WorldWideScience

Sample records for underwent pet scans

  1. Brain PET scan

    Science.gov (United States)

    ... results on a PET scan. Blood sugar or insulin levels may affect the test results in people with diabetes . PET scans may be done along with a CT scan. This combination scan is called a PET/CT. Alternative Names Brain positron emission tomography; PET scan - brain References Chernecky ...

  2. PET scan

    Science.gov (United States)

    ... The PET detects signals from the tracer. A computer changes the signals into 3D pictures. The images ... M. is also a founding member of Hi-Ethics and subscribes to the principles of the Health ...

  3. Heart PET scan

    Science.gov (United States)

    ... nuclear medicine scan; Heart positron emission tomography; Myocardial PET scan ... A PET scan requires a small amount of radioactive material (tracer). This tracer is given through a vein (IV), ...

  4. Model PET Scan Activity

    Science.gov (United States)

    Strunk, Amber; Gazdovich, Jennifer; Redouté, Oriane; Reverte, Juan Manuel; Shelley, Samantha; Todorova, Vesela

    2018-05-01

    This paper provides a brief introduction to antimatter and how it, along with other modern physics topics, is utilized in positron emission tomography (PET) scans. It further describes a hands-on activity for students to help them gain an understanding of how PET scans assist in detecting cancer. Modern physics topics provide an exciting way to introduce students to current applications of physics.

  5. PET scanning in plastic and reconstructive surgery.

    Science.gov (United States)

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

    2012-02-01

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

  6. PET scan as a functional diagnostic tool

    International Nuclear Information System (INIS)

    Kyogoku, Shinsuke; Ogawa, Shoichi; Amano, Maki

    2007-01-01

    Morphological diagnostic imaging, such as computed tomography (CT) and magnetic resonance imaging (MRI) have undergone rapid development of hardware and imaging technique. However, these imaging modalities have some limitations in determining whether lymph node swelling is malignant or benign. It is difficult for the radiologist and physician to differentiate malignant lesion from benign lesion based solely on lymph node size. Mass media has sensationalized the efficacy of positron emission tomography (PET) scan. PET scans have now become a well-known medical examination among the general public. The ministry of health, labor and welfare approved F-18 fluorodeoxyglucose (FDG) as a commercially available isotope in 2005 and PET centers have rapidly spread in Japan. PET scan is considered a breakthrough in cancer detection, as a functional diagnostic tool. This article discusses simple methods and isotopes for PET scan and the diseases for which FDG-PET scan is covered by the medical insurance system. The preparation and workflow of FDG-PET examination are also discussed. Finally, I describe the usefulness of FDG-PET scan using an illustrative case presentation. (author)

  7. PET scanning in plastic and reconstructive surgery

    International Nuclear Information System (INIS)

    Eirini, L.; Emmanouil, L.; Othonas, P.; Hans-Guenther, M.; Nikolaos, P.A.

    2012-01-01

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

  8. PET scan and radiation protection

    International Nuclear Information System (INIS)

    Montoya, F.; Lahmi, A.; Rousseau, A.

    2006-01-01

    The purpose was the optimization of the radiation protection during examinations with 18 F-FDG, The immediate validation by the D.G.S.N.R., the results of dosimetry (h.p.10 = 12 μ sievert (average value/ technician / day for 6 patients) demonstrate the efficiency of the implemented means. From the very beginning, the installation of a PET-scanner requires a multidisciplinary conception. This essential thought contributes to an optimal radiation protection of the entire personnel of the service. (N.C.)

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

    International Nuclear Information System (INIS)

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

    1998-01-01

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

  10. Incidental detection of colorectal lesions by FDG PET/CT scans in melanoma patients.

    Science.gov (United States)

    Young, Christopher J; Zahid, Assad; Choy, Ian; Thompson, John F; Saw, Robyn P M

    2017-11-01

    Increased use of PET/CT scans in oncology patients has raised detection of Colorectal incidentalomas (CIs). The frequency and diagnostic outcomes of identifying these lesions in melanoma patients have not previously been studied. This studies primary objective was to determine the prevalence of CIs found on PET/CT scans in melanoma patients. The secondary objectives were to correlate the PET/CT findings with the pathology found at colonoscopy, and identify which patients were referred for colonoscopy. A retrospective analysis of patients identified from the prospectively collected research database of Melanoma Institute Australia. 2509 patients with melanoma underwent PET/CT scans between 2001 and 2013. The prevalence of CIs, the correlation of lesions, and the survival of patients who underwent colonoscopy versus patients who did not were analyzed. The prevalence of CIs in melanoma patients who had PET/CT scans was 3.2%. Forty-five of the 81 (56%) patients with CIs underwent colonoscopy. Of these, premalignant or malignant disease was found in 58%. Patients with previous metastatic melanoma were significantly less likely to be referred for colonoscopy. Patients undergoing colonoscopy had significantly better survival, as did those without previous distant metastases before the CIs were found, and those without any metastases at the time the CIs were found. These factors were not significant on multivariate analysis. The prevalence of incidental colorectal lesions identified on PET/CT scans in melanoma patients was found to be equivalent to that in the general cancer population. Patients undergoing colonoscopy had better survival than those who did not. Copyright © 2017 Elsevier Ltd, BASO ~ The Association for Cancer Surgery, and the European Society of Surgical Oncology. All rights reserved.

