirmed breast carcinomas were studied. The patients underwent PET/CT examination in prone position, with a specific protocol for assessment of breasts. PET/CT findings were compared with histological and immunohistochemical data. Results: the authors identified 59 malignant breast lesions in 50 patients. The maximum diameter of the lesions ranged from 6 to 80 mm (mean: 32.2 mm). Invasive ductal carcinoma was the most common histological type (n = 47; 79.7%). At PET/CT, 53 (89.8%) of the lesions demonstrated anomalous concentrations of 18 F-FDG, with maximum SUV ranging from 0.8 to 23.1 (mean: 5.5). A statistically significant association was observed between higher values of maximum SUV and histological type, histological grade, molecular subtype, tumor diameter, mitotic index and Ki-67 expression. Conclusion: PET/CT performed with specific protocol for assessment of breasts has demonstrated good sensitivity and was associated with relevant histological/immunohistochemical factors related to aggressiveness and prognosis of breast carcinomas. (author)

  4. Combined approach of perioperative 18F-FDG PET/CT imaging and intraoperative 18F-FDG handheld gamma probe detection for tumor localization and verification of complete tumor resection in breast cancer

    Directory of Open Access Journals (Sweden)

    Knopp Michael V

    2007-12-01

    Full Text Available Abstract Background 18F-fluorodeoxyglucose (18F-FDG positron emission tomography/computed tomography (PET/CT has become an established method for detecting hypermetabolic sites of known and occult disease and is widely used in oncology surgical planning. Intraoperatively, it is often difficult to localize tumors and verify complete resection of tumors that have been previously detected on diagnostic PET/CT at the time of the original evaluation of the cancer patient. Therefore, we propose an innovative approach for intraoperative tumor localization and verification of complete tumor resection utilizing 18F-FDG for perioperative PET/CT imaging and intraoperative gamma probe detection. Methods Two breast cancer patients were evaluated. 18F-FDG was administered and PET/CT was acquired immediately prior to surgery. Intraoperatively, tumors were localized and resected with the assistance of a handheld gamma probe. Resected tumors were scanned with specimen PET/CT prior to pathologic processing. Shortly after the surgical procedure, patients were re-imaged with PET/CT utilizing the same preoperatively administered 18F-FDG dose. Results One patient had primary carcinoma of breast and a metastatic axillary lymph node. The second patient had a solitary metastatic liver lesion. In both cases, preoperative PET/CT verified these findings and demonstrated no additional suspicious hypermetabolic lesions. Furthermore, intraoperative gamma probe detection, specimen PET/CT, and postoperative PET/CT verified complete resection of the hypermetabolic lesions. Conclusion Immediate preoperative and postoperative PET/CT imaging, utilizing the same 18F-FDG injection dose, is feasible and image quality is acceptable. Such perioperative PET/CT imaging, along with intraoperative gamma probe detection and specimen PET/CT, can be used to verify complete tumor resection. This innovative approach demonstrates promise for assisting the oncologic surgeon in localizing and

  5. Correlation between Standardized Uptake Value of 68Ga-DOTA-NOC Positron Emission Tomography/Computed Tomography and Pathological Classification of Neuroendocrine Tumors.

    Science.gov (United States)

    Kaewput, Chalermrat; Suppiah, Subapriya; Vinjamuri, Sobhan

    2018-01-01

    The aim of our study was to correlate tumor uptake of 68 Ga-DOTA-NOC positron emission tomography/computed tomography (PET/CT) with the pathological grade of neuroendocrine tumors (NETs). 68 Ga-DOTA-NOC PET/CT examinations in 41 patients with histopathologically proven NETs were included in the study. Maximum standardized uptake value (SUV max ) and averaged SUV SUV mean of "main tumor lesions" were calculated for quantitative analyses after background subtraction. Uptake on main tumor lesions was compared and correlated with the tumor histological grade based on Ki-67 index and pathological differentiation. Classification was performed into three grades according to Ki-67 levels; low grade: Ki-67 20. Pathological differentiation was graded into well- and poorly differentiated groups. The values were compared and evaluated for correlation and agreement between the two parameters was performed. Our study revealed negatively fair agreement between SUV max of tumor and Ki-67 index ( r = -0.241) and negatively poor agreement between SUV mean of tumor and Ki-67 index ( r = -0.094). SUV max of low-grade, intermediate-grade, and high-grade Ki-67 index is 26.18 ± 14.56, 30.71 ± 24.44, and 6.60 ± 4.59, respectively. Meanwhile, SUV mean of low-grade, intermediate-grade, and high-grade Ki-67 is 8.92 ± 7.15, 9.09 ± 5.18, and 3.00 ± 1.38, respectively. As expected, there was statistically significant decreased SUV max and SUV mean in high-grade tumors (poorly differentiated NETs) as compared with low- and intermediate-grade tumors (well-differentiated NETs). SUV of 68 Ga-DOTA-NOC PET/CT is not correlated with histological grade of NETs. However, there was statistically significant decreased tumor uptake of 68 Ga-DOTA-NOC in poorly differentiated NETs as compared with the well-differentiated group. As a result of this pilot study, we confirm that the lower tumor uptake of 68 Ga-DOTA-NOC may be associated with aggressive behavior and may, therefore, result in poor prognosis.

  6. PET/CT diagnostic of colo-rectal cancers

    International Nuclear Information System (INIS)

    Straciuc, O.

    2012-01-01

    Full text: Objective: Presenting the advantages of Positron Emission Tomography/Computed Tomography (PET/ CT) examination, using the radiotracer fluorure 18-deoxyglucose (FDG) in colo-rectal cancer diagnostic. Basics of the method will be also presented. Introduction: FDG PET/CT is recognized as the most efficient diagnostic imaging weapon in colorectal cancer, enable too comprehend all the 3 targets needed for staging of colo-rectal cancers: 1)Detection and evaluation of primary tumor (T) and recurrence; 2) Lymphadenopathy (N); 3)Metastatic disease (M). Assessment of treatment response during and after therapy, follow up and radiotherapy planning are also indications for PET/CT. There are two essential advantages of the method: 1)The whole body examination; 2)The complementary morphological information offered by CT and functional information offered by PET. Material and methods: Study of a total of 394 patients diagnosed with colo-rectal cancer of the total of 4125 investigated by PET/CT in Diagnosztika Pozitron center of Oradea, between 01.06.2008 - 06.06.2012. All cases had documented preoperative or postoperative histopathologic evaluation. We used a Siemens Biograph 16 device and only FDG as radiotracer, injected intravenously at a dose of 0.1-0.15 mCi /kg. Standard protocol of examination was performed at 60 minutes after FDG injection. CT acquisition consists of 'low dose' from vertex to thighs, followed by PET acquisition in 7 to 8 beds. Results: We followed the performance of PET/CT diagnostic in staging and restaging of colorectal cancer compared with other imaging methods. 141 patients had negative examinations. 107 patients were diagnosed with locally recurrent lesions, lymphadenopathy and/ or metastases. Compared with the results of previous imaging new metabolically active lesions were detected in 87 patients by PET/CT and suspected lesions were denied in 48 patients. Significant clinically cases are presented. Conclusions: The data obtained by PET

  7. The impact of PET/CT on the management of hepatic and extra hepatic metastases from gastrointestinal cancers

    Energy Technology Data Exchange (ETDEWEB)

    Polat, Erdal, E-mail: erdal066@yahoo.com [Kartal Kosuyolu High Specialty Training and Research Hospital, Department of Gastrointestinal Surgery, Istanbul (Turkey); Bostanci, Erdal Birol [Sakarya University, Faculty of Medicine, Department of General Surgery, Sakarya (Turkey); Aksoy, Erol [Turkiye Yuksek Ihtisas Teaching and Research Hospital, Department of Gastroenterological Surgery, Ankara (Turkey); Karaman, Kerem [Sakarya University, Faculty of Medicine, Department of General Surgery, Sakarya (Turkey); Poyraz, Nilufer Yildirim [Ataturk Teaching and Research Hospital, Department of Nuclear Medicine, Ankara (Turkey); Duman, Ugur [Sevket Yilmaz Training and Research Hospital, Department of General Surgery, Bursa (Turkey); Gencturk, Zeynep Biyikli [Ankara University, Faculty of Medicine, Department of Biostatistics, Ankara (Turkey); Yol, Sinan [Medeniyet University, Faculty of Medicine, Department of General surgery, Istanbul (Turkey)

    2015-06-15

    Highlights: • CT is more sensitive than PET/CT in detecting hepatic metastases. • PET/CT is more specific in detecting hepatic metastases. • CT and PET/CT have equal sensitivity in detecting extra hepatic metastases. • PET/CT is more specific in detecting extra hepatic metastases. • PET/CT has an impact of about 40% on changing the management strategies. - Abstract: Purpose: To investigate the efficacy of positron emission tomography/computed tomography (PET/CT) in detection and management of hepatic and extrahepatic metastases from gastrointestinal cancers. Materials and methods: Between February 2008 and July 2010, patients histopathologically diagnosed with gastrointestinal cancer and showing suspected metastasis on CT screening were subsequently evaluated with PET/CT. All patients were subgrouped according to histopathological origin and localization of the primary tumor. Localization of gastrointestinal cancers was further specified as lower gastrointestinal system (GIS), upper GIS, or hepato-pancreato-biliary (HPB). Both accuracy and impact of CT and PET/CT on patient management were retrospectively evaluated. Results: One hundred and thirteen patients diagnosed histopathologically with gastrointestinal cancers were retrospectively evaluated. Seventy-nine patients had adenocarcinoma and 34 patients other gastrointestinal tumors. Forty-one patients were in the upper GIS group, 30 patients in the HPB group, and 42 patients in the lower GIS group. Evaluation the diagnostic performance of PET/CT for suspected metastasis according to histopathological origin of the tumor, revealed that the sensitivity of PET/CT – although statistically not different – was higher in adenocarcinomas than in non-adenocarcinomas (90% (95% CI, 0.78–0.96) vs. 71.4% (95% CI, 0.45–0.88), P = 0.86). The specificity was not significantly different (85.7% (95% CI, 0.70–0.93) vs. 85% (95% CI, 0.63–0.94), P = 1.00). In the overall patient group; CT was significantly more

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

    International Nuclear Information System (INIS)

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

    2012-01-01

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

  9. PET/CT in staging of the high risk prostate cancer

    International Nuclear Information System (INIS)

    Bergero, M.A.; David, C.; Dipatto, F.; Popeneciu, V.; Ríos, L.; Faccio, F.

    2016-01-01

    Objectives: In the last decade multimodal management of the high risk prostate cancer (HRPC) is a therapeutic option in selected patients and the staging of these patients depends on the current diagnostic methods (DM) which have low diagnostic accuracy for detecting metastasis (MTS). The positron emission tomography/computed tomography (PET/CT) would have a greater diagnostic accuracy and it is presented as a better DM for staging prostate cancer (PC). The aim of this article is present 2 patients in whom PET/CT modified the therapeutic decision and conduct a literature review. Materials and methods: 2 patients with HRPC who performed PET/CT and it modified the therapeutic behavior were described and a systematic review of the literature was conducted using PubMed, Embase, SciELO and Cochrane answering the question: has PET/CT a place in HRPC staging? Results: TPET/CT has a sensitivity and specificity between 19% to 100% and 67% to 98,5 %, respectively, in assessing nodal involvement by PC and between 84% to 96% and 92.3% to 100%, respectively, in assessing bone involvement by PC. Besides PET/CT allowed to modify the therapeutic behavior between 20% to 40% of the patients with PC. Conclusions: PET/CT has good specificity and moderate sensitivity for detecting lymph node MTS and good sensitivity and specificity for detecting bone MTS. Besides PET/CT modified the therapeutic behavior in 1/3 of cases and it allowed us to modify the therapeutic behavior in our series. (authors) [es

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2017-10-15

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

  11. Solitary Plasmacytoma of the Sternum Mimicking Bone Metastasis in a Patient with a History of Breast Cancer Evaluated by F-18-FDG PET/CT

    Energy Technology Data Exchange (ETDEWEB)

    Treglia, Giorgio; Luca, Giovanella [Oncology Institute of Southern Switzerland, Bellinzona (Switzerland); Barbara, Muoio; Carmelo, Caldarella [Catholic Univ., Rome (Italy)

    2014-06-15

    A 65-year-old woman with a history of breast cancer (stage T2N0M0 treated with left breast conservative therapy 7 years previously followed by hormone therapy) underwent fluorine-18-fluorodeoxyglucose positron emission tomography/computed tomography (F-18-FDG PET/CT) for restaging due to increased serum tumour markers levels (CA15-3, 37 U/ml and CEA, 8 ng/ml). The patient presented thoracic pain before performing F-18-FDG PET/CT. PET/CT demonstrated an area of increased F-18-FDG uptake corresponding to an osteolytic lesion occupying the upper sternum suspicious for bone metastasis. No other areas of abnormal F-18-FDG uptake were detected in the rest of the body. Based on this PET/CT finding, the patient performed biopsy of the sternal lesion. Histology demonstrated the presence of a sternal plasmacytoma and the patient was addressed to radiation therapy. The role of F-18-FDG PET/CT in patients with multiple myeloma is well known, whereas only some articles evaluated the usefulness of this method in patients with solitary plasmacytomas. In particular, F-18-FDG PET/CT may be useful in demonstrating the evolution of solitary plasmacytomas in multiple myeloma. In our case F-18-FDG PET/CT was useful in detecting a solitary plasmacytoma of the sternum mimicking bone metastasis in a patient with history of breast cancer, correctly addressing to further histological evaluation.

  12. Solitary Plasmacytoma of the Sternum Mimicking Bone Metastasis in a Patient with a History of Breast Cancer Evaluated by F-18-FDG PET/CT

    International Nuclear Information System (INIS)

    Treglia, Giorgio; Luca, Giovanella; Barbara, Muoio; Carmelo, Caldarella

    2014-01-01

    A 65-year-old woman with a history of breast cancer (stage T2N0M0 treated with left breast conservative therapy 7 years previously followed by hormone therapy) underwent fluorine-18-fluorodeoxyglucose positron emission tomography/computed tomography (F-18-FDG PET/CT) for restaging due to increased serum tumour markers levels (CA15-3, 37 U/ml and CEA, 8 ng/ml). The patient presented thoracic pain before performing F-18-FDG PET/CT. PET/CT demonstrated an area of increased F-18-FDG uptake corresponding to an osteolytic lesion occupying the upper sternum suspicious for bone metastasis. No other areas of abnormal F-18-FDG uptake were detected in the rest of the body. Based on this PET/CT finding, the patient performed biopsy of the sternal lesion. Histology demonstrated the presence of a sternal plasmacytoma and the patient was addressed to radiation therapy. The role of F-18-FDG PET/CT in patients with multiple myeloma is well known, whereas only some articles evaluated the usefulness of this method in patients with solitary plasmacytomas. In particular, F-18-FDG PET/CT may be useful in demonstrating the evolution of solitary plasmacytomas in multiple myeloma. In our case F-18-FDG PET/CT was useful in detecting a solitary plasmacytoma of the sternum mimicking bone metastasis in a patient with history of breast cancer, correctly addressing to further histological evaluation

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

    Directory of Open Access Journals (Sweden)

    Gülgün Büyükdereli

    2016-06-01

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

  14. A case of positive 68Ga-DOTATOC-PET/CT pancreatic heterotopia mimicking an intestinal neuroendocrine tumor.

    Science.gov (United States)

    Zilli, Alessandra; Fanetti, Ilaria; Conte, Dario; Massironi, Sara

    Gallium-68 DOTA-peptide positron emission tomography/computed tomography ( 68 Ga-PET/CT) has emerged as a promising tool for the diagnosis and staging of gastro-entero-pancreatic neoplasms, thanks to its high sensitivity and specificity. Heterotopic pancreas, which is relatively rare, has never been reported as a possible cause of false positives of 68 Ga-PET/CT. We report on the first case of a heterotopic pancreas showing pathological uptake at 68 Ga-PET/CT, thus mimicking an intestinal neuroendocrine tumor. The present case suggests that heterotopic pancreas should be included among the possible causes of false positives at 68 Ga PET. Copyright © 2018 Elsevier Inc. All rights reserved.

  15. PET/CT in cancer: moderate sample sizes may suffice to justify replacement of a regional gold standard

    DEFF Research Database (Denmark)

    Gerke, Oke; Poulsen, Mads Hvid; Bouchelouche, Kirsten

    2009-01-01

    PURPOSE: For certain cancer indications, the current patient evaluation strategy is a perfect but locally restricted gold standard procedure. If positron emission tomography/computed tomography (PET/CT) can be shown to be reliable within the gold standard region and if it can be argued that PET...... of metastasized prostate cancer. RESULTS: An added value in accuracy of PET/CT in adjacent areas can outweigh a downsized target level of accuracy in the gold standard region, justifying smaller sample sizes. CONCLUSIONS: If PET/CT provides an accuracy benefit in adjacent regions, then sample sizes can be reduced....../CT also performs well in adjacent areas, then sample sizes in accuracy studies can be reduced. PROCEDURES: Traditional standard power calculations for demonstrating sensitivities of both 80% and 90% are shown. The argument is then described in general terms and demonstrated by an ongoing study...

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2017-09-15

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

  17. 18F-FDG PET/CT for the diagnosis of malignant and infectious complications after solid organ transplantation

    International Nuclear Information System (INIS)

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

    2017-01-01

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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2017-03-15

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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2015-03-15

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

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

    International Nuclear Information System (INIS)

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

    2015-01-01

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

  1. Skin Manifestation of Unsuspecting Prostate Cancer Detected by {sup 18}F-FDG PET/CT Performed To Assess Underlying Multiple Myeloma

    Energy Technology Data Exchange (ETDEWEB)

    AbAziz, Aini; Mahaletchumy, Thanuja; Chung, Junekey [Universiti Kebangsaan Malaysia Medical Centre, Kuala Lumpur (Malaysia)

    2013-12-15

    Skin metastases from either prostate adenocarcinoma or multiple myeloma rarely occur. We report the case of a 73-year-old man with multiple myeloma who presented with multiple subcutaneous nodules 3 years after his initial diagnosis. Fluorine-18 fluorodeoxyglucose (18F-FDG) positron emission tomography/computed tomography (PET/CT) imaging was suggestive of a concomitant second primary from the prostate. This case highlights not only a rare initial manifestation of prostate cancer, but also the role of 18F-FDG-PET/CT in detecting a clinically unsuspected second malignancy. It potentially corroborates the possible association of both diseases, as has been reported before.

  2. The role of (18)fluoro-deoxyglucose positron emission tomography/computed tomography in resectable pancreatic cancer.

    Science.gov (United States)

    Crippa, Stefano; Salgarello, Matteo; Laiti, Silvia; Partelli, Stefano; Castelli, Paola; Spinelli, Antonello E; Tamburrino, Domenico; Zamboni, Giuseppe; Falconi, Massimo

    2014-08-01

    The role of (18)fluoro-deoxyglucose positron emission tomography/computed tomography in pancreatic ductal adenocarcinoma is debated. We retrospectively assessed the value of (18)fluoro-deoxyglucose positron emission tomography/computed tomography in addition to conventional imaging as a staging modality in pancreatic cancer. (18)Fluoro-deoxyglucose positron emission tomography/computed tomography was performed in 72 patients with resectable pancreatic carcinoma after multi-detector computed tomography positron emission tomography was considered positive for a maximum standardized uptake value >3. Overall, 21% of patients had a maximum standardized uptake value ≤ 3, and 60% of those had undergone neoadjuvant treatment (P=0.0001). Furthermore, 11% of patients were spared unwarranted surgery since positron emission tomography/computed tomography detected metastatic disease. All liver metastases were subsequently identified with contrast-enhanced ultrasound. Sensitivity and specificity of positron emission tomography/computed tomography for distant metastases were 78% and 100%. The median CA19.9 concentration was 48.8 U/mL for the entire cohort and 292 U/mL for metastatic patients (P=0.112). The widespread application of (18)fluoro-deoxyglucose positron emission tomography/computed tomography in patients with resectable pancreatic carcinoma seems not justified. It should be considered in selected patients at higher risk of metastatic disease (i.e. CA19.9>200 U/mL) after undergoing other imaging tests. Neoadjuvant treatment is significantly associated with low metabolic activity, limiting the value of positron emission tomography in this setting. Copyright © 2014 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.

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

    International Nuclear Information System (INIS)

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

    2012-01-01

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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2012-03-15

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

  5. Usefulness of {sup 18}F-FDG PET, combined FDG-PET/CT and EUS in diagnosing primary pancreatic carcinoma: A meta-analysis

    Energy Technology Data Exchange (ETDEWEB)

    Tang Shuang [Department of Nuclear Medicine, Renji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200127 (China); Huang Gang, E-mail: huang2802@163.com [Department of Nuclear Medicine, Renji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200127 (China); Liu Jianjun [Department of Nuclear Medicine, Renji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200127 (China); Liu Tao [Department of Orthopedics, Soochow University, Suzhou (China); Treven, Lyndal [Faculty of Public Health, University of Sydney, Sydney (Australia); Song Saoli; Zhang Chenpeng; Pan Lingling [Department of Nuclear Medicine, Renji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200127 (China); Zhang Ting [Department of Anesthesiology, Renji Hospital, Shanghai (China)

    2011-04-15

    The aim was to evaluate the diagnostic value of {sup 18}F-fluorodeoxyglucose-positron emission tomography ({sup 18}F-FDG PET), combined {sup 18}F-fluorodeoxyglucose-positron emission tomography/computed tomography ({sup 18}F-FDG PET/CT) and endoscopic ultrasonography (EUS) in diagnosing patients with pancreatic carcinoma. MEDLINE, EMBASE, Cochrane library and some other databases, from January 1966 to April 2009, were searched for initial studies. All the studies published in English or Chinese relating to the diagnostic value of {sup 18}F-FDG PET, PET/CT and EUS for patients with pancreatic cancer were collected. Methodological quality was assessed. The statistic software called 'Meta-Disc 1.4' was used for data analysis. Results: 51 studies were included in this meta-analysis. The pooled sensitivity estimate for combined PET/CT (90.1%) was significantly higher than PET (88.4%) and EUS (81.2%). The pooled specificity estimate for EUS (93.2%) was significantly higher than PET (83.1%) and PET/CT (80.1%). The pooled DOR estimate for EUS (49.774) was significantly higher than PET (32.778) and PET/CT (27.105). SROC curves for PET/CT and EUS showed a little better diagnostic accuracy than PET alone. For PET alone, when interpreted the results with knowledge of other imaging tests, its sensitivity (89.4%) and specificity (80.1%) were closer to PET/CT. For EUS, its diagnostic value decreased in differentiating pancreatic cancer for patients with chronic pancreatitis. In conclusion, PET/CT was a high sensitive and EUS was a high specific modality in diagnosing patients with pancreatic cancer. PET/CT and EUS could play different roles during different conditions in diagnosing pancreatic carcinoma.

  6. Comparisons of Positron Emission Tomography/Computed Tomography and Ultrasound Imaging for Detection of Internal Mammary Lymph Node Metastases in Patients With Breast Cancer and Pathologic Correlation by Ultrasound-Guided Biopsy Procedures.