  11. Guidance for reading FDG PET scans in dementia patients

    International Nuclear Information System (INIS)

    Herholz, K.

    2014-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Adeeb Majid

    2013-01-01

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

  13. Functional imaging in differentiating bronchial masses: an initial experience with a combination of (18)F-FDG PET-CT scan and (68)Ga DOTA-TOC PET-CT scan.

    Science.gov (United States)

    Kumar, Arvind; Jindal, Tarun; Dutta, Roman; Kumar, Rakesh

    2009-10-01

    To evaluate the role of combination of (18)F-FDG PET-CT scan and (68)Ga DOTA-TOC PET-CT scan in differentiating bronchial tumors observed in contrast enhanced computed tomography scan of chest. Prospective observational study. Place of study: All India Institute of Medical Sciences, New Delhi, India. 7 patients with bronchial mass detected in computed tomography scan of the chest were included in this study. All patients underwent (18)F-FDG PET-CT scan, (68)Ga DOTA-TOC PET-CT scan and fiberoptic bronchoscope guided biopsy followed by definitive surgical excision. The results of functional imaging studies were analyzed and the results are correlated with the final histopathology of the tumor. Histopathological examination of 7 bronchial masses revealed carcinoid tumors (2 typical, 1 atypical), inflammatory myofibroblastic tumor (1), mucoepidermoid carcinoma (1), hamartoma (1), and synovial cell sarcoma (1). The typical carcinoids had mild (18)F-FDG uptake and high (68)Ga DOTA-TOC uptake. Atypical carcinoid had moderate uptake of (18)F-FDG and high (68)Ga DOTA-TOC uptake. Inflammatory myofibroblastic tumor showed high uptake of (18)F-FDG and no uptake of (68)Ga DOTA-TOC. Mucoepidermoid carcinoma showed mild (18)F-FDG uptake and no (68)Ga DOTA-TOC uptake. Hamartoma showed no uptake on either scans. Synovial cell sarcoma showed moderate (18)F-FDG uptake and mild focal (68)Ga DOTA-TOC uptake. This initial experience with the combined use of (18)F-FDG and (68)Ga DOTA-TOC PET-CT scan reveals different uptake patterns in various bronchial tumors. Bronchoscopic biopsy will continue to be the gold standard; however, the interesting observations made in this study merits further evaluation of the utility of the combination of (18)F-FDG PET-CT scan and (68)Ga DOTA-TOC PET-CT scan in larger number of patients with bronchial masses.

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

    International Nuclear Information System (INIS)

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

    2007-01-01

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

  15. PET and paediatrics; La tomographie par emission de positons (ou PET scan) en pediatrie

    Energy Technology Data Exchange (ETDEWEB)

    Boddaert, N. [Necker Enfants Malades, AP-HP, Serv Radiol Pediat, Paris (France); Ribeiro, M.J. [CEA, DSV, I2BM, Serv Hosp Frederic Joliot, F-91406 Orsay (France)

    2008-07-01

    Positon emission tomography (PET scan) is a functional imagery technique.As in scintigraphy, a radioactive tracer is administrated to the patient and its distribution into the organism is detected by a tomograph or a PET scanner. The nuclear medicine techniques which use radioactive tracers allow to obtain an imagery of the regional metabolism of glucose, blood flow or of different neurotransmitters. The PET-TDM (tomodensitometry) is an hybrid imagery system which associates a PET to a multi-bars scanner (4 to 64 bars). The use of hybrid imagery systems allows an anatomic register of the metabolic anomalies or others, as well as the adjustment of the attenuation of the emitted particles. (O.M.)

  16. Adapted Treatment Guided by Interim PET-CT Scan in Advanced Hodgkin's Lymphoma.

    Science.gov (United States)

    Johnson, Peter; Federico, Massimo; Kirkwood, Amy; Fosså, Alexander; Berkahn, Leanne; Carella, Angelo; d'Amore, Francesco; Enblad, Gunilla; Franceschetto, Antonella; Fulham, Michael; Luminari, Stefano; O'Doherty, Michael; Patrick, Pip; Roberts, Thomas; Sidra, Gamal; Stevens, Lindsey; Smith, Paul; Trotman, Judith; Viney, Zaid; Radford, John; Barrington, Sally