    Science.gov (United States)

    An, Yeong Yi; Kim, Sung Hun; Kang, Bong Joo; Lee, Ah Won

    2015-08-01

    To compare the diagnostic performance of [(18)F]fluorodeoxyglucose positron emission tomography/computed tomography (PET/CT) and ultrasound imaging (US) with pathologic results obtained by US-guided biopsy and to evaluate the role of US in detecting internal mammary lymph node (LN) metastases in patients with breast cancer. Between January 2008 and December 2012, 37 patients with breast cancer (median age, 51.4 years; range, 40-79 years) underwent US-guided biopsy for suspected internal mammary LN metastases. Medical records, radiologic images, and reports were reviewed and correlated with pathologic results. The positive internal mammary LN metastasis rate was 78.4%. All biopsies were performed safely without major complications. Only 8.1% of obtained samples were unsatisfactory. There were statistically significant differences in lesion size (P = .0002), standardized uptake value on PET/CT (P = .0015), biopsy methods (P = .002), and specimen adequacy (P = .007) between metastatic and benign groups. Of the clinical factorsreviewed, only concurrent distant metastasis was correlated with internal mammary LN metastasis (P< .0001). Sensitivities for detecting internal mammary LN metastases were 76.7%, 96.7%, and 92.9% for initial US examinations, initial US combined with second-look US for initially missed cases, and PET/CT, respectively (P= .017). In a subgroup analysis, the only significant difference found was in sensitivities between initial and combined US (P = .019). In a receiver operating characteristic curve analysis, the area under the curve for PET/CT using standardized uptake criteria (0.87) was higher than that for US using size criteria (0.83); however, this difference was not significant. Although PET/CT is the best noninvasive method for evaluating internal mammary LN metastases, US is also useful if internal mammary LN evaluation is routine during standard US surveillance of patients with breast cancer. Additionally, US-guided biopsies could be

  7. Role of 11C-choline positron emission tomography/computed tomography in evaluating patients affected by prostate cancer with suspected relapse due to prostate-specific antigen elevation

    International Nuclear Information System (INIS)

    Bertagna, F.; Bosio, G.; Abuhilal, M.

    2011-01-01

    The aim of this study was to evaluate the accuracy of 11 C-choline positron emission tomography/computed tomography (PET/CT) in restaging patients affected by prostate cancer and suspected relapse due to prostate-specific antigen (PSA) increase. We also aimed to determine a PSA cutoff that is most suited to the study in terms of best compromise between sensitivity and specificity. Secondary endpoints were a comparison between 11 C-choline PET/CT and histological results, clinical findings, and radiological imaging (CT and magnetic resonance imaging). We retrospectively evaluated 210 patients (median±standard deviation (SD) age 70±7 years) affected by prostate cancer who underwent 11 C-choline PET/CT. 11 C-choline PET/CT imaging was positive in 116 (55.2%) patients and negative in 94 (44.8%). Receiver operating characteristic (ROC) analysis showed that the highest accuracy (sensitivity 76.8%, specificity 92.5%) for the whole population was achieved when the PSA level of 1.26 ng/ml level was used as the cutoff value for interpreting the results (P=0.0001 and the area under the ROC curve area under the curve (AUC)=0.897). For patients treated with surgery or surgery plus radiotherapy the cutoff was 0.81 ng/ml (sensitivity 73.2%, specificity 86.1%). For patients treated with radiotherapy alone, the cutoff was 2.0 ng/ml (sensitivity 81.8%, specificity 92.9%). Our results indicate that 11 C-choline PET/CT is a useful diagnostic tool in patients affected by prostate cancer and a relapsed PSA level. The highest accuracy for all patients is obtained with a PSA cutoff level of 1.26 ng/ml, above which the imaging study is performed (0.81 ng/ml for patients treated with surgery or surgery plus radiotherapy and 2.0 ng/ml for patients treated with radiotherapy alone). (author)

  8. Immune reconstitution inflammatory syndrome due to Mycobacterium avium complex successfully followed up using 18 F-fluorodeoxyglucose positron emission tomography-computed tomography in a patient with human immunodeficiency virus infection: A case report

    International Nuclear Information System (INIS)

    Namkoong, Ho; Fujiwara, Hiroshi; Ishii, Makoto; Yagi, Kazuma; Haraguchi, Mizuha; Matsusaka, Masako; Suzuki, Shoji; Asakura, Takanori; Asami, Takahiro; Saito, Fumitake; Fukunaga, Koichi; Tasaka, Sadatomo; Betsuyaku, Tomoko; Hasegawa, Naoki

    2015-01-01

    In human immunodeficiency virus (HIV)-infected patients, immune reconstitution inflammatory syndrome (IRIS) due to nontuberculous mycobacteria (NTM) infection is one of the most difficult types of IRIS to manage. 18 F-fluorodeoxyglucose positron emission tomography/computed tomography ( 18 F-FDG PET/CT) has been suggested as a useful tool for evaluating the inflammatory status of HIV-infected patients. We present the first case of Mycobacterium avium complex (MAC)-associated IRIS (MAC-IRIS) that was successfully followed up using 18 F-FDG PET/CT. A 44-year-old homosexual Japanese man was referred to our hospital with fever and dyspnea. He was diagnosed with Pneumocystis jiroveci pneumonia and found to be HIV positive. After the initiation of combined antiretroviral therapy (cART), the patient’s mediastinal and bilateral hilar lymphadenopathy gradually enlarged, and bilateral infiltrates appeared in the upper lung fields. 18 F-FDG PET/CT was performed five months after the initiation of cART and showed intense accumulation of fluorodeoxyglucose (FDG) corresponding to the lesions of infiltration as well as the mediastinal and bilateral hilar lymphadenopathy. A bronchial wash culture and pathology findings led to a diagnosis of MAC-IRIS. Anti-mycobacterial chemotherapy with rifampicin, ethambutol, clarithromycin, and levofloxacin was started. One year after the chemotherapy was initiated, there was a significant reduction in FDG uptake in the area of the lesions except in the mediastinal lymph node. This implied incomplete resolution of the MAC-IRIS-related inflammation. Anti-mycobacterial chemotherapy was continued because of the residual lesion. To date, the patient has not experienced a recurrence of MAC-IRIS, a period of nine months. We present a case of MAC-IRIS in an HIV-infected patient whose disease activity was successfully followed up using 18 F-FDG PET/CT. Our data suggest that 18 F-FDG PET/CT is useful for evaluating the disease activity of NTM-IRIS and

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

    Science.gov (United States)

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

    2017-04-01

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

  10. Positron Emission Tomography/Computed Tomography in the Staging and Treatment of Anal Cancer

    Energy Technology Data Exchange (ETDEWEB)

    Sveistrup, Joen, E-mail: joensveistrup@hotmail.com [Department of Radiation Oncology, Rigshospitalet, Copenhagen (Denmark); Loft, Annika [PET and Cyclotron Unit, Department of Clinical Physiology and Nuclear Medicine, Centre of Diagnostic Investigations, Rigshospitalet, Copenhagen (Denmark); Berthelsen, Anne Kiil [Department of Radiation Oncology, Rigshospitalet, Copenhagen (Denmark); PET and Cyclotron Unit, Department of Clinical Physiology and Nuclear Medicine, Centre of Diagnostic Investigations, Rigshospitalet, Copenhagen (Denmark); Henriksen, Birthe Merete; Nielsen, Michael Bachmann [Department of Radiology, Section of Ultrasound X4123, Rigshospitalet, Copenhagen (Denmark); Engelholm, Svend Aage [Department of Radiation Oncology, Rigshospitalet, Copenhagen (Denmark)

    2012-05-01

    Purpose: This study was intended to determine the role of PET/CT in the staging of anal cancer as a supplement to three-dimensional transanal ultrasound (TAUS) and inguinal ultrasound (US). The impact of the PET/CT on the initial stage and treatment plan proposed by TAUS/US was assessed. Methods and Materials: Ninety-five (95) patients referred to our clinic between July 1, 2005, and December 31, 2009, were retrospectively reviewed. All patients had biopsy-proven primary squamous cell cancer of the anal canal. There were 65 females (68%) and 30 males (32%), and the median age was 58 years (range, 35-88 years). Six (6%) of the patients were HIV positive. All patients were staged with TAUS/US and PET/CT. Results: Twenty-eight (28) patients were diagnosed with suspicious perirectal node metastases. TAUS visualized 24 of these, whereas PET/CT detected 15. Suspicious inguinal nodes were visualized on either US or PET/CT in 41 patients. Seventeen (17) of these had confirmed malignant disease on biopsy, and 15 had confirmed benign disease. All 17 patients (100%) with malignant inguinal nodes were diagnosed by PET/CT, whereas US identified 16 (94%). Ten patients were diagnosed with suspicious inguinal nodes on PET/CT that had not been seen on US. One of these was malignant, three were benign, and six were not biopsied. PET/CT diagnosed eight metastatic sites, whereas TAUS/US diagnosed three. PET/CT discovered three of the five synchronous cancers seen in this study. PET/CT upstaged the disease in 14% of the cases and changed the treatment plan proposed by TAUS/US in 17%. Conclusion: PET/CT has great potential influence on the staging and treatment of anal cancer. TAUS is important in the staging of the primary tumor and N1-stage, whereas PET/CT seems necessary for the N2/3-stage, the M-stage and synchronous cancers.

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

    Science.gov (United States)

    Németh, Zsuzsanna; Boér, Katalin; Borbély, Katalin

    2017-10-09

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

  12. Positron emission tomography/computed tomography data of a tuberculosis mimicking lung cancer: A Case report

    Directory of Open Access Journals (Sweden)

    Amine Benjelloun

    2014-10-01

    Full Text Available PET/CT is a modern and very valuable tool for detecting primary or secondary lung cancers. However, in countries where tuberculosis is endemic, data must be interpreted with caution because of the frequent tuberculomas. We report here a case of a cancer-like tuberculoma of the lung with paralysis of the left vocal cord, and discuss the PET/CT contribution in tuberculomas as well as the noncancer etiologies of this damage.

  13. The value of FDG positron emission tomography/computerised tomography (PET/CT) in pre-operative staging of colorectal cancer: a systematic review and economic evaluation.

    Science.gov (United States)

    Brush, J; Boyd, K; Chappell, F; Crawford, F; Dozier, M; Fenwick, E; Glanville, J; McIntosh, H; Renehan, A; Weller, D; Dunlop, M

    2011-09-01

    In the UK, colorectal cancer (CRC) is the third most common malignancy (behind lung and breast cancer) with 37,514 cases registered in 2006: around two-thirds (23,384) in the colon and one-third (14,130) in the rectum. Treatment of cancers of the colon can vary considerably, but surgical resection is the mainstay of treatment for curative intent. Following surgical resection, there is a comprehensive assessment of the tumour, it's invasion characteristics and spread (tumour staging). A number of imaging modalities are used in the pre-operative staging of CRCs including; computerised tomography (CT), magnetic resonance imaging, ultrasound imaging and positron emission tomography (PET). This report examines the role of CT in combination with PET scanning (PET/CT 'hybrid' scan). The research objectives are: to evaluate the diagnostic accuracy and therapeutic impact of fluorine-18-deoxyglucose (FDG) PET/CT for the pre-operative staging of primary, recurrent and metastatic cancer using systematic review methods; undertake probabilistic decision-analytic modelling (using Monte Carlo simulation); and conduct a value of information analysis to help inform whether or not there is potential worth in undertaking further research. For each aspect of the research - the systematic review, the handsearch study and the economic evaluation - a database was assembled from a comprehensive search for published and unpublished studies, which included database searches, reference lists search and contact with experts. In the systematic review prospective and retrospective patient series (diagnostic cohort) and randomised controlled trials (RCTs) were eligible for inclusion. Both consecutive series and series that are not explicitly reported as consecutive were included. Two reviewers extracted all data and applied the criteria independently and resolved disagreements by discussion. Data to populate 2 × 2 contingency tables consisting of the number of true positives, true negatives

  14. Clinical significance of incidental focal bowel uptake on 18F-FDG PET/CT as related to colorectal cancer

    DEFF Research Database (Denmark)

    Soltau, Sofus Rønne; Hess, Søren; Nguyen, Tram

    2016-01-01

    OBJECTIVE: Increased focal colorectal uptake of fluorine-18-fluorodeoxyglucose ((18)F-FDG) is reported to occur in 1%-3% of patients undergoing (18)F-FDG positron emission tomography/computed tomography (PET/CT) for disease outside the bowel. However, there is no consensus on how to deal with thi......OBJECTIVE: Increased focal colorectal uptake of fluorine-18-fluorodeoxyglucose ((18)F-FDG) is reported to occur in 1%-3% of patients undergoing (18)F-FDG positron emission tomography/computed tomography (PET/CT) for disease outside the bowel. However, there is no consensus on how to deal...... with this finding in the clinic. Due to the non-specific appearance of such lesions and a certain rate of false positive findings, patients may by subjected to unnecessary invasive procedures or, conversely, cancers may be overlooked if the risk of malignancy is downplayed. The purpose of this study was to examine...

  15. Correlation between PET/CT results and histological and immunohistochemical findings in breast carcinomas; Correlacao entre resultado do PET/CT e achados histologicos e imuno-histoquimicos em carcinomas mamarios

    Energy Technology Data Exchange (ETDEWEB)

    Bitencourt, Almir Galvao Vieira; Lima, Eduardo Nobrega Pereira; Chojniak, Rubens; Marques, Elvira Ferreira; Souza, Juliana Alves de; Graziano, Luciana; Andrade, Wesley Pereira; Osorio, Cynthia Aparecida Bueno de Toledo, E-mail: almirgvb@yahoo.com.br [A.C.Camargo Cancer Center, Sao Paulo, SP (Brazil)

    2014-03-15

    Objective: to correlate the results of {sup 18}F-fluoro-2-deoxy-D-glucose ({sup 18}F-FDG) positron emission tomography/computed tomography (PET/CT) performed with a specific protocol for assessment of breasts with histological/immunohistochemical findings in breast carcinoma patients. Materials and methods: cross-sectional study with prospective data collection, where patients with biopsy-confirmed breast carcinomas were studied. The patients underwent PET/CT examination in prone position, with a specific protocol for assessment of breasts. PET/CT findings were compared with histological and immunohistochemical data. Results: the authors identified 59 malignant breast lesions in 50 patients. The maximum diameter of the lesions ranged from 6 to 80 mm (mean: 32.2 mm). Invasive ductal carcinoma was the most common histological type (n = 47; 79.7%). At PET/CT, 53 (89.8%) of the lesions demonstrated anomalous concentrations of {sup 18}F-FDG, with maximum SUV ranging from 0.8 to 23.1 (mean: 5.5). A statistically significant association was observed between higher values of maximum SUV and histological type, histological grade, molecular subtype, tumor diameter, mitotic index and Ki-67 expression. Conclusion: PET/CT performed with specific protocol for assessment of breasts has demonstrated good sensitivity and was associated with relevant histological/immunohistochemical factors related to aggressiveness and prognosis of breast carcinomas. (author)

  16. Fluorodeoxyglucose-positron emission tomography/computed tomography imaging features of colloid adenocarcinoma of the lung: a case report.

    Science.gov (United States)

    Wang, ZhenGuang; Yu, MingMing; Chen, YueHua; Kong, Yan

    2017-07-27

    Colloid adenocarcinoma of the lung is a rare subtype of variants of invasive adenocarcinomas. We report the appearance of this unusual entity on 18 F-fluorodeoxyglucose positron emission tomography/computed tomography. A 60-year-old man of Chinese Han nationality coughed with a little white sputum for 1 month. Chest computed tomography showed multiple bilateral subpleural nodules and plaques accompanied by air bronchograms, which were most concentrated in the lower lobe of his right lung. Positron emission tomography indicated increased radioactivity uptake with a maximum standardized uptake value of 3.5. Positron emission tomography/computed tomography showed a soft tissue density lesion in his left adrenal gland with a maximum standardized uptake value of 4.1. The positron emission tomography/computed tomography appearance suggested a primary colloid adenocarcinoma in the lower lobe of his right lung accompanied by intrapulmonary and left adrenal gland metastases. The diagnostic rate of colloid adenocarcinoma can be increased by combining the anatomic and metabolic information of lesions. The advantage of positron emission tomography/computed tomography in the diagnosis of colloid adenocarcinoma, as with other cancers, is the ability to locate extrapulmonary disease, facilitating clinical staging.

  17. Head-to-head comparison of chest x-ray/head and neck MRI, chest CT/head and neck MRI, and (18)F-FDG-PET/CT for detection of distant metastases and synchronous cancer in oral, pharyngeal, and laryngeal Cancer

    DEFF Research Database (Denmark)

    Rohde, Max; Nielsen, Anne L; Johansen, Jørgen

    2017-01-01

    -fluoro-deoxy-glucose-positron emission tomography/computed tomography (PET/CT) upfront in the diagnostic work-up of patients with oral, pharyngeal, or laryngeal cancer. Methods: A prospective cohort study based on paired data. Consecutive patients with histologically verified primary head and squamous cell carcinoma (HNSCC) at Odense...

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

    International Nuclear Information System (INIS)

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

    2012-01-01

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

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

    International Nuclear Information System (INIS)

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

    2014-01-01

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

  20. 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.

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2013-06-15

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

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

    International Nuclear Information System (INIS)

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

    2011-01-01

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

  3. PET-CT: current applications and new developments in the thorax.

    Science.gov (United States)

    Erasmus, Jeremy J; Mawlawi, Osama; Howard, Brandon; Patz, Edward F

    2014-02-01

    Positron emission tomography computed tomography(PET-CT) imaging has emerged as an essential clinical diagnostic tool in the evaluation of thoracic abnormalities. Currently, its primary role is for tumor imaging; it helps to differentiate benign from malignant nodules, stage tumors, determine response, and follow patients after therapy is complete. It has also been used for nononcologic diseases, but the indications are less well defined. PET is a fundamental component of the molecular imaging initiative, and as new more specific imaging probes and better instrumentation are developed, PET-CT is certain to improve diagnostic accuracy and become even more integrated into the imaging armamentarium. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

  4. Central Pontine Myelinolysis and Localized Fluorodeoxyglucose Uptake Seen on 18F-FDG PET/CT

    DEFF Research Database (Denmark)

    Rønne, Frederik; Tfelt-Hansen, Peer Carsten; Rørdam, Lene

    2017-01-01

    Case report describing the finding of central pontine myelinolysis (CPM) using combined fluorine-18 ( 18F)-fluorodeoxyglucose (FDG) positron emission tomography/computed tomography (PET/CT). The patient was a known alcoholic who, during admission was under treatment for hyponatremia, showed...... a significant decline in both motor and cognitive function. Combined 18F-FDG PET/CT showed localized FDG uptake in the pons, consistent with the finding of CPM observed on magnetic resonance imaging (MRI). CPM is a demyelinating lesion of the pons, resulting in several neurological symptoms. The exact cause...... of CPM is not clear, but a strong relations between loss of myelin and osmotic stress exists, especially during rapid correction of hyponatremia. The osmotic stress is thought to induce disruption of the blood-brain barrier, allowing access for inflammatory mediators in extravascular brain tissue, which...

  5. Prognostic Evaluation of 18F-Fluorodeoxyglucose Positron Emission Tomography/Computed Tomography in Endometrial Cancer

    DEFF Research Database (Denmark)

    Vilstrup, Mie Holm; Jochumsen, Kirsten M; Hess, Søren

    2017-01-01

    .19-8.49) and 1.93 (0.80-4.68), respectively. Whole-body cTLG of greater than or equal to 176.1 g yielded a hazard ratio of 5.70 (1.94-16.78) for OS in a multivariate analysis. CONCLUSIONS: Preoperative SUVmax and cTLG showed potential as independent prognostic markers of OS in patients with primarily high...... and a preoperative F-fluorodeoxyglucose positron emission tomography/computed tomography before curatively intended treatment were included. The scans were evaluated using standard uptake values [maximum standard uptake value (SUVmax) and partial volume corrected (c) mean standardized uptake value (SUVmean...... proportional regression models were used for prognostic evaluation. RESULTS: Eighty-three patients (median age, 69.9 y; range, 26.8-91.1) with primarily high-risk endometrial cancer or suspected high The International Federation of Gynecology and Obstetrics stage were included. Mean follow-up time was 3...

  6. Fluorine-18 fluorodeoxyglucose positron emission tomography/computed tomography in the detection of primary pulmonary angiosarcomas

    International Nuclear Information System (INIS)

    Krishnamurthy, Arvind; Nayak, Deepika; Ramshankar, Vijayalakshmi; Majhi, Urmila

    2015-01-01

    Angiosarcoma is a malignant vascular tumor that originates from the mesenchymal cells which have undergone angioblastic differentiation. Pulmonary angiosarcomas are invariably (>90%) metastatic tumors form primaries of the skin, bone, liver, breast, or heart. Primary pulmonary angiosarcomas are exceedingly rare, with just about 20 cases being reported in the literature. We report an additional case with a brief review of the literature of a primary pulmonary angiosarcoma in a 26-year-old lady who presented with intractable hemoptysis. In addition, we highlight the potential of fluorine-18 fluorodeoxyglucose positron emission tomography/computed tomography as an important diagnostic tool in the evaluation of this tumor and thus contribute to the existing sparse literature on this fascinating yet devastating disease

  7. Uterine cervical melanoma presenting with rapid progression detected by PET/CT

    International Nuclear Information System (INIS)

    Tsai, Ya-Ju; Shueng, Pei-Wei; Chan, Sheng-Chien; Chuang, Wen-Yu; Shiau, Yu-Chien; Hsu, Chung-Huei

    2012-01-01

    Malignant melanoma of the uterine cervix is a rare extracutaneous melanoma which develops aggressively and is associated with a bleak prognosis. To our knowledge, no prior published reports have discussed the role of 18F-FDG positron emission tomography/computed tomography (PET/CT) in managing this disease. Our case study involved a 66-year-old woman with a malignant melanoma of the uterine cervix. The patient received PET/CT that identified metastases and lesions which had not been detected from her MRI. Serial PET/CT elucidated that the disease was initially limited to the pelvis, but then metastasized to the abdominal para-aortic lymph nodes, followed by extensive metastases to the brain, lungs, breast, supraclavicular, neck, and other abdominal lymph nodes, as observed at 6-month follow-up. PET/CT was used to complement conventional anatomic imaging modalities, and provided a novel modality for whole body screening. Visualization of the metabolic activity of indeterminate lesions may help in staging, re-staging, treatment planning, and prognostic prediction for patients with this rare disease

  8. Broncho-esophageal fistula leading to lung abscess: a life-threatening emergency detected on FDG PET/CT in a case of carcinoma of middle third esophagus

    International Nuclear Information System (INIS)

    Puranik, Ameya D.; Purandare, Nilendu C.; Agrawal, Archi; Shah, Sneha; Rangarajan, Venkatesh

    2013-01-01

    Sinister undesirable pathologies often accompany malignancies. Though the entire emphasis is on cancer management, these benign conditions are more life-threatening than the primary malignancy itself. We report an interesting imaging finding of broncho-esophageal fistula leading to lung abscess on 18 F-fluoro-deoxy-glucose positron emission tomography/computed tomography (FDG PET/CT) in large middle esophageal cancer, which due to early detection, was promptly managed. (author)

  9. Broncho-esophageal fistula leading to lung abscess: A life-threatening emergency detected on FDG PET/CT in a case of carcinoma of middle third esophagus.