    2016-06-23

    We tested interim positron-emission tomography-computed tomography (PET-CT) as a measure of early response to chemotherapy in order to guide treatment for patients with advanced Hodgkin's lymphoma. Patients with newly diagnosed advanced classic Hodgkin's lymphoma underwent a baseline PET-CT scan, received two cycles of ABVD (doxorubicin, bleomycin, vinblastine, and dacarbazine) chemotherapy, and then underwent an interim PET-CT scan. Images were centrally reviewed with the use of a 5-point scale for PET findings. Patients with negative PET findings after two cycles were randomly assigned to continue ABVD (ABVD group) or omit bleomycin (AVD group) in cycles 3 through 6. Those with positive PET findings after two cycles received BEACOPP (bleomycin, etoposide, doxorubicin, cyclophosphamide, vincristine, procarbazine, and prednisone). Radiotherapy was not recommended for patients with negative findings on interim scans. The primary outcome was the difference in the 3-year progression-free survival rate between randomized groups, a noninferiority comparison to exclude a difference of 5 or more percentage points. A total of 1214 patients were registered; 937 of the 1119 patients (83.7%) who underwent an interim PET-CT scan according to protocol had negative findings. With a median follow-up of 41 months, the 3-year progression-free survival rate and overall survival rate in the ABVD group were 85.7% (95% confidence interval [CI], 82.1 to 88.6) and 97.2% (95% CI, 95.1 to 98.4), respectively; the corresponding rates in the AVD group were 84.4% (95% CI, 80.7 to 87.5) and 97.6% (95% CI, 95.6 to 98.7). The absolute difference in the 3-year progression-free survival rate (ABVD minus AVD) was 1.6 percentage points (95% CI, -3.2 to 5.3). Respiratory adverse events were more severe in the ABVD group than in the AVD group. BEACOPP was given to the 172 patients with positive findings on the interim scan, and 74.4% had negative findings on a third PET-CT scan; the 3-year progression

  17. Adapted Treatment Guided by Interim PET-CT Scan in Advanced Hodgkin’s Lymphoma

    Science.gov (United States)

    Johnson, Peter; Federico, Massimo; Kirkwood, Amy; Fosså, Alexander; Berkahn, Leanne; Carella, Angelo; d’Amore, Francesco; Enblad, Gunilla; Franceschetto, Antonella; Fulham, Michael; Luminari, Stefano; O’Doherty, Michael; Patrick, Pip; Roberts, Thomas; Sidra, Gamal; Stevens, Lindsey; Smith, Paul; Trotman, Judith; Viney, Zaid; Radford, John; Barrington, Sally

    2016-01-01

    Background We tested interim positron-emission tomography–computed tomography (PET-CT) as a measure of early response to chemotherapy in order to guide treatment for patients with advanced Hodgkin’s lymphoma. Methods Patients with newly diagnosed advanced classic Hodgkin’s lymphoma underwent a baseline PET-CT scan, received two cycles of ABVD (doxorubicin, bleomycin, vinblastine, and dacarbazine) chemotherapy, and then underwent an interim PET-CT scan. Images were centrally reviewed with the use of a 5-point scale for PET findings. Patients with negative PET findings after two cycles were randomly assigned to continue ABVD (ABVD group) or omit bleomycin (AVD group) in cycles 3 through 6. Those with positive PET findings after two cycles received BEACOPP (bleomycin, etoposide, doxorubicin, cyclophosphamide, vincristine, procarbazine, and prednisone). Radiotherapy was not recommended for patients with negative findings on interim scans. The primary outcome was the difference in the 3-year progression-free survival rate between randomized groups, a noninferiority comparison to exclude a difference of 5 or more percentage points. Results A total of 1214 patients were registered; 937 of the 1119 patients (83.7%) who underwent an interim PET-CT scan according to protocol had negative findings. With a median follow-up of 41 months, the 3-year progression-free survival rate and overall survival rate in the ABVD group were 85.7% (95% confidence interval [CI], 82.1 to 88.6) and 97.2% (95% CI, 95.1 to 98.4), respectively; the corresponding rates in the AVD group were 84.4% (95% CI, 80.7 to 87.5) and 97.6% (95% CI, 95.6 to 98.7). The absolute difference in the 3-year progression-free survival rate (ABVD minus AVD) was 1.6 percentage points (95% CI, −3.2 to 5.3). Respiratory adverse events were more severe in the ABVD group than in the AVD group. BEACOPP was given to the 172 patients with positive findings on the interim scan, and 74.4% had negative findings on a third

  18. Impact of 18F-FDG PET scan on the prevalence of benign thoracic lesions at surgical resection

    Directory of Open Access Journals (Sweden)