    Science.gov (United States)

    Puranik, Ameya D; Purandare, Nilendu C; Agrawal, Archi; Shah, Sneha; Rangarajan, Venkatesh

    2013-07-01

    Sinister undesirable pathologies often accompany malignancies. Though the entire emphasis is on cancer management, these benign conditions are more life-threatening than the primary malignancy itself. We report an interesting imaging finding of broncho-esophageal fistula leading to lung abscess on (18)F- fluoro-deoxy-glucose positron emission tomography/computed tomography (FDG PET/CT) in large middle esophageal cancer, which due to early detection, was promptly managed.

  10. Workstation studies and radiological zoning in a temporary PET/CT installation; Etudes de poste et zonage radiologique dans une installation provisoire TEP/TDM

    Energy Technology Data Exchange (ETDEWEB)

    Vrigneaud, J.M.; Lombardo, J.; Hassoun, S.; Riu, J.L.; Leguludec, D. [Service de Medecine Nucleaire, groupe hospitalier Bichat-Claude Bernard, AP-HP, 46, rue Henri Huchard, 75877 Paris Cedex 18 (France); Hassoun, S. [Service de Pharmacie, unite de Radiopharmacie, groupe hospitalier Bichat-Claude (France)

    2008-07-01

    Within the frame of a complete restructuring of the 'Hopital Bichat' nuclear medicine department, a temporary building will host the high energy activity (PET/CT, Positron emission tomography - computed tomography) during these restructuring works. The authors summarize the study performed in terms of radioprotection, dose rate and dose. A radiological zoning has been defined and the different circulations (personnel, patients, wastes, medicines, supplies, and so on) have been optimized. A risk predictive analysis has also been performed

  11. Measurement of hypoxia-related parameters in three sublines of a rat prostate carcinoma using dynamic 18F-FMISO-Pet-Ct and quantitative histology

    OpenAIRE

    Mena-Romano, Pamela; Cheng, Caixia; Glowa, Christin; Peschke, Peter; Pan, Leyun; Haberkorn, Uwe; Dimitrakopoulou-Strauss, Antonia; Karger, Christian P

    2015-01-01

    Hypoxia is an important resistance factor in radiotherapy and measuring its spatial distribution in tumors non-invasively is therefore of major importance. This study characterizes the hypoxic conditions of three tumor sublines (AT1, HI and H) of the Dunning R3327 prostate tumor model, which differ in histology, differentiation degree, volume doubling time and androgenic sensitivity, using dynamic Fluoromisonidazole (18F-FMISO)-Positron Emission Tomography/Computed Tomography (PET-CT) and his...

  12. An analysis of true- and false-positive results of vocal fold uptake in positron emission tomography-computed tomography imaging.

    Science.gov (United States)

    Seymour, N; Burkill, G; Harries, M

    2018-03-01

    Positron emission tomography-computed tomography with fluorine-18 fluorodeoxy-D-glucose has a major role in the investigation of head and neck cancers. Fluorine-18 fluorodeoxy-D-glucose is not a tumour-specific tracer and can also accumulate in benign pathology. Therefore, positron emission tomography-computed tomography scan interpretation difficulties are common in the head and neck, which can produce false-positive results. This study aimed to investigate patients detected as having abnormal vocal fold uptake on fluorine-18 fluorodeoxy-D-glucose positron emission tomography-computed tomography. Positron emission tomography-computed tomography scans were identified over a 15-month period where reports contained evidence of unilateral vocal fold uptake or vocal fold pathology. Patients' notes and laryngoscopy results were analysed. Forty-six patients were identified as having abnormal vocal fold uptake on positron emission tomography-computed tomography. Twenty-three patients underwent positron emission tomography-computed tomography and flexible laryngoscopy: 61 per cent of patients had true-positive positron emission tomography-computed tomography scans and 39 per cent had false-positive scan results. Most patients referred to ENT for abnormal findings on positron emission tomography-computed tomography scans had true-positive findings. Asymmetrical fluorine-18 fluorodeoxy-D-glucose uptake should raise suspicion of vocal fold pathology, accepting a false-positive rate of approximately 40 per cent.

  13. Comparison of Dynamic Contrast-Enhanced MRI and PET/CT in the Evaluation of Laryngeal Cancer After Inadequate CT Results

    International Nuclear Information System (INIS)

    Citil, Serdal; Dogan, Serap; Atilgan, Hasan Ikbal; Menzilcioglu, Mehmet Sait; Sahin, Tuna; Abdulrezzak, Ummuhan; Duymus, Mahmut; Ozturk, Mustafa

    2015-01-01

    To investigate the diagnostic value of dynamic magnetic resonance imaging (MRI) and positron emission tomography/computed tomography (PET/CT) for laryngeal cancers after inadequate CT results. The study comprised 45 patients investigated for primary laryngeal cancer or recurrence-residue in which CT was considered inadequate. A mass was found in 20 patients. Dynamic MRI and PET/CT were compared for diagnosis of mass, lymph node involvement, recurrence and residue. The dynamic curves formed in dynamic MRI were investigated for diagnostic contributions. The sensitivity and specificity of the dynamic MRI, for supraglottic, glottic and subglottic location, was 100%, 80%, and 92%; 100%, 85%, and 100%, respectively. In PET/CT the sensitivity and specificity were 100% for all of those localizations. For lymph node involvement, the sensitivity of dynamic MRI and PET/CT was 100%, the specificity was 100% and 93%, respectively. For recurrence-residue, the sensitivity and specificity of dynamic MRI were 86% and 67%, respectively, with 100% sensitivity and specificity in PET/CT. The sensitivity of type A curve for detection of malignancy was 40%, and specificity was 100%. When type A and B curves were included, the sensitivity was 100%. For patients investigated for laryngeal cancer in which CT is considered inadequate, dynamic MRI or PET/CT is useful

  14. Volume-based predictive biomarkers of sequential FDG-PET/CT for sunitinib in cancer of unknown primary: identification of the best benefited patients

    Energy Technology Data Exchange (ETDEWEB)

    Ma, Yifei [Second Military Medical University, Department of Orthorpedic Oncology, Changzheng Hospital, Shanghai (China); Second Military Medical University, Department of Pathology, Changzheng Hospital, Shanghai (China); Xu, Wei; Xiao, Jianru [Second Military Medical University, Department of Orthorpedic Oncology, Changzheng Hospital, Shanghai (China); Bai, Ruojing [Geriatrics Institute, Department of Geriatrics, Tianjin Medical University General Hospital, Laboratory of Neuro-Trauma and Neurodegenerative Disorder, Tianjin (China); Li, Yiming [Neurosurgery Institute, Department of Neuro-oncology, Beijing (China); Yu, Hongyu [Second Military Medical University, Department of Pathology, Changzheng Hospital, Shanghai (China); Yang, Chunshan [Panorama Medical Imaging Center, Department of PET/CT Radiology, Shanghai (China); Department of PET/CT Radiology Center, Shanghai (China); Shi, Huazheng; Zhang, Jian [Department of PET/CT Radiology Center, Shanghai (China); Li, Jidong [The First People' s Hospital of Shangqiu, Department of Stomatology, Shangqiu, Henan Province (China); Wang, Chenguang [Second Military Medical University, Department of Radiology, Changzheng Hospital, Shanghai (China)

    2017-02-15

    To test the performance of sequential {sup 18}F-fluorodeoxyglucose positron emission tomography/computed tomography (FDG-PET/CT) in predicting survival after sunitinib therapies in patients with cancer of unknown primary (CUP). CUP patients were enrolled for sequential PET/CT scanning for sunitinib and a control group. Univariate and multivariate analysis were applied to test the efficacy of sunitinib therapy in CUP patients. Next, sequential analyses involving PET/CT parameters were performed to identify and validate sensitive PET/CT biomarkers for sunitinib therapy. Finally, time-dependent receiver operating characteristic (TDROC) analyses were performed to compare the predictive accuracy. Multivariate analysis proved that sunitinib group had significantly improved survival (p < 0.01) as compared to control group. After cycle 2 of therapy, multivariate analysis identified volume-based PET/CT parameters as sensitive biomarkers for sunitinib (p < 0.01). TDROC curves demonstrated whole-body total lesion glycolysis reduction (Δ WTLG) and follow-up WTLG to have good accuracy for efficacy prediction. This evidence was validated after cycle 4 of therapy with the same method. Sunitinib therapy proved effective in treatment of CUP. PET/CT volume-based parameters may help predict outcome of sunitinib therapy, in which Δ WTLG and follow-up WTLG seem to be sensitive biomarkers for sunitinib efficacy. Patients with greater reduction and lower WTLG at follow-up seem to have better survival outcome. (orig.)

  15. Volume-based predictive biomarkers of sequential FDG-PET/CT for sunitinib in cancer of unknown primary: identification of the best benefited patients

    International Nuclear Information System (INIS)

    Ma, Yifei; Xu, Wei; Xiao, Jianru; Bai, Ruojing; Li, Yiming; Yu, Hongyu; Yang, Chunshan; Shi, Huazheng; Zhang, Jian; Li, Jidong; Wang, Chenguang

    2017-01-01

    To test the performance of sequential "1"8F-fluorodeoxyglucose positron emission tomography/computed tomography (FDG-PET/CT) in predicting survival after sunitinib therapies in patients with cancer of unknown primary (CUP). CUP patients were enrolled for sequential PET/CT scanning for sunitinib and a control group. Univariate and multivariate analysis were applied to test the efficacy of sunitinib therapy in CUP patients. Next, sequential analyses involving PET/CT parameters were performed to identify and validate sensitive PET/CT biomarkers for sunitinib therapy. Finally, time-dependent receiver operating characteristic (TDROC) analyses were performed to compare the predictive accuracy. Multivariate analysis proved that sunitinib group had significantly improved survival (p < 0.01) as compared to control group. After cycle 2 of therapy, multivariate analysis identified volume-based PET/CT parameters as sensitive biomarkers for sunitinib (p < 0.01). TDROC curves demonstrated whole-body total lesion glycolysis reduction (Δ WTLG) and follow-up WTLG to have good accuracy for efficacy prediction. This evidence was validated after cycle 4 of therapy with the same method. Sunitinib therapy proved effective in treatment of CUP. PET/CT volume-based parameters may help predict outcome of sunitinib therapy, in which Δ WTLG and follow-up WTLG seem to be sensitive biomarkers for sunitinib efficacy. Patients with greater reduction and lower WTLG at follow-up seem to have better survival outcome. (orig.)

  16. Comparison of Dynamic Contrast-Enhanced MRI and PET/CT in the Evaluation of Laryngeal Cancer After Inadequate CT Results.

    Science.gov (United States)

    Citil, Serdal; Dogan, Serap; Atilgan, Hasan Ikbal; Menzilcioglu, Mehmet Sait; Sahin, Tuna; Abdulrezzak, Ummuhan; Duymus, Mahmut; Ozturk, Mustafa

    2015-01-01

    To investigate the diagnostic value of dynamic magnetic resonance imaging (MRI) and positron emission tomography/computed tomography (PET/CT) for laryngeal cancers after inadequate CT results. The study comprised 45 patients investigated for primary laryngeal cancer or recurrence-residue in which CT was considered inadequate. A mass was found in 20 patients. Dynamic MRI and PET/CT were compared for diagnosis of mass, lymph node involvement, recurrence and residue. The dynamic curves formed in dynamic MRI were investigated for diagnostic contributions. The sensitivity and specificity of the dynamic MRI, for supraglottic, glottic and subglottic location, was 100%, 80%, and 92%; 100%, 85%, and 100%, respectively. In PET/CT the sensitivity and specificity were 100% for all of those localizations. For lymph node involvement, the sensitivity of dynamic MRI and PET/CT was 100%, the specificity was 100% and 93%, respectively. For recurrence-residue, the sensitivity and specificity of dynamic MRI were 86% and 67%, respectively, with 100% sensitivity and specificity in PET/CT. The sensitivity of type A curve for detection of malignancy was 40%, and specificity was 100%. When type A and B curves were included, the sensitivity was 100%. For patients investigated for laryngeal cancer in which CT is considered inadequate, dynamic MRI or PET/CT is useful.

  17. Clinical role of 18F-fluorodeoxyglucose positron emission tomography/computed tomography in post-operative follow up of gastric cancer: Initial results

    Institute of Scientific and Technical Information of China (English)

    Long Sun; Xin-Hui Su; Yong-Song Guan; Wei-Ming Pan; Zuo-Ming Luo; Ji-Hong Wei; Hua Wu

    2008-01-01

    AIM: To evaluate the clinical role of 18F-fluorodeo-xyglucose positron emission and computed tomography(18F-FDG PET/CT) in detection of gastric cancer recur rence after initial surgical resection.METHODS: In the period from January 2007 to May 2008, 23 patients who had previous surgical resection of histopathologically diagnosed gastric cancer underwent a total of 25 18F-FDG PET/CT scans as follow-up visits in our center. The standard of reference for tumor recurrence consisted of histopathologic confirmation or clinical follow-up information for at least 5 mo after PET/CT examinations.RESULTS: PET/Cr was positive in 14 patients (61%)and negative in 9 (39%). When correlated with final diagnosis, which was confirmed by histopathologic evidence of tumor recurrence in 8 of the 23 patients(35%) and by clinical follow-up in 15 (65%), PET/CT was true positive in 12 patients, false positive in 2,true negative in 8 and false negative in 2. Overall,the accuracy of PET/CT was 82.6%, the negative predictive value (NPV) was 77.7%, and the positive predictive value (PPV) was 85.7%. The 2 false positive PET/CT findings were actually chronic inflammatory tissue lesions. For the two patients with false negative PET/CT, the final diagnosis was recurrence of mucinous adenocarcinoma in the anastomosis in one patient and abdominal wall metastasis in the other. Importantly,PET/CT revealed true-positive findings in 11 (47.8%)patients who had negative or no definite findings by CT. PET/CT revealed extra-abdominal metastases in 7 patients and additional esophageal carcinoma in onepatient. Clinical treatment decisions were changed in 7 (30.4%) patients after introducing PET/CT into theirconventional post-operative follow-up program.CONCLUSION: Whole body 18F-FDG PET/CT was highly effective in discriminating true recurrence in post-operative patients with gastric cancer and had important impacts on clinical decisions in a considerable portion of patients.

  18. Geometrical differences in target volumes based on 18F-fluorodeoxyglucose positron emission tomography/computed tomography and four-dimensional computed tomography maximum intensity projection images of primary thoracic esophageal cancer.

    Science.gov (United States)

    Guo, Y; Li, J; Wang, W; Zhang, Y; Wang, J; Duan, Y; Shang, D; Fu, Z

    2014-01-01

    The objective of the study was to compare geometrical differences of target volumes based on four-dimensional computed tomography (4DCT) maximum intensity projection (MIP) and 18F-fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG PET/CT) images of primary thoracic esophageal cancer for radiation treatment. Twenty-one patients with thoracic esophageal cancer sequentially underwent contrast-enhanced three-dimensional computed tomography (3DCT), 4DCT, and 18F-FDG PET/CT thoracic simulation scans during normal free breathing. The internal gross target volume defined as IGTVMIP was obtained by contouring on MIP images. The gross target volumes based on PET/CT images (GTVPET ) were determined with nine different standardized uptake value (SUV) thresholds and manual contouring: SUV≥2.0, 2.5, 3.0, 3.5 (SUVn); ≥20%, 25%, 30%, 35%, 40% of the maximum (percentages of SUVmax, SUVn%). The differences in volume ratio (VR), conformity index (CI), and degree of inclusion (DI) between IGTVMIP and GTVPET were investigated. The mean centroid distance between GTVPET and IGTVMIP ranged from 4.98 mm to 6.53 mm. The VR ranged from 0.37 to 1.34, being significantly (P<0.05) closest to 1 at SUV2.5 (0.94), SUV20% (1.07), or manual contouring (1.10). The mean CI ranged from 0.34 to 0.58, being significantly closest to 1 (P<0.05) at SUV2.0 (0.55), SUV2.5 (0.56), SUV20% (0.56), SUV25% (0.53), or manual contouring (0.58). The mean DI of GTVPET in IGTVMIP ranged from 0.61 to 0.91, and the mean DI of IGTVMIP in GTVPET ranged from 0.34 to 0.86. The SUV threshold setting of SUV2.5, SUV20% or manual contouring yields the best tumor VR and CI with internal-gross target volume contoured on MIP of 4DCT dataset, but 3DPET/CT and 4DCT MIP could not replace each other for motion encompassing target volume delineation for radiation treatment. © 2014 International Society for Diseases of the Esophagus.

  19. 18 F-Fluoride positron emission tomography/computed tomography for noninvasive in vivo quantification of pathophysiological bone metabolism in experimental murine arthritis

    Science.gov (United States)

    2014-01-01

    Introduction Evaluation of disease severity in experimental models of rheumatoid arthritis is inevitably associated with assessment of structural bone damage. A noninvasive imaging technology allowing objective quantification of pathophysiological alterations of bone structure in rodents could substantially extend the methods used to date in preclinical arthritis research for staging of autoimmune disease severity or efficacy of therapeutical intervention. Sodium 18 F-fluoride (18 F-NaF) is a bone-seeking tracer well-suited for molecular imaging. Therefore, we systematically examined the use of 18 F-NaF positron emission tomography/computed tomography (PET/CT) in mice with glucose-6-phosphate isomerase (G6PI)–induced arthritis for quantification of pathological bone metabolism. Methods F-fluoride was injected into mice before disease onset and at various time points of progressing experimental arthritis. Radioisotope accumulation in joints in the fore- and hindpaws was analyzed by PET measurements. For validation of bone metabolism quantified by 18 F-fluoride PET, bone surface parameters of high-resolution μCT measurements were used. Results Before clinical arthritis onset, no distinct accumulation of 18 F-fluoride was detectable in the fore- and hindlimbs of mice immunized with G6PI. In the course of experimental autoimmune disease, 18 F-fluoride bone uptake was increased at sites of enhanced bone metabolism caused by pathophysiological processes of autoimmune disease. Moreover, 18 F-fluoride signaling at different stages of G6PI-induced arthritis was significantly correlated with the degree of bone destruction. CT enabled identification of exact localization of 18 F-fluoride signaling in bone and soft tissue. Conclusions The results of this study suggest that small-animal PET/CT using 18 F-fluoride as a tracer is a feasible method for quantitative assessment of pathophysiological bone metabolism in experimental arthritis. Furthermore, the

  20. Estimation of kidneys and urinary bladder doses based on the region of interest in 18fluorine-fluorodeoxyglucose positron emission tomography/computed tomography examination: a preliminary study.

    Science.gov (United States)

    Mustapha, Farida Aimi; Bashah, Farahnaz Ahmad Anwar; Yassin, Ihsan M; Fathinul Fikri, Ahmad Saad; Nordin, Abdul Jalil; Abdul Razak, Hairil Rashmizal

    2017-06-01

    Kidneys and urinary bladder are common physiologic uptake sites of 18fluorine-fluorodeoxyglucose ( 18 F-FDG) causing increased exposure of low energy ionizing radiation to these organs. Accurate measurement of organ dose is vital as 18 F-FDG is directly exposed to the organs. Organ dose from 18 F-FDG PET is calculated according to the injected 18 F-FDG activity with the application of dose coefficients established by International Commission on Radiological Protection (ICRP). But this dose calculation technique is not directly measured from these organs; rather it is calculated based on total injected activity of radiotracer prior to scanning. This study estimated the 18 F-FDG dose to the kidneys and urinary bladder in whole body positron emission tomography/computed tomography (PET/CT) examination by comparing dose from total injected activity of 18 F-FDG (calculated dose) and dose from organs activity based on the region of interest (ROI) (measured dose). Nine subjects were injected intravenously with the mean 18 F-FDG dose of 292.42 MBq prior to whole body PET/CT scanning. Kidneys and urinary bladder doses were estimated by using two approaches which are the total injected activity of 18 F-FDG and organs activity concentration of 18 F-FDG based on drawn ROI with the application of recommended dose coefficients for 18 F-FDG described in the ICRP 80 and ICRP 106. The mean percentage difference between calculated dose and measured dose ranged from 98.95% to 99.29% for the kidneys based on ICRP 80 and 98.96% to 99.32% based on ICRP 106. Whilst, the mean percentage difference between calculated dose and measured dose was 97.08% and 97.27% for urinary bladder based on ICRP 80 while 96.99% and 97.28% based on ICRP 106. Whereas, the range of mean percentage difference between calculated and measured organ doses derived from ICRP 106 and ICRP 80 for kidney doses were from 17.00% to 40.00% and for urinary bladder dose was 18.46% to 18.75%. There is a significant

  1. Positron Emission Tomography/Computed Tomography Assessment After Immunochemotherapy and Irradiation Using the Lugano Classification Criteria in the IELSG-26 Study of Primary Mediastinal B-Cell Lymphoma

    Energy Technology Data Exchange (ETDEWEB)

    Ceriani, Luca, E-mail: luca.ceriani@eoc.ch [Nuclear Medicine and PET-CT Center, Oncology Institute of Southern Switzerland, Bellinzona (Switzerland); Martelli, Maurizio [Department of Cellular Biotechnologies and Hematology, Sapienza University, Rome (Italy); Gospodarowicz, Maria K. [Radiation Oncology, University of Toronto, Toronto, Ontario (Canada); Ricardi, Umberto [Department of Oncology, University of Torino, Torino (Italy); Ferreri, Andrés J.M. [Unit of Lymphoid Malignancies, Department of Onco-Hematology, Istituto Di Ricovero e Cura a Carattere Scientifico (IRCCS) San Raffaele Scientific Institute, Milano (Italy); Chiappella, Annalisa [Hematology, Azienda Ospedaliera Universitaria Città della Salute e della Scienza, Torino (Italy); Stelitano, Caterina [Hematology, Azienda Ospedaliera Bianchi-Melacrino-Morelli, Reggio Calabria (Italy); Balzarotti, Monica [Hematology, IRCCS Humanitas Cancer Center, Rozzano, Milan (Italy); Cabrera, Maria E. [Hematology, Hospital del Salvador, Universidad de Chile, Santiago (Chile); Cunningham, David [Department of Medicine, The Royal Marsden National Health Service Foundation Trust, London and Surrey (United Kingdom); Guarini, Attilio [Hematology Unit, Istituto Nazionale Tumori Giovanni Paolo II IRCCS, Bari (Italy); Zinzani, Pier Luigi [Institute of Hematology and Medical Oncology, Policlinico S.Orsola-Malpighi, Bologna (Italy); Giovanella, Luca [Nuclear Medicine and PET-CT Center, Oncology Institute of Southern Switzerland, Bellinzona (Switzerland); Johnson, Peter W.M. [Cancer Research UK Centre, University of Southampton, Southampton (United Kingdom); Zucca, Emanuele [Oncology Department, Oncology Institute of Southern Switzerland, Bellinzona (Switzerland)

    2017-01-01

    Purpose: To assess the predictive value of {sup 18}F-fluorodeoxyglucose positron emission tomography/computed tomography (PET/CT) for disease recurrence after immunochemotherapy (R-CHT) and mediastinal irradiation (RT), using the recently published criteria of the Lugano classification to predict outcomes for patients with primary mediastinal large B-cell lymphoma. Methods and Materials: Among 125 patients prospectively enrolled in the IELSG-26 study, 88 were eligible for central review of PET/CT scans after completion of RT. Responses were evaluated using the 5-point Deauville scale at the end of induction R-CHT and after consolidation RT. According to the Lugano classification, a complete metabolic response (CMR) was defined by a Deauville score (DS) ≤3. Results: The CMR (DS1, -2, or -3) rate increased from 74% (65 patients) after R-CHT to 89% (78 patients) after consolidation RT. Among the 10 patients (11%) with persistently positive scans, the residual uptake after RT was slightly higher than the liver uptake in 6 patients (DS4; 7%) and markedly higher in 4 patients (DS5; 4%): these patients had a significantly poorer 5-year progression-free survival and overall survival. At a median follow-up of 60 months (range, 35-107 months), no patients with a CMR after RT have relapsed. Among the 10 patients who did not reach a CMR, 3 of the 4 patients (positive predictive value, 75%) with DS5 after RT had subsequent disease progression (within the RT volume in all cases) and died. All patients with DS4 had good outcomes without recurrence. Conclusions: All the patients obtaining a CMR defined as DS ≤3 remained progression-free at 5 years, confirming the excellent negative predictive value of the Lugano classification criteria in primary mediastinal large B-cell lymphoma patients. The few patients with DS4 also had an excellent outcome, suggesting that they do not necessarily require additional therapy, because the residual {sup 18}F-fluorodeoxyglucose uptake may

  2. Detection of non-aggressive stage IA lung cancer using chest computed tomography and positron emission tomography/computed tomography.

    Science.gov (United States)

    Shiono, Satoshi; Yanagawa, Naoki; Abiko, Masami; Sato, Toru

    2014-10-01

    In contrast to lung cancer with ground-glass opacity, the radiological investigation of solid lung cancer has not been well examined. The aim of this study was to explore chest computed tomography (CT) and positron emission tomography (PET)/CT findings with regard to outcomes after lung cancer surgery in order to radiologically classify clinical stage IA lung cancers by tumour aggressiveness. Three hundred and fifteen clinical stage IA patients were analysed. Four groups were defined by tumour solidity on CT and by the standardized uptake value (SUV) index on PET-CT (tumour maximum SUV/mean right liver lobe SUV). We analysed the association between radiological findings and both pathological invasiveness and postoperative outcome. Group A (n = 84) had an SUV index <1.0 and non-solid tumours, Group B (n = 24) had an SUV index <1.0 and solid tumours, Group C (n = 54) had an SUV index ≥1.0 and non-solid tumours, while Group D (n = 153) had an SUV index ≥1.0 and solid tumours. Invasive lung cancer was found in 2/84 (2.4%) patients in Group A, 1/24 (4.2%) in Group B, 13/54 (24.1%) in Group C and 58/153 (37.9%) in Group D (P < 0.01). The 5-year recurrence-free rate was 100% in Groups A and B, 90.3% in C and 65.7% in D (P < 0.01). The cancer-specific survival rate was 100% in A and B, 94.6% in C and 81.7% in D (P < 0.01). The present results suggest that preoperative PET/CT and thin-section CT findings provide important information for a selection of surgical procedures for clinical stage IA lung cancers. In clinical stage IA lung cancers displaying solid or non-solid density in thin-section findings, an SUV index <1.0 may be a better criterion for detecting non-aggressive lung cancer even in solid lung cancers. © The Author 2014. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved.

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

    International Nuclear Information System (INIS)

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

    2013-01-01

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

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

    Science.gov (United States)

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

    2013-01-01

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

  5. Report of two cases of fluorodeoxyglucose positron emission tomography/computed tomography appearance of hibernoma: A rare benign tumor

    International Nuclear Information System (INIS)

    Agrawal, Archi; Kembhavi, Seema; Purandare, Nilendu; Shah, Sneha; Rangarajan, Venkatesh

    2014-01-01

    False-positive findings are commonly seen in positron emission tomography computed tomography imaging. One of the most common false positive finding is uptake of fluorodeoxyglucose in brown adipose tissue. Herein, we report two cases with incidentally detected hibernomas-a brown fat containing tumor with metabolic activity

  6. Unusual sites of metastatic recurrence of osteosarcoma detected on fluorine-18 fluorodeoxyglucose positron emission tomography/computed tomography

    International Nuclear Information System (INIS)

    Kabnurkar, Rasika; Agrawal, Archi; Rekhi, Bharat; Purandare, Nilendu; Shah, Sneha; Rangarajan, Venkatesh

    2015-01-01

    Osteosarcoma (OS) is the most common nonhematolymphoid primary bone malignancy characterized by osteoid or new bone formation. Lungs and bones are the most common sites of metastases. We report a case where unusual sites of the soft tissue recurrence from OS were detected on restaging fluorine-18 fluorodeoxyglucose positron emission tomography/computed tomography scan done post 6 years of disease free interval

  7. Incidental head and neck findings on 18F-fluoro-deoxy-glucose positron emission tomography computed tomography.

    Science.gov (United States)

    Williams, S P; Kinshuck, A J; Williams, C; Dwivedi, R; Wieshmann, H; Jones, T M

    2015-09-01

    The overlapping risk factors for lung and head and neck cancer present a definite risk of synchronous malignant pathology. This is the first study to specifically review incidental positron emission tomography computed tomography findings in the head and neck region in lung carcinoma patients. A retrospective review was performed of all lung cancer patients who underwent positron emission tomography computed tomography imaging over a five-year period (January 2008 - December 2012), identified from the Liverpool thoracic multidisciplinary team database. Six hundred and nine patients underwent positron emission tomography computed tomography imaging over this period. In 76 (12.5 per cent) scans, incidental regions of avid 18F-fluoro-deoxy-glucose uptake were reported in the head and neck region. In the 28 patients who were fully investigated, there were 4 incidental findings of malignancy. In lung cancer patients undergoing investigative positron emission tomography computed tomography scanning, a significant number will also present with areas of clinically significant 18F-fluoro-deoxy-glucose uptake in the head and neck region. Of these, at least 5 per cent may have an undiagnosed malignancy.

  8. Extensive tumor thrombus of hepatocellular carcinoma in the entire portal venous system detected on fluorodeoxyglucose positron emission tomography computed tomography

    International Nuclear Information System (INIS)

    Agrawal, Archi; Purandare, Nilendu; Shah, Sneha; Puranik, Ameya; Rangarajan, Venkatesh

    2013-01-01

    Detection of thrombus is usually an incidental finding on fluorodeoxyglucose positron emission tomography/computed tomography studies. Nevertheless this is an important finding in terms of disease prognostication and in planning the treatment strategy. We herein report a case of a 50-years-old male, a diagnosed case of hepatocellular carcinoma with extensive hypermetabolic thrombus involving the entire portal venous system. (author)

  9. Diagnosis of sinusoidal obstruction syndrome by positron emission tomography/computed tomography: report of two cases treated by defibrotide.

    Science.gov (United States)

    Gauthé, Mathieu; Bozec, Laurence; Bedossa, Pierre

    2014-11-01

    Sinusoidal obstruction syndrome (SOS) is a potentially fatal liver injury that mainly occurs after myeloablative chemotherapy. We report two cases of SOS investigated by 18F-fluorodeoxyglucose positron emission tomography/computed tomography and treated with defibrotide. © 2014 by the American Association for the Study of Liver Diseases.

  10. Application of PET/CT in treatment response evaluation and recurrence prediction in patients with newly-diagnosed multiple myeloma.

    Science.gov (United States)

    Li, Ying; Liu, Junru; Huang, Beihui; Chen, Meilan; Diao, Xiangwen; Li, Juan

    2017-04-11

    Multiple myeloma (MM) causes osteolytic lesions which can be detected by 18F-fluorodeoxyglucose positron emission tomography/Computed tomography (18F-FDG PET/CT). We prospectively involve 96 Newly diagnosed MM to take PET/CT scan at scheduled treatment time (figure 1), and 18F-FDG uptake of lesion was measured by SUVmax and T/Mmax. All MM patients took bortezomib based chemotherapy as induction and received ASCT and maintenance. All clinical features were analyzed with the PET/CT image changes, and some relationships between treatment response and FDG uptakes changes were found: Osteolytic lesions of MM uptakes higher FDG than healthy volunteers, and this trend is more obvious in extramedullary lesions. Compared to X-ray, PET/CT was more sensitive both in discoering bone as well as extramedullary lesions. In newly diagnosed MM, several adverse clinical factors were related to high FDG uptakes of bone lesions. Bone lesion FDG uptakes of MM with P53 mutation or with hypodiploidy and complex karyotype were also higher than those without such changes. In treatment response, PET/CT showed higher sensitivity in detecting tumor residual disease than immunofixation electrophoresis. But in relapse prediction, it might show false positive disease recurrences and the imaging changes might be influenced by infections and hemoglobulin levels. PET/CT is sensitive in discovering meduallary and extrameduallary lesions of MM, and the 18F-FDG uptake of lesions are related with clinical indictors and biological features of plasma cells. In evaluating treatment response and survival, PET/CT showed its superiority. But in predicting relapse or refractory, it may show false positive results.

  11. FDG-PET/CT detection of very early breast cancer in women with breast microcalcification lesions found in mammography screening

    International Nuclear Information System (INIS)

    Peng, Nang-Jing; Chou, Chen-Pin; Pan, Huay-Ben; Chang, Tsung-Hsien; Hu, Chin; Chiu, Yu-Li; Fu, Ting-Ying; Chang, Hong-Tai

    2015-01-01

    To assess the efficacy of positron emission tomography/computed tomography with the glucose analogue 2-[ 18 F]fluoro-2-deoxy-D-glucose (FDG-PET/CT) in Taiwanese women with early breast cancer detected by mammography screening. Dual-time-point imaging of whole-body supine and breast prone scans using FDG-PET/CT were performed sequentially in the pre-operative stage. A total of 11,849 patients underwent screening mammography, of whom 1,209 (10.2%) displayed positive results. After further investigation, 54 patients underwent FDG-PET/CT. Post-operative pathology examinations revealed malignancies in 26 lesions, including invasive breast cancer in 11 cases and non-invasive breast cancer in 15 cases, as well as benign disease in 30 lesions. The FDG-PET/CT findings from the whole-body scans were positive for 9 of 11 invasive breast cancers (81.8%) and 3 of 15 non-invasive cancers (20%), and they were negative for all benign lesions. The sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of FDG-PET/CT with whole-body supine imaging were 46.2%, 100%, 100% and 68.2%, respectively. Breast prone imaging revealed another patient with ductal carcinoma in situ, increasing the sensitivity to 50%. Importantly, positive PET findings were significantly correlated with tumour histology (P = 0.006), tumour size (P = 0.039) and Ki-67 expression (P = 0.011). FDG-PET/CT with whole-body scanning demonstrated high sensitivity to invasive breast cancer, limited sensitivity to non-invasive breast cancer, and high specificity for breast cancer. FDG-PET/CT might be useful for differentiating tumour invasiveness. However, the good PPV but poor NPV do not allow the physician to discard the biopsy.

  12. Clinical impact of PET/CT imaging after adjuvant therapy in patients with oral cavity squamous cell carcinoma

    Energy Technology Data Exchange (ETDEWEB)

    Lin, Huan-Chun [Chang Gung Memorial Hospital and Chang Gung University, Department of Nuclear Medicine and Molecular Imaging Center, Taoyuan (China); Kang, Chung-Jan; Huang, Shiang-Fu; Liao, Chun-Ta [Chang Gung Memorial Hospital and Chang Gung University, Department of Otorhinolaryngology, Head and Neck Surgery, Taoyuan (China); Wang, Hung-Ming [Chang Gung Memorial Hospital and Chang Gung University, Department of Medical Oncology, Taoyuan (China); Lin, Chien-Yu [Chang Gung Memorial Hospital and Chang Gung University, Department of Radiation Oncology, Taoyuan (China); Lee, Li-Yu [Chang Gung Memorial Hospital and Chang Gung University, Department of Pathology, Taoyuan (China); Yen, Tzu-Chen [Chang Gung Memorial Hospital and Chang Gung University, Department of Nuclear Medicine and Molecular Imaging Center, Taoyuan (China); Chang Gung Memorial Hospital at Linkou, Department of Nuclear Medicine, Taoyuan (China)

    2017-09-15

    This single-center retrospective study of prospectively collected data was aimed at comparing the clinical outcomes of positron emission tomography/computed tomography (PET/CT) for patients with oral cavity squamous cell carcinoma (OSCC) with symptomatic recurrences identified by PET/CT imaging following adjuvant therapy (Group A) versus those of cases with asymptomatic recurrences diagnosed through periodic post-adjuvant therapy PET/CT surveillance (Group B). We also sought to establish the priority of salvage therapy in the two study groups. We identified 111 patients with advanced resected OSCC who developed recurrences following adjuvant therapy (51 in Group A and 60 in Group B). Histopathology served as the gold standard for recurrent lesions. The impact of post-adjuvant therapy PET/CT surveillance was examined with Kaplan-Meier curves and Cox proportional hazards regression models. The 2-year DSS and OS rates were marginally or significantly higher in Group B than in Group A (P = 0.073 and P = 0.025, respectively). Time-dependent ROC curve analysis demonstrated that the optimal cutoff values for time to positive PET/CT findings in relation to OS were 12 months for Group A and 9 months for Group B, respectively. Independent risk factors identified in multivariate analyses were used to devise two prognostic scoring systems for 2-year DSS and OS in each study group (all P < 0.001). Scheduled periodic PET/CT surveillance is a valuable tool for early detection of recurrent lesion(s) in asymptomatic OSCC patients who bear risk factors for disease recurrence. The presence of clinical symptoms and a short time to positive PET/CT findings were adverse prognostic factors for clinical outcome in patients with advanced OSCC. The priority of salvage therapy is discussed in each patient subgroup according to the devised prognostic scoring systems. (orig.)

  13. FDG PET/CT Is Superior to Enhanced CT in Detecting Recurrent Subcentimeter Lesions in the Abdominopelvic Cavity in Colorectal Cancer

    Energy Technology Data Exchange (ETDEWEB)

    Yoon, Hai Jeon; Kim, Yu Kyeong; Kim, Sang Eun [Seoul National Univ. Bundang Hospital, Seoul (Korea, Republic of); Lee, Jong Jin [Asan Medical Center, Univ. of Ulsan College of Medicine, Seoul (Korea, Republic of)

    2011-06-15

    This study aims to compare the performance of contrast enhanced computed tomography (CeCT) and 18 F fluorodeoxyglucose positron emission tomography/computed tomography (FDG PET/CT) in detecting small tumor implants and metastatic lymph nodes (LNs) in the abdominopelvic cavity in patients with colorectal cancer. We enrolled 16 patients who were clinically suspected of experiencing a recurrences (6 male, 10 female; mean age 61{+-}14 years). All subjects underwent CeCT and PET/CT, and the performance of these methods was compared with regard to detecting recurrences. The final diagnosis of a recurrence was made clinically. CeCT identified 38 lesions in 12 patients, all of which were detected by PET/CT. PET/CT found 27 additional lesions in 8 patients, comprising 9 seeding nodules (2 in the right upper quadrant of the abdomen and 7 in the pelvic cavity) and 18 LNs (2 celiac, 2 paraaortic, 2 hepatic hilar, 11 common iliac, 1 external iliac). Most additional lesions were located in the pelvic cavity (approximately 78% of seeding nodules that were detected solely by PET/CT was significantly higher compared with the CeCT and PET/CT confirmed nodules (5.5{+-}4.2 vs. 2.9{+-}2.5, p=0.03). The seeding nodules that were detected only by PET/CT were significantly smaller than the CeCT and PET/CT confirmed nodules (long axis:1.0{+-}0.3cm vs. 2.0{+-}1.1cm, p=0.001; short axis: 0.8{+-}0.3cm vs. 1.7{+-}0.9cm, p=0.001). Similarly, PET/CT only detected LNs were significantly smaller than CeCT and PET/CT identified LNs (0.7{+-}0.1cm vs. 2.3{+-}1.2cm, p<0.0001). PET/CT is superior to CeCT in detecting seeding nodules and metastatic LNs in patients with recurrent colorectal cancer. Specifically, PET/CT detects subcentimeter lesions in anatomically deformed pelvic cavities.

  14. 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

  15. 18F-FLT Positron Emission Tomography/Computed Tomography Imaging in Pancreatic Cancer: Determination of Tumor Proliferative Activity and Comparison with Glycolytic Activity as Measured by 18F-FDG Positron Emission Tomography/Computed Tomography Imaging

    Directory of Open Access Journals (Sweden)

    Senait Aknaw Debebe

    2016-02-01

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

  16. Bilateral primary renal lymphoma in a pediatric patient: staging and response evaluation with ¹⁸F-FDG PET/CT.

    Science.gov (United States)

    Dhull, V S; Mukherjee, A; Karunanithi, S; Durgapal, P; Bal, C; Kumar, R

    2015-01-01

    Primary renal lymphoma (PRL) is a rare disease. We here present the case of an 8-year-old child who presented with bilateral renal masses. On biopsy, it was confirmed to be B-cell non-Hodgkin's lymphoma. (18)F-fluorodeoxyglucose ((18)F-FDG) positron emission tomography-computed tomography (PET/CT) for staging demonstrated (18)F-FDG avid bilateral renal masses, with no other abnormal focus. Follow up (18)F-FDG PET/CT showed complete resolution of the disease after six cycles of chemotherapy. Here we have highlighted the potential role of (18)F-FDG PET/CT in staging and response evaluation of a patient with PRL and presented a brief review. Copyright © 2014 Elsevier España, S.L.U. and SEMNIM. All rights reserved.

  17. PET/CT in the evaluation of anti-NMDA-receptor encephalitis: what we need to know as a NM physician

    International Nuclear Information System (INIS)

    Padma, S.; Shanmuga Sundaram, P.; Marmattom, Bobby Varkey

    2011-01-01

    Anti N-methyl-D-aspartate receptor encephalitis (ANMDARE), also known as limbic encephalitis (LE), is a treatable rare disorder characterized by personality changes, irritability, depression, seizures, memory loss and sometimes dementia. It is classified under paraneoplastic syndrome (PNS) and produces antibodies against NR1 and NR2 subunits of glutamate aspartate receptor. It is thought to be closely related with malignancies like small cell lung cancer, ovarian teratoma and Hodgkin's lymphoma, apart from testis, breast and rarely gastric malignancies. Non-paraneoplastic encephalitis cases are the ones with no detectable malignancy and may be triggered by severe infection. As nuclear medicine physicians, we must be aware of the diverse presentation of ANMDARE or LE and should include a whole body positron emission tomography/computed tomography (PET/CT) and not just brain PET/CT during imaging. We describe the first case of PET/CT in an idiopathic ANMDARE Indian adolescent girl. (author)

  18. [Diagnostic use of positron emission tomography in France: from the coincidence gamma-camera to mobile hybrid PET/CT devices].

    Science.gov (United States)

    Talbot, Jean-Noël

    2010-11-01

    Positron emission tomography (PET) is a well-established medical imaging method. PET is increasingly used for diagnostic purposes, especially in oncology. The most widely used radiopharmaceutical is FDG, a glucose analogue. Other radiopharmaceuticals have recently been registered or are in development. We outline technical improvements of PET machines during more than a decade of clinical use in France. Even though image quality has improved considerably and PET-CT hybrid machines have emerged, spending per examination has remained remarkably constant. Replacement and maintenance costs have remained in the range of 170-190 Euros per examination since 1997, whether early CDET gamma cameras or the latest time-of-flight PET/CT devices are used. This is mainly due to shorter acquisition times and more efficient use of FDG New reimbursement rates for PET/CT are needed in France in order to favor regular acquisition of state-of-the-art devices. One major development is the coupling of PET and MR imaging.

  19. 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

  20. 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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2016-12-15

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

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

    International Nuclear Information System (INIS)

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

    2016-01-01

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

  3. 18F-FDG PET/CT for initial assessment and response monitoring in a case of high grade primary lymphoma of the thyroid gland: A case report and review of literature

    International Nuclear Information System (INIS)

    Naswa, Niraj; Sharma, Punit; Nazar, Aftab Hasan; Mohapatra, Tushar Kumar; Bal, Chandrasekhar; Kumar, Rakesh

    2014-01-01

    Thyroid lymphoma is a rare disease entity of elderly females. Chronic lymphocytic thyroiditis is said to be the precursor of thyroid lymphoma, suggesting a role of chronic antigen stimulation in the development of the disease. We present a case of male with lymphocytic thyroiditis who presented with painless progressive neck enlargement and pathology revealed features of high grade lymphoma. Staging and posttreatment 18 F-fluorodeoxyglucose ( 18 F-FDG) positron emission tomography/computed tomography (PET/CT) was performed. This report reemphasizes the role of 18 F-FDG PET/CT in the diagnosis, staging, and assessment of therapy response in patients with extranodal lymphoma, including the primary thyroid lymphoma

  4. Restaging oesophageal cancer after neoadjuvant therapy with "1"8F-FDG PET-CT: identifying interval metastases and predicting incurable disease at surgery

    International Nuclear Information System (INIS)

    Findlay, John M.; Gillies, Richard S.; Maynard, Nicholas D.; Franklin, James M.; Teoh, Eugene J.; Gleeson, Fergus V.; Bradley, Kevin M.; Jones, Greg E.; Di Carlo, Sara; Middleton, Mark R.

    2016-01-01

    It is unknown whether restaging oesophageal cancer after neoadjuvant therapy with positron emission tomography-computed tomography (PET-CT) is more sensitive than contrast-enhanced CT for disease progression. We aimed to determine this and stratify risk. This was a retrospective study of patients staged before neoadjuvant chemotherapy (NAC) by "1"8F-FDG PET-CT and restaged with CT or PET-CT in a single centre (2006-2014). Three hundred and eighty-three patients were restaged (103 CT, 280 PET-CT). Incurable disease was detected by CT in 3 (2.91 %) and PET-CT in 17 (6.07 %). Despite restaging unsuspected incurable disease was encountered at surgery in 34/336 patients (10.1 %). PET-CT was more sensitive than CT (p = 0.005, McNemar's test). A new classification of FDG-avid nodal stage (mN) before NAC (plus tumour FDG-avid length) predicted subsequent progression, independent of conventional nodal stage. The presence of FDG-avid nodes after NAC and an impassable tumour stratified risk of incurable disease at surgery into high (75.0 %; both risk factors), medium (22.4 %; either), and low risk (3.87 %; neither) groups (p < 0.001). Decision theory supported restaging PET-CT. PET-CT is more sensitive than CT for detecting interval progression; however, it is insufficient in at least higher risk patients. mN stage and response (mNR) plus primary tumour characteristics can stratify this risk simply. (orig.)