    Kamlesh Mohan

    2011-10-01

    Full Text Available OBJECTIVE: The main utility of 18-fluorodeoxyglucose positron emission tomography (FDG-PET lies in the staging of lung cancer. However, it can also be used to differentiate indeterminate pulmonary lesions, but its impact on the resection of benign lesions at surgery is unknown. The aim of this study was to compare the prevalence of benign lesions at thoracotomy carried out for suspected lung cancer, before and after the introduction of PET scanning in a large thoracic surgical centre. MATERIALS AND METHODS: We reviewed our prospectively recorded surgical database for all consecutive patients undergoing thoracotomy for suspected or proven lung cancer and compared the prevalence of benign lesions in 2 consecutive 2-year groups, before (group I and after (group II the introduction of FDG-PET scan respectively. RESULTS: Surgical resection was performed on 1233 patients during the study period. The prevalence of benign lesions at surgery in groups I and II was similar (44/626 and 41/607, both 7%, and also in group II between those who underwent FDG-PET scan and the remainder (21/301 and 20/306 respectively, both 7%. In group II, of the 21 patients with benign lesions, who underwent FDG-PET, 19 had a false positive scan (mean standardised uptake value 5.3 [range 2.6-12.7]. Of these, 13 and 4 patients respectively had non-diagnostic bronchoscopy and percutaneous transthoracic lung biopsy pre thoracotomy. There was no difference in the proportion of different benign lesions resected between group I and those with FDG-PET in group II. CONCLUSION: The introduction of FDG-PET scanning has not altered the proportion of patients undergoing thoracotomy for ultimately benign lesions, mainly due to the avidity for the isotope of some non-malignant lesions. Such false positive results need to be considered when patients with unconfirmed lung cancer are contemplated for surgical resection.

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

    International Nuclear Information System (INIS)

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

    1998-01-01

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

  20. Joint accumulations of FDG in whole body PET scans

    Energy Technology Data Exchange (ETDEWEB)

    Schulthess, G.K. von; Meier, N.; Stumpe, K.D.M. [Dept. of Medical Radiology: Nuclear Medicine, Univ. Hospital of Zurich (Switzerland)

    2001-12-01

    Purpose: To retrospectively evaluate FDG accumulations in major joints in a large series of non-absorption corrected partial body and whole body FDG-PET scans, and to determine the frequency and intensity of accumulation. Materials and methods: 354 consecutive PET partial- and whole body non-transmission corrected scans of patients obtained for tumor staging were examined with respect to FDG accumulations in the acromio-clavicular (AC)-, gleno-humeral-, hip,, knee- and talo-tibial joints. FDG-uptake was graded using a semi-quantitative scale from 0 (no accumulation) to 4 (very strong accumulation comparable to brain uptake). Results: Joint activity of grade 1-2 was noted frequently, while grade 3 was rare, occurring only in the knee and shoulder joints, and grade 4 was inexistent. The 43 patients with grade 3 accumulations or with at least 4 joints showing grade 2 uptake were interviewed, but all denied pain specifically referred to a joint. Joint accumulations were seen in 50% of the acromio-clavicular-, 80% in the gleno-humeral-, 50% in the hip-, 90% in the knee and 80% in the talo-tibial joints. The intensities of joint accumulations correlated positively and significantly with patient age, ranging from r = 0.7 and p <0.05 in the knee to r = 0.96 and p <0.0001 in the AC joint. Conclusions: FDG accumulations in the joints in whole body FDG-PET scans are frequent and are very likely not related to symptoms. As there is a strong age correlation, and FDG is known to accumulate in inflammatory lesions, the findings are most likely a result of sub-clinical inflammatory synovial proliferation or other chronic inflammatory processes occurring in aging joints. (orig.)

  1. ¹⁸F-FDG PET/CT and Colorectal Cancer: Value of Fourth and Subsequent Posttherapy Follow-up Scans for Patient Management.

    Science.gov (United States)

    Marcus, Charles; Marashdeh, Wael; Ahn, Se Jin; Taghipour, Mehdi; Subramaniam, Rathan M

    2015-07-01

    The purpose of this study was to evaluate the added value of a fourth and subsequent follow-up PET/CT scans to clinical assessment and impact on patient management in patients with colorectal cancer. This was an institutional review board-approved, retrospective study. Eight hundred twenty-two patients with biopsy-proven colorectal cancer, who underwent (18)F-FDG PET/CT, were identified from 2000 to 2012. Among these, 73 (8.9%) patients underwent 4 or more follow-up PET/CT scans, with a total of 313 fourth and subsequent follow-up PET/CT scans. Median follow-up from the fourth follow-up PET/CT scan was 41.7 mo. The added value of each follow-up PET/CT scan, for clinical assessment and the treatment changes subsequent to each follow-up PET/CT scan, was established. Overall survival prediction was established using Kaplan-Meier plots with a Mantel-Cox log-rank test. Of the 313 fourth and subsequent follow-up PET/CT scans, 174 (55.6%) were interpreted as positive and 139 (44.4%) were interpreted as negative for recurrence or metastases. Thirty-four (46.6%) patients died during the study period. PET/CT identified recurrence or metastasis in 40.0% of scans obtained without prior clinical suspicion and ruled out disease in 23.6% of scans obtained with prior clinical suspicion. The PET/CT scan resulted in treatment change after 34.2% (107/313) of the scans. New treatment was initiated after 24.0% (75/313) of the scans, and treatment was changed after 8.0% (25/313) scans. There was a statistically significant difference in the overall survival between patients with a positive and all negative fourth and subsequent follow-up PET/CT scans at the patient level (log-rank, P = 0.001). The fourth and subsequent (18)F-FDG PET/CT scans obtained after primary treatment completion add value to clinical assessment and the management plan and provide prognostic information in patients with colorectal cancer. © 2015 by the Society of Nuclear Medicine and Molecular Imaging, Inc.