  5. Restaging oesophageal cancer after neoadjuvant therapy with {sup 18}F-FDG PET-CT: identifying interval metastases and predicting incurable disease at surgery

    Energy Technology Data Exchange (ETDEWEB)

    Findlay, John M. [Churchill Hospital, Oxford OesophagoGastric Centre, Oxford (United Kingdom); Churchill Hospital, NIHR Oxford Biomedical Research Centre, Oxford (United Kingdom); Gillies, Richard S.; Maynard, Nicholas D. [Churchill Hospital, Oxford OesophagoGastric Centre, Oxford (United Kingdom); Franklin, James M.; Teoh, Eugene J.; Gleeson, Fergus V.; Bradley, Kevin M. [Churchill Hospital, Department of Nuclear Medicine, Oxford (United Kingdom); Jones, Greg E. [Churchill Hospital, Oxford OesophagoGastric Centre, Oxford (United Kingdom); Royal Berkshire Hospital, Reading (United Kingdom); Di Carlo, Sara [Churchill Hospital, Oxford OesophagoGastric Centre, Oxford (United Kingdom); Queen' s Medical Centre, Nottingham (United Kingdom); Middleton, Mark R. [Churchill Hospital, NIHR Oxford Biomedical Research Centre, Oxford (United Kingdom)

    2016-10-15

    It is unknown whether restaging oesophageal cancer after neoadjuvant therapy with positron emission tomography-computed tomography (PET-CT) is more sensitive than contrast-enhanced CT for disease progression. We aimed to determine this and stratify risk. This was a retrospective study of patients staged before neoadjuvant chemotherapy (NAC) by {sup 18}F-FDG PET-CT and restaged with CT or PET-CT in a single centre (2006-2014). Three hundred and eighty-three patients were restaged (103 CT, 280 PET-CT). Incurable disease was detected by CT in 3 (2.91 %) and PET-CT in 17 (6.07 %). Despite restaging unsuspected incurable disease was encountered at surgery in 34/336 patients (10.1 %). PET-CT was more sensitive than CT (p = 0.005, McNemar's test). A new classification of FDG-avid nodal stage (mN) before NAC (plus tumour FDG-avid length) predicted subsequent progression, independent of conventional nodal stage. The presence of FDG-avid nodes after NAC and an impassable tumour stratified risk of incurable disease at surgery into high (75.0 %; both risk factors), medium (22.4 %; either), and low risk (3.87 %; neither) groups (p < 0.001). Decision theory supported restaging PET-CT. PET-CT is more sensitive than CT for detecting interval progression; however, it is insufficient in at least higher risk patients. mN stage and response (mNR) plus primary tumour characteristics can stratify this risk simply. (orig.)

  6. 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.)

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

    Science.gov (United States)

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

    2018-06-05

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

  8. F-18-Fluorodeoxyglucose Positron Emission Tomography/Computed Tomography Appearance of Extramedullary Hematopoesis in a Case of Primary Myelofibrosis

    Science.gov (United States)

    Mukherjee, Anirban; Bal, Chandrasekhar; Tripathi, Madhavi; Das, Chandan Jyoti; Shamim, Shamim Ahmed

    2017-01-01

    A 44-year-old female with known primary myelofibrosis presented with shortness of breath. High Resolution Computed Tomography thorax revealed large heterogeneously enhancing extraparenchymal soft tissue density mass involving bilateral lung fields. F-18-fluorodeoxyglucose (FDG) positron emission tomography/computed tomography revealed mildly FDG avid soft tissue density mass with specks of calcification involving bilateral lung fields, liver, and spleen. Subsequent histopathologic evaluation from the right lung mass was suggestive of extramedullary hematopoesis. PMID:28533647

  9. Bone formation rather than inflammation reflects ankylosing spondylitis activity on PET-CT: a pilot study.

    Science.gov (United States)

    Bruijnen, Stefan T G; van der Weijden, Mignon A C; Klein, Joannes P; Hoekstra, Otto S; Boellaard, Ronald; van Denderen, J Christiaan; Dijkmans, Ben A C; Voskuyl, Alexandre E; van der Horst-Bruinsma, Irene E; van der Laken, Conny J

    2012-04-02

    Positron Emission Tomography - Computer Tomography (PET-CT) is an interesting imaging technique to visualize Ankylosing Spondylitis (AS) activity using specific PET tracers. Previous studies have shown that the PET tracers [18F]FDG and [11C](R)PK11195 can target inflammation (synovitis) in rheumatoid arthritis (RA) and may therefore be useful in AS. Another interesting tracer for AS is [18F]Fluoride, which targets bone formation. In a pilot setting, the potential of PET-CT in imaging AS activity was tested using different tracers, with Magnetic Resonance Imaging (MRI) and conventional radiographs as reference. In a stepwise approach different PET tracers were investigated. First, whole body [18F]FDG and [11C](R)PK11195 PET-CT scans were obtained of ten AS patients fulfilling the modified New York criteria. According to the BASDAI five of these patients had low and five had high disease activity. Secondly, an extra PET-CT scan using [18F]Fluoride was made of two additional AS patients with high disease activity. MRI scans of the total spine and sacroiliac joints were performed, and conventional radiographs of the total spine and sacroiliac joints were available for all patients. Scans and radiographs were visually scored by two observers blinded for clinical data. No increased [18F]FDG and [11C](R)PK11195 uptake was noticed on PET-CT scans of the first 10 patients. In contrast, MRI demonstrated a total of five bone edema lesions in three out of 10 patients. In the two additional AS patients scanned with [18F]Fluoride PET-CT, [18F]Fluoride depicted 17 regions with increased uptake in both vertebral column and sacroiliac joints. In contrast, [18F]FDG depicted only three lesions, with an uptake of five times lower compared to [18F]Fluoride, and again no [11C](R)PK11195 positive lesions were found. In these two patients, MRI detected nine lesions and six out of nine matched with the anatomical position of [18F]Fluoride uptake. Conventional radiographs showed structural

  10. Morphologic and Metabolic Comparison of Treatment Responsiveness with 18Fludeoxyglucose-Positron Emission Tomography/Computed Tomography According to Lung Cancer Type

    Directory of Open Access Journals (Sweden)

    Mehmet Fatih Börksüz

    2016-06-01

    Full Text Available Objective: The aim of the present study was to evaluate the response to treatment by histopathologic type in patients with lung cancer and under follow-up with 18F-fluoro-2deoxy-glucose-positron emission tomography/computed tomography (18F-FDG PET/CT imaging by using Response Evaluation Criteria in Solid Tumors (RECIST and European Organisation for Research and Treatment of Cancer (EORTC criteria that evaluate morphologic and metabolic parameters. Methods: On two separate (pre- and post-treatment 18F-FDG PET/CT images, the longest dimension of primary tumor as well as of secondary lesions were measured and sum of these two measurements was recorded as the total dimension in 40 patients. PET parameters such as standardized uptake value (SUVmax, metabolic volume and total lesion glycolysis (TLG were also recorded for these target lesions on two separate 18F-FDG PET/CT images. The percent (% change was calculated for all these parameters. Morphologic evaluation was based on RECIST 1.1 and the metabolic evaluation was based on EORTC. Results: When evaluated before and after treatment, in spite of the statistically significant change (p0.05. In histopathologic typing, when we compare the post-treatment phase change with the treatment responses of RECIST 1.1 and EORTC criteria; for RECIST 1.1 in squamous cell lung cancer group, progression was observed in sixteen patients (57%, stability in seven patients (25%, partial response in five patients (18%; and for EORTC progression was detected in four patients (14%, stability in thirteen patients (47%, partial response in eleven patients (39%, in 12 of these patients an increase in stage (43%, in 4 of them a decrease in stage (14%, and in 12 of them stability in stage (43% were determined. But in adenocancer patients (n=7, for RECIST 1.1, progression was determined in four patients (57%, stability in two patients (29%, partial response in one patient (14%; for EORTC, progression in one patient (14

  11. FDG PET/CT features of ovarian metastasis

    Energy Technology Data Exchange (ETDEWEB)

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

    2011-03-15

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

  12. FDG PET/CT features of ovarian metastasis

    International Nuclear Information System (INIS)

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

    2011-01-01

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

  13. Clinical practice guidelines for the utilization of positron emission tomography/computed tomography imaging in selected oncologic applications: suggestions from a provider group.

    Science.gov (United States)

    Manning, Ken; Tepfer, Beth; Goldklang, Gerald; Loyd, Richard; Garimella, Prasad; Halkar, Raghuveer

    2007-01-01

    Positron emission tomography, combined with computed tomography (PET/CT) has provided clinicians with useful information regarding the diagnosis, initial staging, restaging, and therapy monitoring of malignancies since the beginning of the current century. Our intent here is to identify the critical steps in clinical workups and follow-up, in the true outpatient clinical setting of a freestanding imaging center, for utilization of PET/CT in four different cancer types. The four most common reasons for referrals to our facility were identified by reviewing two years of referral data. They were lung cancer (including solitary pulmonary nodule), lymphomas, breast cancer, and colorectal cancer. A review of published literature from 1996 and later was accepted as evidence of appropriateness for utilizing PET/CT in various clinical scenarios. In addition, a medical advisory board consisting of 15 referring physicians representing various specialties was established to provide practical advice regarding the appropriate use of PET/CT in clinical situations. National Comprehensive Cancer Network (NCCN) guidelines were also referenced to establish a baseline for clinical workups at various stages of disease. Several inconsistencies were identified among the three primary sources of information leading to the establishment of a standardized algorithm for each cancer type. NCCN data did not always agree with published literature, which was also often different from actual clinical practices of referring physicians. The most common inconsistencies included differing opinions from the referrers vs what was published in the NCCN guidelines, especially with regard to the utilization of PET/CT for applications not yet covered by insurance companies. After a reconciliation of the medical advisory board's clinical practices and several published articles, a consensus was established by the medical advisory board for the use of PET/CT imaging for the four cancer types, enabling us to

  14. Additional benefit of {sup 18}F-fluorodeoxyglucose integrated positron emission tomography/computed tomography in the staging of oesophageal cancer

    Energy Technology Data Exchange (ETDEWEB)

    Gillies, R.S. [Oxford Cancer and Haematology Centre, Churchill Hospital, Department of Medical Oncology, Oxford (United Kingdom); Oxford Cancer and Haematology Centre, Churchill Hospital, Department of Oesophagogastric Surgery, Oxford (United Kingdom); Middleton, M.R. [Oxford Cancer and Haematology Centre, Churchill Hospital, Department of Medical Oncology, Oxford (United Kingdom); Maynard, N.D. [Oxford Cancer and Haematology Centre, Churchill Hospital, Department of Oesophagogastric Surgery, Oxford (United Kingdom); Bradley, K.M.; Gleeson, F.V. [Oxford Cancer and Haematology Centre, Churchill Hospital, Department of Radiology, Oxford (United Kingdom)

    2011-02-15

    {sup 18}F-fluorodeoxyglucose positron emission tomography (FDG PET) has been shown to improve the accuracy of staging in oesophageal cancer. We assessed the benefit of PET/CT over conventional staging and determined if tumour histology had any significant impact on PET/CT findings. A retrospective cohort study, reviewing the results from 200 consecutive patients considered suitable for radical treatment, undergoing routine PET/CT staging comparing the results from CT and endoscopic ultrasound, as well as multi-disciplinary team records. Adenocarcinoma and squamous cell carcinoma were compared for maximum Standardised Uptake Value (SUV{sub max}), involvement of local lymph nodes and distant metastases. PET/CT provided additional information in 37 patients (18.5%) and directly altered management in 34 (17%): 22 (11%) were upstaged; 15 (7.5%) were downstaged, 12 of whom (6%) received radical treatment. There were 11 false negatives (5.5%) and 1 false positive (0.5%). SUV{sub max} was significantly lower for adenocarcinoma than squamous cell carcinoma (median 9.1 versus 13.5, p = 0.003). Staging with PET/CT offers additional benefit over conventional imaging and should form part of routine staging for oesophageal cancer. Adenocarcinoma and squamous cell carcinoma display significantly different FDG-avidity. (orig.)

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

    International Nuclear Information System (INIS)

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

    2011-01-01

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

  16. Evaluation of 68Ga-DOTA-TOC PET/CT for the detection of duodenopancreatic neuroendocrine tumors in patients with MEN1

    International Nuclear Information System (INIS)

    Morgat, Clement; Mazere, Joachim; Hindie, Elif; Fernandez, Philippe; Velayoudom-Cephise, Fritz-Line; Nunes, Marie-Laure; Tabarin, Antoine; Schwartz, Paul; Guyot, Martine; Gaye, Delphine; Vimont, Delphine; Schulz, Juergen; Smith, Denis

    2016-01-01

    Somatostatin receptor scintigraphy with 111 In-pentetreotide (SRS) is used to detect duodenopancreatic neuroendocrine tumors (dpNETs) in multiple endocrine neoplasia type 1 (MEN1). However, SRS has limited sensitivity for this purpose. Positron emission tomography/computed tomography (PET/CT) with 68 Ga-DOTA-TOC has a higher rate of sporadic dpNETs detection than SRS but there is little data for dpNETs detection in MEN1. To compare the performances of 68 Ga-DOTA-TOC PET/CT, SRS and contrast-enhanced computed tomography (CE-CT) to diagnose dpNETs in MEN1. Single-institution prospective comparative study Nineteen consecutive MEN1 patients (aged 47 ± 13 years) underwent 68 Ga-DOTA-TOC PET/CT, SRS, and CE-CT within 2 months in random order. Blinded readings of images were performed separately by experienced physicians. Unblinded analysis of CE-CT, combined with additional magnetic resonance imaging, endoscopic-ultrasound, 18 F-2-fluoro-deoxy-d-glucose ( 18 F-FDG) PET/CT or histopathology results served as reference standard for dpNETs diagnosis. The sensitivity of 68 Ga-DOTA-TOC PET/CT, SRS, and CE-CT was 76, 20, and 60 %, respectively (p < 0.0001). All the true-positive lesions detected by SRS were also depicted on 68 Ga-DOTA-TOC PET/CT. 68 Ga-DOTA-TOC PET/CT detected lesions of smaller size than SRS (10.7 ± 7.6 and 15.2 ± 5.9 mm, respectively, p < 0.03). False negatives of 68 Ga-DOTA-TOC PET/CT included small dpNETs (<10 mm) and 18 F-FDG PET/CT positive aggressive dpNETs. No false positives were recorded. In addition, whole-body mapping with 68 Ga-DOTA-TOC PET/CT identified extra-abdominal MEN1-related tumors including one neuroendocrine thymic carcinoma identified by the three imaging procedures, one bronchial carcinoid undetected by CE-CT and three meningiomas undetected by SRS. Owing to higher diagnostic performance, 68 Ga-DOTA-TOC PET/CT (or alternative 68 Ga-labeled somatostatin analogues) should replace 111 In-pentetreotide in the investigation of MEN1

  17. Evaluation of {sup 68}Ga-DOTA-TOC PET/CT for the detection of duodenopancreatic neuroendocrine tumors in patients with MEN1

    Energy Technology Data Exchange (ETDEWEB)

    Morgat, Clement; Mazere, Joachim; Hindie, Elif; Fernandez, Philippe [CNRS, INCIA, Bordeaux (France); University of Bordeaux, INCIA, Bordeaux (France); University Hospital of Bordeaux, Department of Nuclear Medicine, Bordeaux (France); Velayoudom-Cephise, Fritz-Line; Nunes, Marie-Laure; Tabarin, Antoine [USN Haut-Leveque, Department of Endocrinology, Pessac (France); Schwartz, Paul; Guyot, Martine [University Hospital of Bordeaux, Department of Nuclear Medicine, Bordeaux (France); Gaye, Delphine [University Hospital of Bordeaux, Department of Radiology, Pessac (France); Vimont, Delphine; Schulz, Juergen [CNRS, INCIA, Bordeaux (France); University of Bordeaux, INCIA, Bordeaux (France); Smith, Denis [University Hospital of Bordeaux, Department of Oncology, Bordeaux (France)

    2016-07-15

    Somatostatin receptor scintigraphy with {sup 111}In-pentetreotide (SRS) is used to detect duodenopancreatic neuroendocrine tumors (dpNETs) in multiple endocrine neoplasia type 1 (MEN1). However, SRS has limited sensitivity for this purpose. Positron emission tomography/computed tomography (PET/CT) with {sup 68}Ga-DOTA-TOC has a higher rate of sporadic dpNETs detection than SRS but there is little data for dpNETs detection in MEN1. To compare the performances of {sup 68}Ga-DOTA-TOC PET/CT, SRS and contrast-enhanced computed tomography (CE-CT) to diagnose dpNETs in MEN1. Single-institution prospective comparative study Nineteen consecutive MEN1 patients (aged 47 ± 13 years) underwent {sup 68}Ga-DOTA-TOC PET/CT, SRS, and CE-CT within 2 months in random order. Blinded readings of images were performed separately by experienced physicians. Unblinded analysis of CE-CT, combined with additional magnetic resonance imaging, endoscopic-ultrasound, {sup 18}F-2-fluoro-deoxy-d-glucose ({sup 18}F-FDG) PET/CT or histopathology results served as reference standard for dpNETs diagnosis. The sensitivity of {sup 68}Ga-DOTA-TOC PET/CT, SRS, and CE-CT was 76, 20, and 60 %, respectively (p < 0.0001). All the true-positive lesions detected by SRS were also depicted on {sup 68}Ga-DOTA-TOC PET/CT. {sup 68}Ga-DOTA-TOC PET/CT detected lesions of smaller size than SRS (10.7 ± 7.6 and 15.2 ± 5.9 mm, respectively, p < 0.03). False negatives of {sup 68}Ga-DOTA-TOC PET/CT included small dpNETs (<10 mm) and {sup 18}F-FDG PET/CT positive aggressive dpNETs. No false positives were recorded. In addition, whole-body mapping with {sup 68}Ga-DOTA-TOC PET/CT identified extra-abdominal MEN1-related tumors including one neuroendocrine thymic carcinoma identified by the three imaging procedures, one bronchial carcinoid undetected by CE-CT and three meningiomas undetected by SRS. Owing to higher diagnostic performance, {sup 68}Ga-DOTA-TOC PET/CT (or alternative {sup 68}Ga-labeled somatostatin analogues

  18. 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

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

    International Nuclear Information System (INIS)

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

    2009-01-01

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

  20. 18F-Choline Positron Emission Tomography/Computed Tomography–Driven High-Dose Salvage Radiation Therapy in Patients With Biochemical Progression After Radical Prostatectomy: Feasibility Study in 60 Patients

    International Nuclear Information System (INIS)

    D'Angelillo, Rolando M.; Sciuto, Rosa; Ramella, Sara; Papalia, Rocco; Jereczek-Fossa, Barbara A.; Trodella, Luca E.; Fiore, Michele; Gallucci, Michele; Maini, Carlo L.; Trodella, Lucio

    2014-01-01

    Purpose: To retrospectively review data of a cohort of patients with biochemical progression after radical prostatectomy, treated according to a uniform institutional treatment policy, to evaluate toxicity and feasibility of high-dose salvage radiation therapy (80 Gy). Methods and Materials: Data on 60 patients with biochemical progression after radical prostatectomy between January 2009 and September 2011 were reviewed. The median value of prostate-specific antigen before radiation therapy was 0.9 ng/mL. All patients at time of diagnosis of biochemical recurrence underwent dynamic 18 F-choline positron emission tomography/computed tomography (PET/CT), which revealed in all cases a local recurrence. High-dose salvage radiation therapy was delivered up to total dose of 80 Gy to 18F-choline PET/CT-positive area. Toxicity was recorded according to the Common Terminology Criteria for Adverse Events, version 3.0, scale. Results: Treatment was generally well tolerated: 54 patients (90%) completed salvage radiation therapy without any interruption. Gastrointestinal grade ≥2 acute toxicity was recorded in 6 patients (10%), whereas no patient experienced a grade ≥2 genitourinary toxicity. No grade 4 acute toxicity events were recorded. Only 1 patient (1.7%) experienced a grade 2 gastrointestinal late toxicity. With a mean follow-up of 31.2 months, 46 of 60 patients (76.6%) were free of recurrence. The 3-year biochemical progression-free survival rate was 72.5%. Conclusions: At early follow-up, 18 F-choline PET/CT-driven high-dose salvage radiation therapy seems to be feasible and well tolerated, with a low rate of toxicity

  1. 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...

  2. Appropriateness criteria of FDG PET/CT in oncology

    International Nuclear Information System (INIS)

    Agrawal, Archi; Rangarajan, Venkatesh

    2015-01-01

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

  3. Oral cancer diagnosed using PET/CT: A case report

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Young Hee; Yang, Byoung Eun; Cho, Young Min [Hallym Univ. College of Medicine, Anyang (Korea, Republic of); Kim, Seong Gon [Sam Anyang General Hospital, Anyang (Korea, Republic of)

    2006-06-15

    PET/CT is a new imaging technology that combines high-quality Position Emission Tomography (PET) and Computed Tomography (CT). This imaging provides simultaneous anatomical and metabolic information. Therefore PET/CT is useful diagnostic modality for early detection og malignant tumor, accurate at aging, decision on therapeutic plan, monitoring response to therapy and rapid detection of recurrence. We report oral and maxillofacial cancers diagnosed by using PET/CT and the usefulness of PET/CT in the evaluation of postoperative recurrence.

  4. Variabilities of Magnetic Resonance Imaging-, Computed Tomography-, and Positron Emission Tomography-Computed Tomography-Based Tumor and Lymph Node Delineations for Lung Cancer Radiation Therapy Planning.

    Science.gov (United States)

    Karki, Kishor; Saraiya, Siddharth; Hugo, Geoffrey D; Mukhopadhyay, Nitai; Jan, Nuzhat; Schuster, Jessica; Schutzer, Matthew; Fahrner, Lester; Groves, Robert; Olsen, Kathryn M; Ford, John C; Weiss, Elisabeth

    2017-09-01

    To investigate interobserver delineation variability for gross tumor volumes of primary lung tumors and associated pathologic lymph nodes using magnetic resonance imaging (MRI), and to compare the results with computed tomography (CT) alone- and positron emission tomography (PET)-CT-based delineations. Seven physicians delineated the tumor volumes of 10 patients for the following scenarios: (1) CT only, (2) PET-CT fusion images registered to CT ("clinical standard"), and (3) postcontrast T1-weighted MRI registered with diffusion-weighted MRI. To compute interobserver variability, the median surface was generated from all observers' contours and used as the reference surface. A physician labeled the interface types (tumor to lung, atelectasis (collapsed lung), hilum, mediastinum, or chest wall) on the median surface. Contoured volumes and bidirectional local distances between individual observers' contours and the reference contour were analyzed. Computed tomography- and MRI-based tumor volumes normalized relative to PET-CT-based volumes were 1.62 ± 0.76 (mean ± standard deviation) and 1.38 ± 0.44, respectively. Volume differences between the imaging modalities were not significant. Between observers, the mean normalized volumes per patient averaged over all patients varied significantly by a factor of 1.6 (MRI) and 2.0 (CT and PET-CT) (P=4.10 × 10 -5 to 3.82 × 10 -9 ). The tumor-atelectasis interface had a significantly higher variability than other interfaces for all modalities combined (P=.0006). The interfaces with the smallest uncertainties were tumor-lung (on CT) and tumor-mediastinum (on PET-CT and MRI). Although MRI-based contouring showed overall larger variability than PET-CT, contouring variability depended on the interface type and was not significantly different between modalities, despite the limited observer experience with MRI. Multimodality imaging and combining different imaging characteristics might be the best approach to define

  5. 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.

  6. Retroperitoneal Endometriosis: A Possible Cause of False Positive Finding at 18F-Fluorodeoxyglucose Positron Emission Tomography/Computed Tomography

    International Nuclear Information System (INIS)

    Maffione, Anna Margherita; Panzavolta, Riccardo; Lisato, Laura Camilla; Ballotta, Maria; D'Isanto, Mariangela Zanforlini; Rubello, Domenico

    2015-01-01

    Endometriosis is a frequent and clinically relevant problem in young women. Laparoscopy is still the gold standard for the diagnosis of endometriosis, but frequently both morphologic and functional imaging techniques are involved in the diagnostic course before achieving a conclusive diagnosis. We present a case of a patient affected by infiltrating retroperitoneal endometriosis falsely interpreted as a malignant mass by contrast-enhanced magnetic resonance imaging and 18 F-fluorodeoxyglucose positron emission tomography/computed tomography

  7. Promising role of single photon emission computed tomography/computed tomography in Meckel's scan

    International Nuclear Information System (INIS)

    Jain, Anurag; Chauhan, MS; Pandit, AG; Kumar, Rajeev; Sharma, Amit

    2012-01-01

    Meckel's scan is a common procedure performed in nuclear medicine. Single-photon emission computed tomography/computed tomography (SPECT/CT) in a suspected case of heterotopic location of gastric mucosa can increase the accuracy of its anatomic localization. We present two suspected cases of Meckel's diverticulum in, which SPECT/CT co-registration has helped in better localization of the pathology

  8. Positron emission tomography-computed tomography protocol considerations for head and neck cancer imaging.

    Science.gov (United States)

    Escott, Edward J

    2008-08-01

    Positron emission tomographic-computed tomographic (PET-CT) imaging of patients with primary head and neck cancers has become an established approach for staging and restaging, as well as radiation therapy planning. The inherent co-registration of PET and CT images made possible by the integrated PET-CT scanner is particularly valuable in head and neck cancer imaging due to the complex and closely situated anatomy in this part of the body, the varied sources of physiologic and benign 2-deoxy-2-[F-18]fluoro-D-glucose (FDG) tracer uptake that occurs in the neck, and the varied and complex posttreatment appearance of the neck. Careful optimization of both the CT and the PET portion of the examination is essential to insure the most accurate and clinically valuable interpretation of these examinations.

  9. Positron emission tomography/computed tomography surveillance in patients with Hodgkin lymphoma in first remission has a low positive predictive value and high costs.

    Science.gov (United States)

    El-Galaly, Tarec Christoffer; Mylam, Karen Juul; Brown, Peter; Specht, Lena; Christiansen, Ilse; Munksgaard, Lars; Johnsen, Hans Erik; Loft, Annika; Bukh, Anne; Iyer, Victor; Nielsen, Anne Lerberg; Hutchings, Martin

    2012-06-01

    The value of performing post-therapy routine surveillance imaging in patients with Hodgkin lymphoma is controversial. This study evaluates the utility of positron emission tomography/computed tomography using 2-[18F]fluoro-2-deoxyglucose for this purpose and in situations with suspected lymphoma relapse. We conducted a multicenter retrospective study. Patients with newly diagnosed Hodgkin lymphoma achieving at least a partial remission on first-line therapy were eligible if they received positron emission tomography/computed tomography surveillance during follow-up. Two types of imaging surveillance were analyzed: "routine" when patients showed no signs of relapse at referral to positron emission tomography/computed tomography, and "clinically indicated" when recurrence was suspected. A total of 211 routine and 88 clinically indicated positron emission tomography/computed tomography studies were performed in 161 patients. In ten of 22 patients with recurrence of Hodgkin lymphoma, routine imaging surveillance was the primary tool for the diagnosis of the relapse. Extranodal disease, interim positron emission tomography-positive lesions and positron emission tomography activity at response evaluation were all associated with a positron emission tomography/computed tomography-diagnosed preclinical relapse. The true positive rates of routine and clinically indicated imaging were 5% and 13%, respectively (P = 0.02). The overall positive predictive value and negative predictive value of positron emission tomography/computed tomography were 28% and 100%, respectively. The estimated cost per routine imaging diagnosed relapse was US$ 50,778. Negative positron emission tomography/computed tomography reliably rules out a relapse. The high false positive rate is, however, an important limitation and a confirmatory biopsy is mandatory for the diagnosis of a relapse. With no proven survival benefit for patients with a pre-clinically diagnosed relapse, the high costs and low

  10. The Added Diagnostic Value of 18F-Fluorodihydroxyphenylalanine PET/CT in the Preoperative Work-Up of Small Bowel Neuroendocrine Tumors.

    Science.gov (United States)

    Addeo, Pietro; Poncet, Gilles; Goichot, Bernard; Leclerc, Loic; Brigand, Cécile; Mutter, Didier; Romain, Benoit; Namer, Izzie-Jacques; Bachellier, Philippe; Imperiale, Alessio

    2018-04-01

    The precise localization of the primary tumor and/or the identification of multiple primary tumors improves the preoperative work-up in patients with small bowel (SB) neuroendocrine tumor (NET). The present study assesses the diagnostic value of 18 F-fluorodihydroxyphenylalanine ( 18 F-FDOPA) positron emission tomography/computed tomography (PET/CT) during the preoperative wok-up of SB NETs. Between January 2010 and June 2017, all consecutive patients with SB NETs undergoing preoperative 18 F-FDOPA PET/CT and successive resection were analyzed. Preoperative work-up included computed tomography (CT), somatostatin receptor scintigraphy (SRS), and 18 F-FDOPA PET/CT. Sensitivity and accuracy ratio for primary and multiple tumor detection were compared with data from surgery and pathology. There were 17 consecutive patients with SB NETs undergoing surgery. Nine patients (53%) had multiple tumors, 15 (88%) metastatic lymph nodes, 3 (18%) peritoneal carcinomatosis, and 9 patients (53%) liver metastases. A total of 70 SB NETs were found by pathology. Surgery identified the primary in 17/17 (100%) patients and recognized seven of 9 patients (78%) with multiple synchronous SB. Preoperatively, 18 F-FDOPA PET/CT displayed a statistically significant higher sensitivity for primary tumor localization (100 vs. 23.5 vs. 29.5%) and multiple tumor detection (78 vs. 22 vs. 11%) over SRS and CT. Compared with pathology, 18 F-FDOPA PET/CT displayed the highest accuracy ratio for number of tumor detected over CT and SRS (2.0 ± 2.2 vs. 0.4 ± 0.7 vs. 0.6 ± 1.5, p = 0.0003). 18 F-FDOPA PET/CT significantly increased the sensitivity and accuracy for primary and multiple SB NET identification. 18 F-FDOPA PET/CT should be included systematically in the preoperative work-up of SB NET.

  11. Performance of Positron Emission Tomography and Positron Emission Tomography/Computed Tomography Using Fluorine-18-Fluorodeoxyglucose for the Diagnosis, Staging, and Recurrence Assessment of Bone Sarcoma

    Science.gov (United States)

    Liu, Fanxiao; Zhang, Qingyu; Zhu, Dezhi; Li, Zhenfeng; Li, Jianmin; Wang, Boim; Zhou, Dongsheng; Dong, Jinlei

    2015-01-01

    Abstract To investigate the performance of fluorine-18-fluorodeoxyglucose (18F-FDG) positron emission tomography (PET) and PET/computed tomography (CT) in the diagnosis, staging, restaging, and recurrence surveillance of bone sarcoma by systematically reviewing and meta-analyzing the published literature. To retrieve eligible studies, we searched the MEDLINE, Embase, and the Cochrane Central library databases using combinations of following Keywords: “positron emission tomography” or “PET,” and “bone tumor” or “bone sarcoma” or “sarcoma.” Bibliographies from relevant articles were also screened manually. Data were extracted and the pooled sensitivity, specificity, and diagnostic odds ratio (DOR), on an examination-based or lesion-based level, were calculated to appraise the diagnostic accuracy of 18F-FDG PET and PET/CT. All statistical analyses were performed using Meta-Disc 1.4. Forty-two trials were eligible. The pooled sensitivity and specificity of PET/CT to differentiate primary bone sarcomas from benign lesions were 96% (95% confidence interval [CI], 93–98) and 79% (95% CI, 63–90), respectively. For detecting recurrence, the pooled results on an examination-based level were sensitivity 92% (95% CI, 85–97), specificity 93% (95% CI, 88–96), positive likelihood ratio (PLR) 10.26 (95% CI, 5.99–17.60), and negative likelihood ratio (NLR) 0.11 (95% CI, 0.05–0.22). For detecting distant metastasis, the pooled results on a lesion-based level were sensitivity 90% (95% CI, 86–93), specificity 85% (95% CI, 81–87), PLR 5.16 (95% CI, 2.37–11.25), and NLR 0.15 (95% CI, 0.11–0.20). The accuracies of PET/CT for detecting local recurrence, lung metastasis, and bone metastasis were satisfactory. Pooled outcome estimates of 18F-FDG PET were less complete compared with those of PET/CT. 18F-FDG PET and PET/CT showed a high sensitivity for diagnosing primary bone sarcoma. Moreover, PET/CT demonstrated excellent accuracy for the staging

  12. Efficacy of PET/CT to exclude leiomyoma in patients with lesions suspicious for uterine sarcoma on MRI.

    Science.gov (United States)

    Kusunoki, Soshi; Terao, Yasuhisa; Ujihira, Takafumi; Fujino, Kazunari; Kaneda, Hiroshi; Kimura, Miki; Ota, Tsuyoshi; Takeda, Satoru

    2017-08-01

    To analyze the efficacy of positron emission tomography/computed tomography (PET/CT) for the diagnosis of uterine sarcoma. Thirty-four patients evaluated between January 2010 and March 2015 were retrospectively enrolled. All patients in whom uterine sarcoma was suspected based on contrast-enhanced magnetic resonance imaging (MRI) findings (heterogeneous, high signal intensity on T2-weighted images and/or high intensity on T1-weighted images) underwent PET/CT for further assessment. Patients were divided into 2 groups based on postoperative pathological findings: uterine sarcoma (n = 15) and leiomyoma (n = 19). The maximum standardized uptake value (SUVmax) of all lesions was measured using PET/CT; we calculated the optimal cutoff value for diagnosing sarcoma. The median SUVmax for uterine sarcoma and leiomyoma was 12 and 4.1, respectively; these values were significantly different. An SUVmax of greater than 7.5 was able to exclude leiomyoma with 80.8% sensitivity and 100% specificity (area under the curve, 95.3%). A cutoff SUVmax of 7.5 yields 100% specificity, and a cutoff SUVmax of 4.4 yields a 100% negative predictive value (NPV). The combination of PET/CT and lactate dehydrogenase (LDH) levels had a sensitivity of 86.6%, specificity of 100%, positive predictive value of 100%, and an NPV of 90.4%. No relation between histopathology or International Federation of Gynecology and Obstetrics (FIGO) stage and 18-fluoro-2-deoxy-d-glucose uptake value on PET/CT was seen. The surgical outcome trended toward a correlation with the SUVmax, although this was not statistically significant. In patients with MRI findings consistent with either uterine sarcoma or leiomyoma, PET/CT can decrease the false-positive rate by setting an optimal cutoff SUVmax of 7.5. Using this cutoff can avoid unnecessary surgery. Copyright © 2017. Published by Elsevier B.V.

  13. Cost-effectiveness analysis of PET-CT-guided management for locally advanced head and neck cancer.

    Science.gov (United States)

    Smith, A F; Hall, P S; Hulme, C T; Dunn, J A; McConkey, C C; Rahman, J K; McCabe, C; Mehanna, H

    2017-11-01

    A recent large United Kingdom (UK) clinical trial demonstrated that positron-emission tomography-computed tomography (PET-CT)-guided administration of neck dissection (ND) in patients with advanced head and neck cancer after primary chemo-radiotherapy treatment produces similar survival outcomes to planned ND (standard care) and is cost-effective over a short-term horizon. Further assessment of long-term outcomes is required to inform a robust adoption decision. Here we present results of a lifetime cost-effectiveness analysis of PET-CT-guided management from a UK secondary care perspective. Initial 6-month cost and health outcomes were derived from trial data; subsequent incidence of recurrence and mortality was simulated using a de novo Markov model. Health benefit was measured in quality-adjusted life years (QALYs) and costs reported in 2015 British pounds. Model parameters were derived from trial data and published literature. Sensitivity analyses were conducted to assess the impact of uncertainty and broader National Health Service (NHS) and personal social services (PSS) costs on the results. PET-CT management produced an average per-person lifetime cost saving of £1485 and an additional 0.13 QALYs. At a £20,000 willingness-to-pay per additional QALY threshold, there was a 75% probability that PET-CT was cost-effective, and the results remained cost-effective over the majority of sensitivity analyses. When adopting a broader NHS and PSS perspective, PET-CT management produced an average saving of £700 and had an 81% probability of being cost-effective. This analysis indicates that PET-CT-guided management is cost-effective in the long-term and supports the case for wide-scale adoption. Copyright © 2017 Elsevier Ltd. All rights reserved.

  14. [Comparison of ¹⁸F-FDG PET/CT and large-scale DWI for evaluation of non-Hodgkin lymphoma bone marrow infiltration].

    Science.gov (United States)

    Tang, Rijie; Gui, Si; Li, Jiansheng; Zhang, Hainan; Lu, Bingui; Yang, Peiyu; Fu, Donghai; Fu, Wenhai; Li, Wei; Cai, Liang

    2014-03-01

    To compare the diagnostic value of ¹⁸F-fluorodeoxyglucose-positron emission tomography/computed tomography (¹⁸F-FDG PET/CT) and large-scale diffusion weighted imaging (DWI) for evaluation of non-Hodgkin lymphoma (NHL) bone marrow (BM) infiltration. A total of 79 patients with pathologically diagnosed NHL underwent ¹⁸F-FDG PET/CT, large scale DWI and BM pathological examination. BM examination as the "gold standard", the performance (the sensitivity, specificity, accuracy, positive and negative predictive value) of ¹⁸F-FDG PET/CT and large scale DWI for evaluation of BM infiltration was compared and the risk of BM infiltration of different subtypes and sources of NHL was analyzed. 25 of 79 cases were diagnosed as BM infiltration by pathological examination with 57 BM sites. Abnormal high BM metabolisms were identified in 22 cases with 56 BM sites by ¹⁸F-FDG PET/CT and 25 cases with 58 BM sites by large-scale DWI. The sensitivity, specificity, accuracy, positive and negative predictive value of ¹⁸F-FDG PET/CT were 80.0%, 96.3%, 91.1%, 90.9%, 91.2%, respectively. And they were 84.0%, 92.6%, 89.9%, 84.0%, and 92.6% by large-scale DWI, respectively. A receiver operating characteristic (ROC) analysis demonstrated that there was no statistical difference in ¹⁸F-FDG PET/CT and large-scale DWI (P>0.05). The area under ROC curve for ¹⁸F-FDG PET/CT and large-scale DWI were 0.911 and 0.883 respectively. The incidences of BM infiltration in aggressive NHL patients by ¹⁸F-FDG PET/CT (21/69, 30.4%) and large-scale DWI (23/69, 33.3%) were higher than those (PET/CT: 10.0%; large-scale DWI: 20.0%; P>0.05) in indolent NHL patients. ¹⁸F-FDG PET/CT and large-scale DWI had important clinical value in diagnosing BM infiltration of NHL. A combination of ¹⁸F-FDG PET/CT, large-scale DWI and pathological examination could improve the positive rate of BM infiltration in NHL.

  15. Detection of skeletal muscle metastasis: torso FDG PET-CT versus contrast-enhanced chest or abdomen CT.

    Science.gov (United States)

    So, Young; Yi, Jeong Geun; Song, Inyoung; Lee, Won Woo; Chung, Hyun Woo; Park, Jeong Hee; Moon, Sung Gyu

    2015-07-01

    Skeletal muscle metastasis (SMM) in cancer patients has not been sufficiently evaluated regarding prevalence and proper method of detection. To determine the prevalence of SMM and compare the diagnostic competencies for SMM of torso F-18 fluorodeoxyglucose (FDG) positron emission tomography-computed tomography (PET-CT) and contrast-enhanced chest or abdomen CT. We investigated 18,225 PET-CT studies of 6359 cancer patients performed from 2005 to 2012. The PET-CT studies describing potential SMM were retrieved and the corresponding medical records were reviewed. The gold standard for SMM was histopathologically-proven SMM or imaging study-based disease progression. The detectability of SMM was compared between PET-CT and contrast-enhanced CT. Twenty-six patients had 84 SMM lesions, representing a SMM prevalence of 0.41%. Lung cancer was the most common SMM-associated malignancy (54%) and the gluteal/pelvic girdle muscle was the most frequently involved SMM site (37%). All 84 SMM lesions were visualized on PET-CT (100%). Of these PET-CT positive 84 SMM lesions, 51 lesions were in the CT field of view (FOV) (61%), whereas 33 lesions were out of the CT FOV (39%). Among these 51 lesions, 17 lesions showed rim-enhancing nodules/masses (33%), eight lesions showed homogeneously enhancing nodules (16%), three lesions showed heterogeneously enhancing nodules (6%), and 23 SMM lesions (45%) were non-diagnostic by CT. All 51 SMM lesions within CT FOV were detected on PET-CT (100%), whereas only 28 were visualized on CT (54.9%), resulting in a significant difference (P SMM was revealed by PET-CT. The prevalence of SMM was as low as 0.41% in the current large cohort of cancer patients. Torso PET-CT was a more competent modality than contrast-enhanced CT in the detection of SMM. © The Foundation Acta Radiologica 2014 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav.

  16. Efficacy of 18F-FDG PET/CT in investigation of elevated CEA without known primary malignancy

    Directory of Open Access Journals (Sweden)

    Simon Sin-man Wong

    2016-01-01

    Full Text Available Aim: To evaluate the efficacy of 18flurodeoxyglucose positron emission tomography/computer tomography (18F-FDG PET/CT in investigating patients with elevated carcinoembryonic antigen (CEA and without known primary malignancy, and the impact of PET/CT findings on patient management. Setting and Design: PET/CT scans done in a tertiary hospital between December 2007 and February 2012 for elevated CEA in patients without known primary malignancy were retrospectively reviewed. Materials and Methods: The PET/CT findings, patients' clinical information, level of CEA, histological diagnosis, and subsequent management were retrieved by the electronic patient record for analysis. Statistical Analysis: Data were analyzed using SPSS version 19. Results: One hundred and one PET/CT scans were performed for patients with elevated CEA. Fifty-eight of these were performed for patients with known primary malignancy and were excluded; 43 PET/CT scans were performed for patients without known primary malignancy and were included. Thirty-three (77% had a positive PET/CT. Among the 32 patients with malignancy, 15 (47% suffered from lung cancer and 8 (25% suffered from colorectal cancer. The sensitivity (97%, specificity (82%, positive predictive value (94%, negative predictive value (90%, and accuracy (93% were calculated. Thirty (91% patients had resultant change in management. The mean CEA level for patients with malignancy (46.1 ng/ml was significantly higher than those without malignancy (3.82 ng/ml (P < 0.05. In predicting the presence of malignancy, a CEA cutoff at 7.55 ng/ml will achieve a sensitivity of 91% and a specificity of 73%. Conclusion: PET/CT, in our study population, appears to be sensitive, specific, and accurate in investigating patients with elevated CEA and without known primary malignancy. In addition to diagnosis of underlying primary malignancy, PET/CT also reveals occult metastases which would affect patient treatment options.Its role in

  17. 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.)

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

    Energy Technology Data Exchange (ETDEWEB)

    Seo, Hyo Jung; Choi, Yun Jung; Kim, Hyun Jeong; Jeong, Yong Hyu; Cho, Arthur; Lee, Jae Hoon; Yun, Mijin; Lee, Jong Doo; Kang, Won Jun [Yonsei Univ. College of Medicine, Seoul (Korea, Republic of)

    2011-09-15

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

  19. Uterine intravenous leiomyomatosis with intracardiac extension and pulmonary benign metastases on FDG PET/CT: A case report

    International Nuclear Information System (INIS)

    Wang, Hui Chun; Wang, Yu Bin; Chen, Xiao Hong; Cu, Lan Lan

    2016-01-01

    A 48-year-old woman presented with a 50-day history of irregular vaginal bleeding and lower abdominal pain. Ultrasound indicated an extremely large occupying lesion in the pelvic cavity that was highly suggestive of malignancy. Fluorodeoxyglucose (FDG) positron emission tomography/computed tomography (PET/CT) was performed to further assess the nature of pelvic abnormality. PET/CT images demonstrated a diffusely lobulated mass ranging from cervix up to the inferior pole of kidneys with mild FDG uptake. Simultaneously, multiple nodules in bilateral lungs and a hypodense lesion in the right ventricle were shown without FDG-avidity. Based on the imaging results, the presumptive diagnosis was uterine intravenous leiomyomatosis with intracardiac extension and pulmonary benign metastases, which was subsequently confirmed by MRI and the lesion biopsy

  20. Uterine intravenous leiomyomatosis with intracardiac extension and pulmonary benign metastases on FDG PET/CT: A case report

    Energy Technology Data Exchange (ETDEWEB)

    Wang, Hui Chun; Wang, Yu Bin; Chen, Xiao Hong; Cu, Lan Lan [PET/CT Center, Gansu Provincial Hospital, Lanzhou (China)

    2016-04-15

    A 48-year-old woman presented with a 50-day history of irregular vaginal bleeding and lower abdominal pain. Ultrasound indicated an extremely large occupying lesion in the pelvic cavity that was highly suggestive of malignancy. Fluorodeoxyglucose (FDG) positron emission tomography/computed tomography (PET/CT) was performed to further assess the nature of pelvic abnormality. PET/CT images demonstrated a diffusely lobulated mass ranging from cervix up to the inferior pole of kidneys with mild FDG uptake. Simultaneously, multiple nodules in bilateral lungs and a hypodense lesion in the right ventricle were shown without FDG-avidity. Based on the imaging results, the presumptive diagnosis was uterine intravenous leiomyomatosis with intracardiac extension and pulmonary benign metastases, which was subsequently confirmed by MRI and the lesion biopsy.

  1. Integration of PET-CT and cone-beam CT for image-guided radiotherapy with high image quality and registration accuracy

    Science.gov (United States)

    Wu, T.-H.; Liang, C.-H.; Wu, J.-K.; Lien, C.-Y.; Yang, B.-H.; Huang, Y.-H.; Lee, J. J. S.