  2. Utility of FDG-PET-CT scanning in assessing the extent of disease activity and response to treatment in sarcoidosis

    Directory of Open Access Journals (Sweden)

    Randeep Guleria

    2014-01-01

    Full Text Available Background: Radionuclide imaging modalities have increasingly been evaluated in the assessment of organ involvement in sarcoidosis. Fluoro-deoxyglucose positron emission tomography-computed tomography (FDG-PET-CT scanning has received increasing attention in the recent years. The aim of our study was to evaluate the utility of FDG-PET-CT in determining the extent of organ involvement and disease activity in patients of sarcoidosis and to assess its utility in the evaluation of response to therapy. The secondary objective was to compare the agreement between clinical, radiological (HRCT and metabolic indices (FDG-PET-CT of disease activity. Materials and Methods: This was a prospective observational study conducted between March 2007 and December 2008 at a tertiary care referral center in north India. Twenty-five symptomatic and histopathologically proven cases of sarcoidosis underwent FDG-PET-CT scanning at baseline and a follow-up scan in 21 patients at 6-9 months post-treatment with glucocorticoids. Results: FDG-PET-CT scan detected metabolic disease activity in 24 of the 25 patients with clinically active sarcoidosis. It also demonstrated many clinically inapparent sites of disease activity. Complete or partial metabolic response was seen in 17 of the 21 patients in whom a follow-up scan was available. Substantial degree of agreement was found between the metabolic response and the radiological response, whereas moderate agreement was found between clinical and metabolic responses. Conclusions: FDG-PET-CT scanning is a useful imaging modality to assess disease activity, extent of disease involvement and response to treatment in clinically active sarcoidosis. There is substantial agreement between the HRCT and metabolic parameters of disease activity. Further, large sample size studies are proposed in order to identify the subset of patients who are likely to benefit the most from this sensitive modality of imaging, especially in developing

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

    Science.gov (United States)

    Awan, Umm-e-kalsoom; Siddiqui, Neelam; SaadUllah, Mohammad; Bashir, Humayun; Farooqui, Zia Salman; Muzaffar, Narjis; Mahmmood, Mohammad Tariq

    2013-06-01

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

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

    International Nuclear Information System (INIS)

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

    2005-01-01

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

  5. Convexity Subarachnoid Hemorrhage with PiB Positive Pet Scans: Clinical Features and Prognosis.

    Science.gov (United States)

    Ly, John V; Singhal, Shaloo; Rowe, Christopher C; Kempster, Peter; Bower, Simon; Phan, Thanh G

    2015-01-01

    Cerebral amyloid angiopathy (CAA) has been reported to present as convexity subarachnoid hemorrhage (cSAH). Lesser known is that cSAH can herald intracerebral hemorrhage (ICH) and ischemic lesions. We present seven new cases with (11) C-Pittsburgh compound B (PiB) positive positron emission tomography (PET) scans including two with biopsy, review the literature and comment on clinical and radiological findings. Patients with cSAH identified on CT, underwent MR imaging and MR angiography to exclude intracranial aneurysm. Nonaneurysmal cSAH were further prospectively evaluated for amyloid angiopathy using PiB. Clinical and radiological features of cSAH, subsequent ICH and ischemic lesions were characterized. Seven patients with nonaneurysmal cSAH fulfilled the Boston criteria for probable CAA. All had PiB PET scans consistent with CAA. Of the 4 patients who had contrast MR Imaging all had enhancement overlying the cSAH, followed by ICH in three cases. All patients presented with transient sensory symptoms. All patients had small punctate subcortical and cortical infarcts on diffusion-weighted MR imaging. Literature review revealed subsequent ICH in approximately 11/79 patients. The finding of cSAH and PiB binding in our patients suggest underlying CAA. cSAH may be associated with ischemic lesion as well as future ICH occurrence. Copyright © 2014 by the American Society of Neuroimaging.

  6. Role of -FDG PET Scan in Rheumatoid Lung Nodule: Case Report and Review of the Literature

    Directory of Open Access Journals (Sweden)

    Christine L. Chhakchhuak

    2013-01-01

    Full Text Available Flourine-18 fluoro-2-deoxy-glucose (18F-FDG positron emission tomography combined with computed tomography (PET/CT is a useful test for the management of malignant conditions. Inflammatory and infectious processes, however, can cause increased uptake on PET scanning, often causing diagnostic dilemmas. This knowledge is important to the rheumatologist not only because of the inflammatory conditions we treat but also because certain rheumatic diseases impose an increased risk of malignancy either due to the disease itself or as a consequence of medications used to treat the rheumatic diseases. There is an increasing body of evidence investigating the role of PET scans in inflammatory conditions. This paper describes a patient with rheumatoid arthritis who developed pulmonary nodules that showed increased uptake on PET/CT scan and reviews the use of PET scanning in the diagnosis and management of rheumatoid arthritis.

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

    Energy Technology Data Exchange (ETDEWEB)

    Kundu, Parveen; Lata, Sneh; Sharma, Punit; Singh, Harmandeep; Malhotra, Arun; Bal, Chandrasekhar [All India Institute of Medical Sciences, Department of Nuclear Medicine, Ansari Nagar, New Delhi (India)

    2014-07-15

    The purpose of the study was to evaluate the role of {sup 68}Ga-DOTANOC PET-CT in differentiated thyroid cancer (DTC) patients with negative {sup 131}I-whole body scan (WBS) along with serially increasing serum thyroglobulin (Tg), and compare the same with {sup 18}F-FDG PET-CT. Sixty two DTC patients with serially rising Tg levels and negative {sup 131}I-WBS were prospectively enrolled. All patients underwent {sup 68}Ga-DOTANOC PET-CT and {sup 18}F-FDG PET-CT within an interval of two weeks. PET-CT analysis was done on a per-patient basis, location wise and lesion wise. All PET-CT lesions were divided into four categories-local, nodal, pulmonary and skeletal. Histopathology and/or serial serum Tg level, clinical and imaging follow up (minimum-1 year) were used as a reference standard. Ga-DOTANOC PET-CT demonstrated disease in 40/62 (65 %) patients and {sup 18}F-FDG PET-CT in 45/62 (72 %) patients, with no significant difference on McNemar analysis (p = 0.226). Per-patient sensitivity and specificity of {sup 68}Ga-DOTANOC PET-CT was 78.4 %, 100 %, and for {sup 18}F-FDG PET-CT was 86.3 %, 90.9 %, respectively. Out of 186 lesions detected by both PET-CTs, 121/186 (65 %) lesions were seen on {sup 68}Ga-DOTANOC PET-CT and 168/186 (90.3 %) lesions on {sup 18}F-FDG PET-CT (p < 0.0001). There were 103/186 (55 %) lesions concordant on both. Excellent agreement was noted between {sup 68}Ga-DOTANOC PET-CT and {sup 18}F-FDG PET-CT for detection of local disease (k = 0.92), while moderate agreement was noted for nodal and pulmonary disease (k = 0.67). {sup 68}Ga-DOTANOC PET-CT changed management in 21/62 (34 %) patients and {sup 18}F-FDG PET-CT in 17/62 (27 %) patients. Ga-DOTANOC PET-CT is inferior to {sup 18}F-FDG PET-CT on lesion based but not on patient based analysis for detection of recurrent/residual disease in DTC patients with negative WBS scan and elevated serum Tg levels. It can also help in selection of potential candidates for peptide receptor radionuclide therapy

  8. Forced diuresis and dual-phase 18F-fluorodeoxyglucose-PET/CT scan for restaging of urinary bladder cancers

    International Nuclear Information System (INIS)

    Harkirat, S; Anand, SS; Jacob, MJ

    2010-01-01

    The results of 18 F-fluorodeoxyglucose (FDG)-PET imaging carried out with the current standard techniques for assessment of urinary tract cancers have been reported to be less than satisfactory because of the urinary excretion of the tracer. To investigate the role of dual-phase FDG-PET/CT in the restaging of invasive cancers of the urinary bladder, with delayed imaging after forced diuresis and oral hydration as the scanning protocol. FDG-PET has been considered to be of limited value for the detection of urinary tract cancers because of interference by the FDG excreted in urine. We investigated the efficacy of delayed FDG-PET/CT in the restaging of invasive bladder cancer, with imaging performed after intravenous (IV) administration of a potent diuretic and oral hydration. Twenty-nine patients with invasive cancer of the urinary bladder were included in this study. Patients were divided into two groups: Group I (22 patients) included cases with invasive bladder cancer who had not undergone cystectomy and group II (seven patients) included cases with invasive bladder cancer who had undergone cystectomy and urinary diversion procedure. All patients underwent FDG-PET/CT scan from the skull base to the mid-thighs 60 min after IV injection of 370 mega-Becquerel (MBq) of FDG. Additional delayed images were acquired 60-90 min after IV furosemide and oral hydration. PET/CT data were analyzed as PET and CT images studied separately as well as fused PET/CT images and the findings were recorded. The imaging findings were confirmed by cystoscopy, biopsy or follow-up PET/CT. The technique was successful in achieving adequate washout of urinary FDG and overcame the problems posed by the excess FDG in the urinary tract. Hypermetabolic lesions could be easily detected by PET and precisely localized to the bladder wall, perivesical region and pelvic lymph nodes. PET/CT delayed images were able to demonstrate 16 intravesical lesions (in 13 patients), with excellent clarity. Lymph