    2009-07-01

    Hybrid positron emission tomography-computed tomography (PET-CT) system enhances better differentiation of tissue uptake of 18F-fluorodeoxyglucose (18F-FDG) and provides much more diagnostic value in the non-small-cell lung cancer and nasopharyngeal carcinoma (NPC). In PET-CT, high quality CT images not only offer diagnostic value on anatomic delineation of the tissues but also shorten the acquisition time for attenuation correction (AC) compared with PET-alone imaging. The linear accelerators equipped with the X-ray cone-beam computed tomography (CBCT) imaging system for image-guided radiotherapy (IGRT) provides excellent verification on position setup error. The purposes of our study were to optimize the CT acquisition protocols of PET-CT and to integrate the PET-CT and CBCT for IGRT. The CT imaging parameters were modified in PET-CT for increasing the image quality in order to enhance the diagnostic value on tumour delineation. Reproducibility and registration accuracy via bone co-registration algorithm between the PET-CT and CBCT were evaluated by using a head phantom to simulate a head and neck treatment condition. Dose measurement in computed tomography dose index (CTDI) was also estimated. Optimization of the CT acquisition protocols of PET-CT was feasible in this study. Co-registration accuracy between CBCT and PET-CT on axial and helical modes was in the range of 1.06 to 2.08 and 0.99 to 2.05 mm, respectively. In our result, it revealed that the accuracy of the co-registration with CBCT on helical mode was more accurate than that on axial mode. Radiation doses in CTDI were 4.76 to 18.5 mGy and 4.83 to 18.79 mGy on axial and helical modes, respectively. Registration between PET-CT and CBCT is a state-of-the-art registration technology which could provide much information on diagnosis and accurate tumour contouring on radiotherapy while implementing radiotherapy procedures. This novelty technology of PET-CT and cone-beam CT integration for IGRT may have a

  2. Integration of PET-CT and cone-beam CT for image-guided radiotherapy with high image quality and registration accuracy

    International Nuclear Information System (INIS)

    Wu, T-H; Liang, C-H; Wu, J-K; Lien, C-Y; Yang, B-H; Lee, J J S; Huang, Y-H

    2009-01-01

    Hybrid positron emission tomography-computed tomography (PET-CT) system enhances better differentiation of tissue uptake of 18 F-fluorodeoxyglucose ( 18 F-FDG) and provides much more diagnostic value in the non-small-cell lung cancer and nasopharyngeal carcinoma (NPC). In PET-CT, high quality CT images not only offer diagnostic value on anatomic delineation of the tissues but also shorten the acquisition time for attenuation correction (AC) compared with PET-alone imaging. The linear accelerators equipped with the X-ray cone-beam computed tomography (CBCT) imaging system for image-guided radiotherapy (IGRT) provides excellent verification on position setup error. The purposes of our study were to optimize the CT acquisition protocols of PET-CT and to integrate the PET-CT and CBCT for IGRT. The CT imaging parameters were modified in PET-CT for increasing the image quality in order to enhance the diagnostic value on tumour delineation. Reproducibility and registration accuracy via bone co-registration algorithm between the PET-CT and CBCT were evaluated by using a head phantom to simulate a head and neck treatment condition. Dose measurement in computed tomography dose index (CTDI) was also estimated. Optimization of the CT acquisition protocols of PET-CT was feasible in this study. Co-registration accuracy between CBCT and PET-CT on axial and helical modes was in the range of 1.06 to 2.08 and 0.99 to 2.05 mm, respectively. In our result, it revealed that the accuracy of the co-registration with CBCT on helical mode was more accurate than that on axial mode. Radiation doses in CTDI were 4.76 to 18.5 mGy and 4.83 to 18.79 mGy on axial and helical modes, respectively. Registration between PET-CT and CBCT is a state-of-the-art registration technology which could provide much information on diagnosis and accurate tumour contouring on radiotherapy while implementing radiotherapy procedures. This novelty technology of PET-CT and cone-beam CT integration for IGRT may have a

  3. PET/CT alignment calibration with a non-radioactive phantom and the intrinsic 176Lu radiation of PET detector

    International Nuclear Information System (INIS)

    Wei, Qingyang; Ma, Tianyu; Wang, Shi; Liu, Yaqiang; Gu, Yu; Dai, Tiantian

    2016-01-01

    Positron emission tomography/computed tomography (PET/CT) is an important tool for clinical studies and pre-clinical researches which provides both functional and anatomical images. To achieve high quality co-registered PET/CT images, alignment calibration of PET and CT scanner is a critical procedure. The existing methods reported use positron source phantoms imaged both by PET and CT scanner and then derive the transformation matrix from the reconstructed images of the two modalities. In this paper, a novel PET/CT alignment calibration method with a non-radioactive phantom and the intrinsic 176 Lu radiation of the PET detector was developed. Firstly, a multi-tungsten-alloy-sphere phantom without positron source was designed and imaged by CT and the PET scanner using intrinsic 176 Lu radiation included in LYSO. Secondly, the centroids of the spheres were derived and matched by an automatic program. Lastly, the rotation matrix and the translation vector were calculated by least-square fitting of the centroid data. The proposed method was employed in an animal PET/CT system (InliView-3000) developed in our lab. Experimental results showed that the proposed method achieves high accuracy and is feasible to replace the conventional positron source based methods.

  4. PET/CT alignment calibration with a non-radioactive phantom and the intrinsic 176Lu radiation of PET detector

    Science.gov (United States)

    Wei, Qingyang; Ma, Tianyu; Wang, Shi; Liu, Yaqiang; Gu, Yu; Dai, Tiantian

    2016-11-01

    Positron emission tomography/computed tomography (PET/CT) is an important tool for clinical studies and pre-clinical researches which provides both functional and anatomical images. To achieve high quality co-registered PET/CT images, alignment calibration of PET and CT scanner is a critical procedure. The existing methods reported use positron source phantoms imaged both by PET and CT scanner and then derive the transformation matrix from the reconstructed images of the two modalities. In this paper, a novel PET/CT alignment calibration method with a non-radioactive phantom and the intrinsic 176Lu radiation of the PET detector was developed. Firstly, a multi-tungsten-alloy-sphere phantom without positron source was designed and imaged by CT and the PET scanner using intrinsic 176Lu radiation included in LYSO. Secondly, the centroids of the spheres were derived and matched by an automatic program. Lastly, the rotation matrix and the translation vector were calculated by least-square fitting of the centroid data. The proposed method was employed in an animal PET/CT system (InliView-3000) developed in our lab. Experimental results showed that the proposed method achieves high accuracy and is feasible to replace the conventional positron source based methods.

  5. DW MRI at 3.0 T versus FDG PET/CT for detection of malignant pulmonary tumors.

    Science.gov (United States)

    Zhang, Jian; Cui, Long-Biao; Tang, Xing; Ren, Xin-Ling; Shi, Jie-Ran; Yang, Hai-Nan; Zhang, Yan; Li, Zhi-Kui; Wu, Chang-Gui; Jian, Wen; Zhao, Feng; Ti, Xin-Yu; Yin, Hong

    2014-02-01

    Emerging evidence suggests that diffusion-weighted magnetic resonance imaging (DW MRI) could be useful for tumor detection with N and M staging of lung cancer in place of fluorine 18 fluorodeoxyglucose positron emission tomography/computed tomography (FDG PET/CT). DW MRI at 3.0 T and FDG PET/CT were performed before therapy in 113 patients with pulmonary nodules. Mean apparent diffusion coefficient (ADC), maximal standardized uptake value (SUVmax ) and Ki-67 scores were assessed. Quantitatively, specificity and accuracy of ADC (91.7 and 92.9%, respectively) were significantly higher than those of SUVmax (66.7 and 77.9% respectively, p 0.05). Qualitatively, sensitivity, specificity and accuracy of DW MRI (96.1, 83.3 and 92.0%, respectively) were also not significantly different from that of FDG PET/CT (88.3, 83.3 and 86.7%, respectively, p > 0.05). Significant negative correlation was found between Ki-67 score and ADC (r = -0.66, p 0.05). In conclusion, quantitative and qualitative assessments for detection of malignant pulmonary tumors with DW MRI at 3.0 T are superior to those with FDG PET/CT. Furthermore, ADC could predict the malignancy of lung cancer. © 2013 UICC.

  6. Effects of Respiration-Averaged Computed Tomography on Positron Emission Tomography/Computed Tomography Quantification and its Potential Impact on Gross Tumor Volume Delineation

    International Nuclear Information System (INIS)

    Chi, Pai-Chun Melinda; Mawlawi, Osama; Luo Dershan; Liao Zhongxing; Macapinlac, Homer A.; Pan Tinsu

    2008-01-01

    Purpose: Patient respiratory motion can cause image artifacts in positron emission tomography (PET) from PET/computed tomography (CT) and change the quantification of PET for thoracic patients. In this study, respiration-averaged CT (ACT) was used to remove the artifacts, and the changes in standardized uptake value (SUV) and gross tumor volume (GTV) were quantified. Methods and Materials: We incorporated the ACT acquisition in a PET/CT session for 216 lung patients, generating two PET/CT data sets for each patient. The first data set (PET HCT /HCT) contained the clinical PET/CT in which PET was attenuation corrected with a helical CT (HCT). The second data set (PET ACT /ACT) contained the PET/CT in which PET was corrected with ACT. We quantified the differences between the two datasets in image alignment, maximum SUV (SUV max ), and GTV contours. Results: Of the patients, 68% demonstrated respiratory artifacts in the PET HCT , and for all patients the artifact was removed or reduced in the corresponding PET ACT . The impact of respiration artifact was the worst for lesions less than 50 cm 3 and located below the dome of the diaphragm. For lesions in this group, the mean SUV max difference, GTV volume change, shift in GTV centroid location, and concordance index were 21%, 154%, 2.4 mm, and 0.61, respectively. Conclusion: This study benchmarked the differences between the PET data with and without artifacts. It is important to pay attention to the potential existence of these artifacts during GTV contouring, as such artifacts may increase the uncertainties in the lesion volume and the centroid location

  7. [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.

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

    Science.gov (United States)

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

    2016-01-01

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

  9. 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.)

  10. Utility of FDG PET/CT in IgG4-related systemic disease

    Energy Technology Data Exchange (ETDEWEB)

    Nakatani, K., E-mail: koyakn@kuhp.kyoto-u.ac.jp [Department of Diagnostic Imaging and Nuclear Medicine, Kyoto University Graduate School of Medicine, Sakyo-ku, Kyoto (Japan); Nakamoto, Y.; Togashi, K. [Department of Diagnostic Imaging and Nuclear Medicine, Kyoto University Graduate School of Medicine, Sakyo-ku, Kyoto (Japan)

    2012-04-15

    IgG4-related systemic disease (IgG4-RSD) is an emerging clinical entity about which much remains to be elucidated, in terms of its aetiology, pathogenesis, diagnosis, treatment and outcome. Autoimmune pancreatitis (AIP) and Mikulicz disease (MD) are the two major, well-studied constituents of IgG4-RSD. AIP and MD have common characteristics of forming tumour-mimicking lesions that consist of lymphoplasmacytic infiltrates and fibrosclerosis with numerous immunoglobulin G4 (IgG4)-positive plasma cells, as well as various multi-organ manifestations of IgG4-RSD. 2-[{sup 18}F]-fluoro-2-deoxy-D-glucose positron-emission tomography/ computed tomography (FDG PET/CT) enables the acquisition of whole-body images and provides functional information about disease activity; as such it has a valuable role in staging extent of disease, guiding biopsy, and monitoring response to treatment. However, FDG PET/CT is likely to be only one component of the management strategy, and clinical, laboratory, imaging and histological findings are crucial in the overall diagnosis of the condition. At present FDG PET/CT does not have a well-established role in the assessment of patients with IgG4-RSD and future prospective studies are required to define the cost-effectiveness and clinical impact in this patient group more accurately.

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

    International Nuclear Information System (INIS)

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

    2016-01-01

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

  12. 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.)

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2016-03-15

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

  14. Utility of FDG PET/CT in IgG4-related systemic disease

    International Nuclear Information System (INIS)

    Nakatani, K.; Nakamoto, Y.; Togashi, K.

    2012-01-01

    IgG4-related systemic disease (IgG4-RSD) is an emerging clinical entity about which much remains to be elucidated, in terms of its aetiology, pathogenesis, diagnosis, treatment and outcome. Autoimmune pancreatitis (AIP) and Mikulicz disease (MD) are the two major, well-studied constituents of IgG4-RSD. AIP and MD have common characteristics of forming tumour-mimicking lesions that consist of lymphoplasmacytic infiltrates and fibrosclerosis with numerous immunoglobulin G4 (IgG4)-positive plasma cells, as well as various multi-organ manifestations of IgG4-RSD. 2-[ 18 F]-fluoro-2-deoxy-D-glucose positron-emission tomography/ computed tomography (FDG PET/CT) enables the acquisition of whole-body images and provides functional information about disease activity; as such it has a valuable role in staging extent of disease, guiding biopsy, and monitoring response to treatment. However, FDG PET/CT is likely to be only one component of the management strategy, and clinical, laboratory, imaging and histological findings are crucial in the overall diagnosis of the condition. At present FDG PET/CT does not have a well-established role in the assessment of patients with IgG4-RSD and future prospective studies are required to define the cost-effectiveness and clinical impact in this patient group more accurately.

  15. PET/CT in Radiation Therapy Planning

    DEFF Research Database (Denmark)

    Specht, Lena; Berthelsen, Anne Kiil

    2018-01-01

    Radiation therapy (RT) is an important component of the management of lymphoma patients. Most lymphomas are metabolically active and accumulate 18F-fluorodeoxyglucose (FDG). Positron emission tomography with computer tomography (PET/CT) imaging using FDG is used routinely in staging and treatment...

  16. Evaluation of (68)Ga-DOTA-TOC PET/CT for the detection of duodenopancreatic neuroendocrine tumors in patients with MEN1.

    Science.gov (United States)

    Morgat, Clément; Vélayoudom-Céphise, Fritz-Line; Schwartz, Paul; Guyot, Martine; Gaye, Delphine; Vimont, Delphine; Schulz, Jürgen; Mazère, Joachim; Nunes, Marie-Laure; Smith, Denis; Hindié, Elif; Fernandez, Philippe; Tabarin, Antoine

    2016-07-01

    Somatostatin receptor scintigraphy with (111)In-pentetreotide (SRS) is used to detect duodenopancreatic neuroendocrine tumors (dpNETs) in multiple endocrine neoplasia type 1 (MEN1). However, SRS has limited sensitivity for this purpose. Positron emission tomography/computed tomography (PET/CT) with (68)Ga-DOTA-TOC has a higher rate of sporadic dpNETs detection than SRS but there is little data for dpNETs detection in MEN1. To compare the performances of (68)Ga-DOTA-TOC PET/CT, SRS and contrast-enhanced computed tomography (CE-CT) to diagnose dpNETs in MEN1. Single-institution prospective comparative study Nineteen consecutive MEN1 patients (aged 47 ± 13 years) underwent (68)Ga-DOTA-TOC PET/CT, SRS, and CE-CT within 2 months in random order. Blinded readings of images were performed separately by experienced physicians. Unblinded analysis of CE-CT, combined with additional magnetic resonance imaging, endoscopic-ultrasound, (18)F-2-fluoro-deoxy-D-glucose ((18)F-FDG) PET/CT or histopathology results served as reference standard for dpNETs diagnosis. The sensitivity of (68)Ga-DOTA-TOC PET/CT, SRS, and CE-CT was 76, 20, and 60 %, respectively (p TOC PET/CT. (68)Ga-DOTA-TOC PET/CT detected lesions of smaller size than SRS (10.7 ± 7.6 and 15.2 ± 5.9 mm, respectively, p TOC PET/CT included small dpNETs (TOC PET/CT identified extra-abdominal MEN1-related tumors including one neuroendocrine thymic carcinoma identified by the three imaging procedures, one bronchial carcinoid undetected by CE-CT and three meningiomas undetected by SRS. Owing to higher diagnostic performance, (68)Ga-DOTA-TOC PET/CT (or alternative (68)Ga-labeled somatostatin analogues) should replace (111)In-pentetreotide in the investigation of MEN1 patients.

  17. Diuretic {sup 18}F-FDG PET/CT imaging for detection and locoregional staging of urinary bladder cancer: prospective evaluation of a novel technique

    Energy Technology Data Exchange (ETDEWEB)

    Nayak, Brusabhanu; Dogra, Prem Nath [All India Institute of Medical Sciences, Department of Urology, New Delhi (India); Naswa, Niraj [All India Institute of Medical Sciences, Department of Nuclear Medicine, New Delhi (India); Kumar, Rakesh [All India Institute of Medical Sciences, Department of Nuclear Medicine, New Delhi (India); New Delhi (India)

    2013-03-15

    Positron emission tomography/computed tomography (PET/CT) with {sup 18}F-fluorodeoxyglucose (FDG) has been used with limited success in the past in primary diagnosis and locoregional staging of urinary bladder cancer, mainly because of the pharmacokinetics of renal excretion of {sup 18}F-FDG. In the present prospective study, we have evaluated the potential application of diuretic {sup 18}F-FDG PET/CT in improving detection and locoregional staging of urinary bladder tumours. Twenty-five patients suspected of having primary carcinoma of the urinary bladder were evaluated prospectively for diagnosis and staging. All of these 25 patients underwent conventional contrast-enhanced computed tomography (CECT) of the abdomen/pelvis and whole-body diuretic {sup 18}F-FDG PET/CT. In addition, pelvic PET/CT images were obtained using the special technique of forced diuresis using intravenous furosemide (20-40 mg). Of the 25 patients, 10 underwent radical cystectomy and 15 underwent transurethral resection of the bladder tumour (TURBT). Results of CECT and diuretic {sup 18}F-FDG PET/CT were compared considering histopathology as a reference standard. Of the 25 patients, CECT detected a primary tumour in 23 (sensitivity 92 %), while {sup 18}F-FDG PET/CT was positive in 24 patients (sensitivity 96 %). Mean size and maximum standardized uptake value of the bladder tumours were 3.33 cm (range 1.6-6.2) and 5.3 (range 1.3-11.7), respectively. Of the 25 patients, only 10 patients underwent radical cystectomy based on disease status on TURBT. Among those ten patients, nine had locoregional metastases. Among the nine patients who had positive lymph nodes for metastasis on histopathology, CECT and PET/CT scan had a sensitivity of 44 and 78 %, respectively. {sup 18}F-FDG PET/CT was found to be superior to CECT in the detection of the primary tumour and locoregional staging (p < 0.05). Diuretic {sup 18}F-FDG PET/CT is highly sensitive and specific and plays an important role in improving

  18. Diuretic 18F-FDG PET/CT imaging for detection and locoregional staging of urinary bladder cancer: prospective evaluation of a novel technique

    International Nuclear Information System (INIS)

    Nayak, Brusabhanu; Dogra, Prem Nath; Naswa, Niraj; Kumar, Rakesh

    2013-01-01

    Positron emission tomography/computed tomography (PET/CT) with 18 F-fluorodeoxyglucose (FDG) has been used with limited success in the past in primary diagnosis and locoregional staging of urinary bladder cancer, mainly because of the pharmacokinetics of renal excretion of 18 F-FDG. In the present prospective study, we have evaluated the potential application of diuretic 18 F-FDG PET/CT in improving detection and locoregional staging of urinary bladder tumours. Twenty-five patients suspected of having primary carcinoma of the urinary bladder were evaluated prospectively for diagnosis and staging. All of these 25 patients underwent conventional contrast-enhanced computed tomography (CECT) of the abdomen/pelvis and whole-body diuretic 18 F-FDG PET/CT. In addition, pelvic PET/CT images were obtained using the special technique of forced diuresis using intravenous furosemide (20-40 mg). Of the 25 patients, 10 underwent radical cystectomy and 15 underwent transurethral resection of the bladder tumour (TURBT). Results of CECT and diuretic 18 F-FDG PET/CT were compared considering histopathology as a reference standard. Of the 25 patients, CECT detected a primary tumour in 23 (sensitivity 92 %), while 18 F-FDG PET/CT was positive in 24 patients (sensitivity 96 %). Mean size and maximum standardized uptake value of the bladder tumours were 3.33 cm (range 1.6-6.2) and 5.3 (range 1.3-11.7), respectively. Of the 25 patients, only 10 patients underwent radical cystectomy based on disease status on TURBT. Among those ten patients, nine had locoregional metastases. Among the nine patients who had positive lymph nodes for metastasis on histopathology, CECT and PET/CT scan had a sensitivity of 44 and 78 %, respectively. 18 F-FDG PET/CT was found to be superior to CECT in the detection of the primary tumour and locoregional staging (p 18 F-FDG PET/CT is highly sensitive and specific and plays an important role in improving detection of the primary tumour and locoregional staging of

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2011-08-15

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

  20. Initial Assessment of β3-Adrenoceptor-Activated Brown Adipose Tissue in Streptozotocin-Induced Type 1 Diabetes Rodent Model Using [18F]Fluorodeoxyglucose Positron Emission Tomography/Computed Tomography

    Directory of Open Access Journals (Sweden)

    Aparna Baranwal

    2015-12-01

    Full Text Available Metabolic activity of brown adipose tissue (BAT is activated by β3-adrenoceptor agonists and norepinephrine transporter (NET blockers and is measurable using [18F]fluorodeoxyglucose ([18F]FDG positron emission tomography/computed tomography (PET/CT in rats. Using the streptozotocin (STZ-treated rat model of type 1 diabetes mellitus (T1DM, we investigated BAT activity in this rat model under fasting and nonfasting conditions using [18F]FDG PET/CT. Drugs that enhance BAT activity may have a potential for therapeutic development in lowering blood sugar in insulin-resistant diabetes. Rats were rendered diabetic by administration of STZand confirmed by glucose measures. [18F]FDG was injected in the rats (fasted or nonfasted pretreated with either saline or β3-adrenoceptor agonist CL316,243 or the NET blocker atomoxetine for PET/CT scans. [18F]FDG metabolic activity was computed as standard uptake values (SUVs in interscapular brown adipose tissue (IBAT and compared across the different drug treatment conditions. Blood glucose levels > 500 mg/dL were established for the STZ-treated diabetic rats. Under fasting conditions, average uptake of [18F]FDG in the IBAT of STZ-treated diabetic rats was approximately 70% lower compared to that of normal rats. Both CL316,243 and atomoxetine activated IBAT in normal rats had an SUV > 5, whereas activation in STZ-treated rats was significantly lower. The agonist CL316,243 activated IBAT up to threefold compared to saline in the fasted STZ-treated rat. In the nonfasted rat, the IBAT activation was up by twofold by CL316243. Atomoxetine had a greater effect on lowering blood sugar levels compared to CL316,243 in the nonfasted rats. A significant reduction in metabolic activity was observed in the STZ-treated diabetic rodent model. Increased IBAT activity in the STZ-treated diabetic rat under nonfasted conditions using the β3-adrenoceptor agonist CL316,243 suggests a potential role of BAT in modulating blood sugar

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

    Science.gov (United States)

    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.

  2. Technetium-99m methylene diphosphonate uptake in the brachialis muscle hematoma in a patient with prostate cancer and coagulation disorder mimicking bone metastasis evaluated by single-photon emission tomography-computed tomography/computed tomography

    Energy Technology Data Exchange (ETDEWEB)

    Kamaleshwaran, Koramadai Karuppusamy; Mohanan, Vyshakh; Shinto, Ajit Sugunan, E-mail: dr.kamaleshwar@gmail.com [Department of Nuclear Medicine and PET/CT, Kovai Medical Centre and Hospital Limited, Coimbatore (India); Madhavan, Devdas [Department of Urology, Comprehensive Cancer Care Centre, Kovai Medical Centre and Hospital Limited, Coimbatore (India)

    2013-10-15

    We report a case of 79-year-old male with prostate cancer and coagulation disorder presented with left shoulder pain. He underwent bone scintigraphy to rule out metastasis, which showed intense foci of tracer activity in the left axilla. Hybrid single-photon emission tomography-computed tomography (SPECT/CT) of the shoulder region localized tracer uptake to the left brachialis muscle hematoma. (author)

  3. Technetium-99m methylene diphosphonate uptake in the brachialis muscle hematoma in a patient with prostate cancer and coagulation disorder mimicking bone metastasis evaluated by single-photon emission tomography-computed tomography/computed tomography

    International Nuclear Information System (INIS)

    Kamaleshwaran, Koramadai Karuppusamy; Mohanan, Vyshakh; Shinto, Ajit Sugunan; Madhavan, Devdas

    2013-01-01

    We report a case of 79-year-old male with prostate cancer and coagulation disorder presented with left shoulder pain. He underwent bone scintigraphy to rule out metastasis, which showed intense foci of tracer activity in the left axilla. Hybrid single-photon emission tomography-computed tomography (SPECT/CT) of the shoulder region localized tracer uptake to the left brachialis muscle hematoma. (author)

  4. FDG PET/CT in infection and inflammation—current and emerging clinical applications

    International Nuclear Information System (INIS)

    Vaidyanathan, S.; Patel, C.N.; Scarsbrook, A.F.; Chowdhury, F.U.