  9. Technical Considerations on Scanning and Image Analysis for Amyloid PET in Dementia.

    Science.gov (United States)

    Akamatsu, Go; Ohnishi, Akihito; Aita, Kazuki; Ikari, Yasuhiko; Yamamoto, Yasuji; Senda, Michio

    2017-01-01

    Brain imaging techniques, such as computed tomography (CT), magnetic resonance imaging (MRI), single photon emission computed tomography (SPECT), and positron emission tomography (PET), can provide essential and objective information for the early and differential diagnosis of dementia. Amyloid PET is especially useful to evaluate the amyloid-β pathological process as a biomarker of Alzheimer's disease. This article reviews critical points about technical considerations on the scanning and image analysis methods for amyloid PET. Each amyloid PET agent has its own proper administration instructions and recommended uptake time, scan duration, and the method of image display and interpretation. In addition, we have introduced general scanning information, including subject positioning, reconstruction parameters, and quantitative and statistical image analysis. We believe that this article could make amyloid PET a more reliable tool in clinical study and practice.

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

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Jong Hoon

    1998-12-01

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

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

    International Nuclear Information System (INIS)

    Kim, Jong Hoon

    1998-12-01

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

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

    International Nuclear Information System (INIS)

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

    2013-01-01

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

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

    DEFF Research Database (Denmark)

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

    2007-01-01

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

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

    International Nuclear Information System (INIS)

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

    2005-01-01

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

  15. Partial-Volume Effect Correction Improves Quantitative Analysis of 18F-Florbetaben β-Amyloid PET Scans.

    Science.gov (United States)

    Rullmann, Michael; Dukart, Juergen; Hoffmann, Karl-Titus; Luthardt, Julia; Tiepolt, Solveig; Patt, Marianne; Gertz, Hermann-Josef; Schroeter, Matthias L; Seibyl, John; Schulz-Schaeffer, Walter J; Sabri, Osama; Barthel, Henryk

    2016-02-01

    Neocortical atrophy reduces PET signal intensity, potentially affecting the diagnostic efficacy of β-amyloid (Aβ) brain PET imaging. This study investigated whether partial-volume effect correction (PVEC), adjusting for this atrophy bias, improves the accuracy of (18)F-florbetaben Aβ PET. We analyzed (18)F-florbetaben PET and MRI data obtained from 3 cohorts. The first was 10 patients with probable Alzheimer disease (AD) and 10 age-matched healthy controls (HCs), the second was 31 subjects who underwent in vivo imaging and postmortem histopathology for Aβ plaques, and the third was 5 subjects who underwent PET and MRI at baseline and 1 y later. The imaging data were coregistered and segmented. PVEC was performed using the voxel-based modified Müller-Gärtner method (PVELab, SPM8). From the PET data, regional and composite SUV ratios (SUVRs) with and without PVEC were obtained. In the MRI data, mesial temporal lobe atrophy was determined by the Scheltens mesial temporal atrophy scale and gray matter volumes by voxel-based morphometry. In cohort 1, PVEC increased the effect on AD-versus-HC discrimination from a Cohen d value of 1.68 to 2.0 for composite SUVRs and from 0.04 to 1.04 for mesial temporal cortex SUVRs. The PVEC-related increase in mesial temporal cortex SUVR correlated with the Scheltens score (r = 0.84, P < 0.001), and that of composite SUVR correlated with the composite gray matter volume (r = -0.75, P < 0.001). In cohort 2, PVEC increased the correlation coefficient between mesial temporal cortex SUVR and histopathology score for Aβ plaque load from 0.28 (P = 0.09) to 0.37 (P = 0.03). In cohort 3, PVEC did not affect the composite SUVR dynamics over time for the Aβ-negative subject. This finding was in contrast to the 4 Aβ-positive subjects, in 2 of whom PVEC changed the composite SUVR dynamics. The influence of PVEC on (18)F-florbetaben PET data is associated with the degree of brain atrophy. Thus, PVEC increases the ability of (18)F

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

    International Nuclear Information System (INIS)

    Bartholomeusz, Dylan; Schultz, Christopher

    2009-01-01

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

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

    Science.gov (United States)

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

    2013-03-05

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

  18. Estimation of absorbed dose of radiosensitive organs and effective sose in patients underwent abdominopelvic spiral CT scan using impact CT patient dosimetry

    Directory of Open Access Journals (Sweden)