    2015-01-01

    Integrated positron emission tomography/computed tomography (PET/CT) with the glucose analogue, 2-[ 18 F]-fluoro-2-deoxy-D-glucose (FDG), is an evolving hybrid imaging technique in the evaluation of an important and diverse group of pathological conditions, which are characterised by infection and aseptic inflammation. With a rapidly expanding body of evidence, it is being increasingly recognised that, in addition to its established role in oncological imaging, FDG PET/CT also has clinical utility in suspected infection and inflammation. The technique can identify the source of infection or inflammation in a timely fashion ahead of morphological changes on conventional anatomical imaging techniques, such as computed tomography (CT) and magnetic resonance imaging (MRI), map the extent and severity of disease, identify sites for tissue sampling, and assess therapy response. FDG PET/CT exhibits distinct advantages over traditional radionuclide imaging techniques in terms of shorter duration of examination, higher spatial resolution, non-invasive nature of acquisition, ability to perform quantitative analyses, and the provision of a synergistic combination of functional and anatomical imaging. With the use of illustrative clinico-radiological cases, this article discusses the current and emerging evidence for the use of FDG PET/CT in a broad spectrum of disorders, such as fever of unknown origin, sarcoidosis, large vessel vasculitis, musculoskeletal infections, joint prosthesis or implant-related complications, human immunodeficiency virus (HIV)-related infections, and miscellaneous indications, such as IgG4-related systemic disease. It will also briefly summarise the role of more novel tracers such as FDG-labelled leukocytes and gallium-68 PET tracers in this arena

  5. The role of 11C-choline positron emission tomography- computed tomography and videomediastinoscopy in the evaluation of diseases of middle mediastinum

    Institute of Scientific and Technical Information of China (English)

    2006-01-01

    Background Middle mediastinal masses comprise a wide variety of tumors but may also reflect lymphadenopathy, and thus remain an interesting diagnostic challenge. We performed positron emission tomography (PET) of mediastinal masses in order to evaluate the ability of PET to predict the malignancy of these tumors. We compared histologic findings, videomediastinoscopy, computed tomography (CT), and PET-CT in patients with mediastinal disease. Methods Thirty-two patients were evaluated with CT, PET-CT and videomediastionoscopy, and all studies were performed within four weeks in each patient. 11C-choline as a PET tracer was used to visualize masses. PET data were evaluated using the standardized uptake value (SUV) and were compared with pathologic data.Results There were 13 men and 19 women aged from 21 to 74 (mean 45.2) years. Among the patients with mediastinal diseases, sarcoidosis was diagnosed in 12 patients, tuberculosis in 5 patients, lymphoma in 5 patients, and noncaseating granulomata without classical "sarcoid" finding in 3 patients. N2 or N3 nodal metastasis was revealed in 6 of 7 patients who had non-small cell lung cancer or suspected lung cancer, and one was negative (the pathological diagnosis was reactive hyperplasia). The accuracies for correctly diagnosing mediastinal masses for CT, PET-CT and videomediastinoscopy were 38% (12/32), 63% (20/32), and 91% (29/32) respectively. The diagnostic accuracy of videomediastinoscopy was superior to that of PET-CT (χ2=11.130,P<0.001). The SUVs were similar among these diseases. On the other hand, if the diagnostic classification was benign vs malignancy, the accuracies for CT, PET-CT and videomediastinoscopy were 53% (17/32), 75% (24/32), 100% (32/32) respectively. The diagnostic accuracy of videomediastinoscopy was superior to that of PET-CT (χ2=22.042, P<0.001). The SUV of malignant lesions (6.9, 3.2-9.8; n=11) appeared to be higher than that of benign lesions (4.9, 2.9-8.3; n=21), however, this difference

  6. Preoperative PET/CT in early-stage breast cancer

    DEFF Research Database (Denmark)

    Bernsdorf, M; Berthelsen, A K; Timmermans-Wielenga, Vera

    2012-01-01

    The aim of this study was to assess the diagnostic and therapeutic impact of preoperative positron emission tomography and computed tomography (PET/CT) in the initial staging of patients with early-stage breast cancer.......The aim of this study was to assess the diagnostic and therapeutic impact of preoperative positron emission tomography and computed tomography (PET/CT) in the initial staging of patients with early-stage breast cancer....

  7. Diagnostic accuracy of FDG PET/CT in mediastinal lymph nodal staging of the non-small cell lung cancer: prospective study with PET/CT of 182 cases

    International Nuclear Information System (INIS)

    Lee, J. W.; Kang, W. J.; Kim, B. S.; Lee, D. S.; Jeong, J. K.; Lee, M. C.

    2007-01-01

    This study was performed to assess the accuracy of fluorodeoxyglucose - positron emission tomography/computed tomography (FDG-PET/CT) in the mediastinal lymph nodal staging of non-small cell lung cancer as compared with CT. Between March 2004 and February 2006, 182 patients (126 men and 56 women; mean age, 60.7 y) with non-small cell lung cancer underwent FDG PET/CT and enhanced chest CT. PET/CT and CT images were acquired in a prospective manner. These images were evaluated separately by 2 different physicians and nodal stages were determined by using American Joint Committee on Cancer staging systems. The maxSUV, location, size, calcification and pattern of FDG uptake of lymph nodes were considered. Surgical and histological findings served as the reference standard. A total of 182 patients with 778 mediastinal nodal stations were evaluated. Among them, metastases were found in 36 patients with 53 nodal stations. The respective values for sensitivity, specificity, positive predictive value, negative predictive value and accuracy of mediastinal lymph node staging were 36%, 80%, 30%, 84% and 71% with CT and 75%, 89%, 63%, 94% and 86% with PET/CT on per-patient basis, and 23%, 92%, 18%, 94% and 88% with CT and 66%, 96%, 54%, 98% and 94% with PET/CT on per-nodal-station basis. The maxSUVs of metastatic lymph nodes were significantly higher than those of benign nodes (p = 0.0008). Seventy seven percent (27/35) of the metastatic lymph nodes on FDG-PET/CT images were less than a 1cm in the short axis. Moreover, some benign lymph node patterns, such as bilateral symmetric nodes with similar FDG uptake, benign pattern of nodal calcification and small-sized lymph node with much higher maxSUV than primary tumor, were noted during the evaluation of FDG-PET/CT images. This prospective study suggests that FDG-PET/CT is more accurately stage the mediastinal lymph node staging than CT, and that it provides high specificity and a negative predictive value

  8. Clinical value of whole body fluorine-18 fluorodeoxyglucose positron emission tomography/computed tomography in the detection of metastatic bladder cancer.

    Science.gov (United States)

    Yang, Zhongyi; Pan, Lingling; Cheng, Jingyi; Hu, Silong; Xu, Junyan; Ye, Dingwei; Zhang, Yingjian

    2012-07-01

    To investigate the value of whole-body fluorine-18 2-fluoro-2-deoxy-D-glucose positron emission tomography/computed tomography for the detection of metastatic bladder cancer. From December 2006 to August 2010, 60 bladder cancer patients (median age 60.5 years old, range 32-96) underwent whole body positron emission tomography/computed tomography positron emission tomography/computed tomography. The diagnostic accuracy was assessed by performing both organ-based and patient-based analyses. Identified lesions were further studied by biopsy or clinically followed for at least 6 months. One hundred and thirty-four suspicious lesions were identified. Among them, 4 primary cancers (2 pancreatic cancers, 1 colonic and 1 nasopharyngeal cancer) were incidentally detected, and the patients could be treated on time. For the remaining 130 lesions, positron emission tomography/computed tomography detected 118 true positive lesions (sensitivity = 95.9%). On the patient-based analysis, the overall sensitivity and specificity resulted to be 87.1% and 89.7%, respectively. There was no difference of sensitivity and specificity in patients with or without adjuvant treatment in terms of detection of metastatic sites by positron emission tomography/computed tomography. Compared with conventional imaging modality, positron emission tomography/computed tomography correctly changed the management in 15 patients (25.0%). Positron emission tomography/computed tomography has excellent sensitivity and specificity in the detection of metastatic bladder cancer and it provides additional diagnostic information compared to standard imaging techniques. © 2012 The Japanese Urological Association.

  9. Clinical value of whole body fluorine-18 fluorodeoxyglucose positron emission tomography/computed tomography in the detection of metastatic bladder cancer

    International Nuclear Information System (INIS)

    Yang Zhongyi; Pan Lingling; Cheng Jingyi; Hu Silong; Xu Junyan; Zhang Yingjian; Ye Dingwei

    2012-01-01

    The objective of this study was to investigate the value of whole-body fluorine-18 2-fluoro-2-deoxy-D-glucose positron emission tomography/computed tomography for the detection of metastatic bladder cancer. From December 2006 to August 2010, 60 bladder cancer patients (median age 60.5 years old, range 32-96) underwent whole body positron emission tomography/computed tomography positron emission tomography/computed tomography. The diagnostic accuracy was assessed by performing both organ-based and patient-based analyses. Identified lesions were further studied by biopsy or clinically followed for at least 6 months. One hundred and thirty-four suspicious lesions were identified. Among them, 4 primary cancers (2 pancreatic cancers, 1 colonic and 1 nasopharyngeal cancer) were incidentally detected, and the patients could be treated on time. For the remaining 130 lesions, positron emission tomography/computed tomography detected 118 true positive lesions (sensitivity=95.9%). On the patient-based analysis, the overall sensitivity and specificity resulted to be 87.1% and 89.7%, respectively. There was no difference of sensitivity and specificity in patients with or without adjuvant treatment in terms of detection of metastatic sites by positron emission tomography/computed tomography. Compared with conventional imaging modality, positron emission tomography/computed tomography correctly changed the management in 15 patients (25.0%). Positron emission tomography/computed tomography has excellent sensitivity and specificity in the detection of metastatic bladder cancer and it provides additional diagnostic information compared to standard imaging techniques. (author)

  10. Fluorodeoxyglucose positron emission tomography scan may be helpful in the case of ductal variant prostate cancer when prostate specific membrane antigen ligand positron emission tomography scan is negative

    International Nuclear Information System (INIS)

    McEwan, Louise M.; Wong, David; Yaxley, John

    2017-01-01

    Gallium-68 prostate specific membrane antigen ligand (Ga-68 PSMA) positron emission tomography/computed tomography (PET/CT) scanning is emerging as a useful imaging modality for the staging of suspected and known recurrent or metastatic prostate cancer and in staging of newly diagnosed higher grade prostate cancer. However, we have observed at our institution that in some cases of the more aggressive ductal variant, Ga-68 PSMA uptake has sometimes been poor compared with prominent 18-fluorodeoxyglucose (F-18 FDG) avidity seen in F-18 FDG PET/CT, which would suggest that FDG PET/CT scans are important in staging of ductal pattern prostate cancer.

  11. 18 F-fluorodeoxyglucose positron emission tomography-computed tomography for preoperative lymph node staging in patients undergoing radical cystectomy for bladder cancer: a prospective study.

    Science.gov (United States)

    Hitier-Berthault, Maryam; Ansquer, Catherine; Branchereau, Julien; Renaudin, Karine; Bodere, Françoise; Bouchot, Olivier; Rigaud, Jérôme

    2013-08-01

    The objective of our study was to analyze the diagnostic performance of (18) F-fluorodeoxyglucose positron emission tomography-computed tomography for lymph node staging in patients with bladder cancer before radical cystectomy and to compare it with that of computed tomography. A total of 52 patients operated on between 2005 and 2010 were prospectively included in this prospective, mono-institutional, open, non-randomized pilot study. Patients who had received neoadjuvant chemotherapy or radiotherapy were excluded. (18) F-fluorodeoxyglucose positron emission tomography-computed tomography in addition to computed tomography was carried out for lymph node staging of bladder cancer before radical cystectomy. Lymph node dissection during radical cystectomy was carried out. Findings from (18) F-fluorodeoxyglucose positron emission tomography-computed tomography and computed tomography were compared with the results of definitive histological examination of the lymph node dissection. The diagnostic performance of the two imaging modalities was assessed and compared. The mean number of lymph nodes removed during lymph node dissection was 16.5 ± 10.9. Lymph node metastasis was confirmed on histological examination in 22 cases (42.3%). This had been suspected in five cases (9.6%) on computed tomography and in 12 cases (23.1%) on (18) F-fluorodeoxyglucose positron emission tomography-computed tomography. Sensitivity, specificity, positive predictive value, negative predictive value, relative risk and accuracy were 9.1%, 90%, 40%, 57.4%, 0.91 and 55.7%, respectively, for computed tomography, and 36.4%, 86.7%, 66.7%, 65%, 2.72, 65.4%, respectively, for (18) F-fluorodeoxyglucose positron emission tomography-computed tomography. (18) F-fluorodeoxyglucose positron emission tomography-computed tomography is more reliable than computed tomography for preoperative lymph node staging in patients with invasive bladder carcinoma undergoing radical cystectomy. © 2012 The Japanese

  12. Recurrent proliferating trichilemmal tumor with malignant change on the f-18 fluorodeoxyglucose position emission tomography/computed tomography

    Energy Technology Data Exchange (ETDEWEB)

    Moon, Eun Ha; Kim, Eun Ha; Kim, Young Jun; Yoo, Seol Bong; Nam, Kyung Hwa [Presbyterian Medical Center, Seonam University College of Medicine, Jeonju (Korea, Republic of)

    2016-06-15

    F-18 fluorodeoxyglucose (FDG) positron emission tomography/computed tomography scan has been used for the diagnosis, assessment of treatment response, and follow-up of various neoplasms. Proliferating trichilemmal cyst or tumor (PTT) is a rare neoplasm, originated from the outer root sheath of a hair follicle. Because this tumor has unpredictable biological and clinical behavior, the long-term clinical follow-up is necessary to detect metastasis or recurrence. We reported a case of recurrent malignant PTT on scalp that showed increased FDG uptake.

  13. 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.

  14. 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

  15. 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)

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

    Directory of Open Access Journals (Sweden)

    William Makis

    2017-10-01

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

  17. Toxoplasmic Lymphadenitis Mimicking a Metastatic Thyroid Carcinoma at 18F-FDG-PET/CT

    International Nuclear Information System (INIS)

    Treglia, Giorgio; Bongiovanni, Massimo; Ceriani, Luca; Paone, Gaetano; Giovanella, Luca

    2013-01-01

    A 28-year-old woman underwent total thyroidectomy for a papillary thyroid carcinoma in the right thyroid lobe (pTx, pN1b). Subsequently a 131 I-ablation (4.4 GBq) was performed. Four years later the patient presented increased thyroglobulin (Tg) serum levels (8.4 μg/l) during thyroxine treatment. Furthermore, enlarged hypoechoic and round-shaped bilateral cervical lymph nodes were detected at cervical ultrasonography (US). Based on laboratory and US findings suspicious for lymph nodal recurrence of thyroid carcinoma, the patient underwent an 18 F-fluorodeoxyglucose positron emission tomography/computed tomography ( 18 F-FDG-PET/CT) to check for distant metastases (Fig. 1). The patient underwent a US-guided fine-needle aspiration cytology on an 18 F-FDG-avid cervical lymph-node. The smears were hypercellulated and consisted of numerous small- to medium-sized lymphocytes, macrophages, dendritic cells and tingible body macrophages. The cytological diagnosis was consistent with that of reactive lymphadenitis. Serological test revealed elevated IgM and IgG anti-Toxoplasma antibodies with a very low IgG-avidity, indicating an acute toxoplasmosis. Serum Tg was then measured by using heterophilic antibody blocking tubes, as previously reported, and serum value dropped to 18 F-FDG-PET/CT in oncological patients. Few reports have described toxoplasmic infection mimicking malignancy at 18 F-FDG-PET/CT; these findings were found mainly in immunodepressive patients or with history of lymphoma. Conversely, we described here a case of toxoplasmosis inducing false-positive Tg measurement, neck US and 18 F-FDG-PET/CT findings in a patient with papillary thyroid carcinoma

  18. Prospective Study of 68Ga-DOTATATE Positron Emission Tomography/Computed Tomography for Detecting Gastro-Entero-Pancreatic Neuroendocrine Tumors and Unknown Primary Sites.

    Science.gov (United States)

    Sadowski, Samira M; Neychev, Vladimir; Millo, Corina; Shih, Joanna; Nilubol, Naris; Herscovitch, Peter; Pacak, Karel; Marx, Stephen J; Kebebew, Electron

    2016-02-20

    Gastro-entero-pancreatic neuroendocrine tumors (GEPNETs) are increasing in incidence, and accurate staging is important for selecting the appropriate treatment. (68)Ga-DOTATATE imaging is a promising approach for detecting GEPNETs and could help in selecting optimal therapeutic strategies. The aim of this study was to prospectively determine the clinical utility of (68)Ga-DOTATATE positron emission tomography (PET)/computed tomography (CT) in detecting unknown primary and metastatic GEPNETs. One hundred thirty-one patients were enrolled in a prospective study of patients undergoing (68)Ga-DOTATATE PET/CT, (111)In-pentetreotide single-photon emission computed tomography (SPECT)/CT and multiphasic CT scan, and/or magnetic resonance imaging in a blinded fashion with comprehensive biochemical testing. The primary outcome measure was the detection of lesions by each imaging study. (68)Ga-DOTATATE PET/CT imaging detected 95.1% of lesions (95% CI, 92.4% to 96.8%) with an average maximum standardized uptake value of 65.4 ± 47 (range, 6.9 to 244), anatomic imaging detected 45.3% of lesions (95% CI, 37.9% to 52.9%), and (111)In-pentetreotide SPECT/CT detected 30.9% of lesions (95% CI, 25.0% to 37.5%), with a significant difference between imaging modalities (P < .001). In four of 14 patients (28.6%), (68)Ga-DOTATATE PET/CT found a previously unknown primary tumor, and detected primary GEPNET, lymph node, and distant metastases correctly in 72 of 113 lesions (63.7%) when compared with histopathology, with 22.1% and 38.9% detected by using (111)In-pentetreotide SPECT/CT and anatomic imaging, respectively. On the basis of findings with (68)Ga-DOTATATE PET/CT, 43 of 131 patients (32.8%) had a change in management recommendation. In patients with carcinoid symptoms but negative biochemical testing, (68)Ga-DOTATATE PET/CT detected lesions in 65.2% of patients, 40% of which were detected neither by anatomic imaging nor by (111)In-pentetreotide SPECT/CT. (68)Ga-DOTATATE PET/CT

  19. Multicentic primary angiosarcoma of bone mimicking metastasis on 18F-FDG PET/CT in a patient with a history of sigmoid colon cancer: A case report

    International Nuclear Information System (INIS)

    Yoo, Min Young; Kim, Seok Ki; Park, Seog Yun; Kwon, Young Mee; Yun, Tak; Kim, Tae Sung; Lee, Eun Seong

    2015-01-01

    Primary angiosarcoma of the bone (PAB) is a rare and fatal high-grade malignant vascular bone tumor. We report a rare case of multicentric PAB mimicking bone metastasis in a 59-year-old female patient with a history of sigmoid colon cancer. This patient complained of lower back and pelvic pain and presented with multiple osteolytic bone lesions on plain radiography and pelvic computed tomography. First, bone metastasis of sigmoid colon cancer was suspected. However, on the 18 F-fluorodeoxyglucose ( 18 F-FDG) positron emission tomography/computed tomography (PET/CT) scan, the patient presented unusual multiple hypermetabolic osteolytic bone lesions involving contiguous bones of the lower half of the body. After bone biopsy, these lesions were confirmed to be multicentric PAB. To the best of our knowledge, this is the first case report of an 18 F-FDG PET/CT scan in a patient with multicentric primary bone angiosarcoma

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

    Science.gov (United States)

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

    2007-01-01

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

  1. 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.

  2. A PET/CT-based strategy is a stronger predictor of survival than a standard imaging strategy in patients with head and neck squamous cell carcinoma

    DEFF Research Database (Denmark)

    Rohde, Max; Nielsen, Anne L; Pareek, Manan

    2018-01-01

    Purpose: To examine whether tumor staging by upfront (18)F-fluoro-deoxy-glucose-positron emission tomography/computed tomography (PET/CT) leads to improved discrimination of survival, when compared with traditionally used imaging strategies based on chest X-ray + head and neck magnetic resonance...... imaging (CXR/MRI) or chest computed tomography + head and neck MRI (CCT/MRI) in patients with head and neck squamous cell carcinoma (HNSCC). Methods: Blinded prospective cohort study based on paired data. Consecutive patients with histologically verified primary HNSCC were recruited at Odense University...

  3. PET/CT applications in oncology

    International Nuclear Information System (INIS)

    Oliva González, Juan Perfecto; Martínez Ramírez, Aldo; Baum, Richard Paul

    2017-01-01

    PET means Positron Emission Tomography, it is a nuclear medicine technique in which radiopharmaceuticals labeled with positron emitters are used to obtain biochemical-metabolic images of the human body. The use of PET / CT contributes to obtain multimodal images that combine anatomical and metabolic information, allowing a more reliable diagnosis of a tumor or local or distant metastases in an organ or tissue. Other multimodal devices combine metabolic imaging with nuclear magnetic resonance. PET/CT is mainly used in Oncology (85-90%), Neurology, Cardiology, Inflammation and Infection although it is currently also used in different medical and surgical pathologies. The present work is aimed at showing what PET/CT is and how useful it is in Oncology. (author)

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2011-12-15

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

  5. Differentiation and diagnosis of benign and malignant testicular lesions using 18F-FDG PET/CT.

    Science.gov (United States)

    Shao, Dan; Gao, Qiang; Tian, Xu-Wei; Wang, Si-Yun; Liang, Chang-Hong; Wang, Shu-Xia

    2017-08-01

    The purpose of this study was to evaluate the differential diagnostic value of 18 F-fluorodeoxy glucose positron emission tomography/computed tomography ( 18 F-FDG PET/CT) for benign and malignant testicular lesions. The PET/CT scans of 53 patients with testicular lesions confirmed by biopsy or surgical pathology were retrospectively analyzed. There were 32 cases of malignant tumors and 21 cases of benign lesions. Differences in the maximum standardized uptake value (SUVmax) measurements and the SUVmax lesion/background ratios between benign and malignant lesions were analyzed. The diagnostic value of this PET/CT modality for the differential diagnosis of benign versus malignant testicular lesions was calculated. The differences in the SUVmax measurements and the SUVmax lesion/background ratios between benign and malignant lesions were statistically significant (SUVmax: Z=-4.295, p=0.000; SUVmax lesion/background ratio: Z=-5.219, p=0.000); specifically, both of these indicators were higher in malignant lesions compared to benign lesions. An SUVmax of 3.75 was the optimal cutoff value to differentiate between benign and malignant testicular lesions. The diagnostic sensitivity, specificity, accuracy, positive predictive value, and negative predictive value of this PET/CT modality in the differential diagnosis of benign versus malignant testicular lesions were 90.6%, 80.9%, 86.8%, 87.9%, and 85.0%, respectively. 18 F-FDG PET/CT can accurately identify benign and malignant testicular lesions. Copyright © 2017 Elsevier B.V. All rights reserved.

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

    International Nuclear Information System (INIS)

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

    2018-01-01

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