    Ayoub Amirnia

    2017-05-01

    Full Text Available Background: Due to the presence of radiosensitive organs in the abdominopelvic region and increasing the number of requests for CT scan examinations, concerns about increasing radiation doses in patients has been greatly elevated. Therefore, the goal of this study was to determine the absorbed dose of radiosensitive organs and the effective dose in patients underwent abdominopelvic CT scan using ImPACT CT patient dosimetry Calculator (version 1.0.4, Imaging Performance Assessment on Computed Tomography, www.impactscan.org. Methods: This prospective cross-sectional study was conducted in Imam Reza Hospital from November to February 2015 February 2015 in the Imam Reza Hospital, in Urmia, Iran. The demographic and dosimetric information of 100 patients who underwent abdominopelvic CT scan in a 6-slice CT scanner were obtained through the data collection forms. The demographic data of the patients included age, weight, gender, and BMI. The dosimetric parameters included pitch value, CT dose volume index (CTDIvol, dose-length product (DLP, tube voltage, tube current, exposure time, collimation size, scan length, and scan time. To determine the absorbed dose of radiosensitive organs and also the effective dose in patients, ImPACT CT patient dosimetry calculator was used. Results: The results of this study demonstrated that the mean and standard deviation (SD of patients' effective dose in abdominopelvic CT scan was 4.927±0.164 mSv. The bladder in both genders had the greatest mean organ dose, which was 64.71±17.15 mGy for men and 77.56±18.48 mGy for women (P<0.001. Conclusion: The effective dose values of this examination are in the same range as previous studies, as well as International Commission on Radiological Protection (ICRP recommendations. However, the radiation dose from CT scan has the largest contribution to the medical imaging. According to the ALARA principle, it is recommended that the scan parameters, especially mAs, should be

  19. Metal Artifact Reduction of CT Scans to Improve PET/CT.

    Science.gov (United States)

    van der Vos, Charlotte S; Arens, Anne I J; Hamill, James J; Hofmann, Christian; Panin, Vladimir Y; Meeuwis, Antoi P W; Visser, Eric P; de Geus-Oei, Lioe-Fee

    2017-11-01

    In recent years, different metal artifact reduction methods have been developed for CT. These methods have only recently been introduced for PET/CT even though they could be beneficial for interpretation, segmentation, and quantification of the PET/CT images. In this study, phantom and patient scans were analyzed visually and quantitatively to measure the effect on PET images of iterative metal artifact reduction (iMAR) of CT data. Methods: The phantom consisted of 2 types of hip prostheses in a solution of 18 F-FDG and water. 18 F-FDG PET/CT scans of 14 patients with metal implants (either dental implants, hip prostheses, shoulder prostheses, or pedicle screws) and 68 Ga-labeled prostate-specific membrane antigen ( 68 Ga-PSMA) PET/CT scans of 7 patients with hip prostheses were scored by 2 experienced nuclear medicine physicians to analyze clinical relevance. For all patients, a lesion was located in the field of view of the metal implant. Phantom and patients were scanned in a PET/CT scanner. The standard low-dose CT scans were processed with the iMAR algorithm. The PET data were reconstructed using attenuation correction provided by both standard CT and iMAR-processed CT. Results: For the phantom scans, cold artifacts were visible on the PET image. There was a 30% deficit in 18 F-FDG concentration, which was restored by iMAR processing, indicating that metal artifacts on CT images induce quantification errors in PET data. The iMAR algorithm was useful for most patients. When iMAR was used, the confidence in interpretation increased or stayed the same, with an average improvement of 28% ± 20% (scored on a scale of 0%-100% confidence). The SUV increase or decrease depended on the type of metal artifact. The mean difference in absolute values of SUV mean of the lesions was 3.5% ± 3.3%. Conclusion: The iMAR algorithm increases the confidence of the interpretation of the PET/CT scan and influences the SUV. The added value of iMAR depends on the indication for the

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2002-09-01

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

  1. Identifying the sources of greatest radiation exposure to NMT's during PET scanning

    International Nuclear Information System (INIS)

    Norton, Sarah; Cowell, Simon F.; Mi, Tian; Every, Bruce Van

    2009-01-01

    Full text: Introduction: The higher penetrating ability of 511 kev photons emitted by PET radionuclides combined with the long duration of the studies raises concern that NMTs receive higher radiation exposure levels while working with PET patients. Previous studies found the greatest exposure occurred while injecting the patient. This study aimed to determine the stage in the PET study with the highest radiation exposure to a NMT. Method: A Polimaster PM 1604A personal dosimeter was worn by one of the researchers whilst working alongside a NMT. 20 PET procedures were monitored over a four-day period. The average administered activity of F18-FDG was 332 MBq. Stages identified for measurement included: observing patient injection, escorting the patient to the toilet, setting-up the patient for the scan and escorting them to the change room. The time spent and the cumulative equivalent dose (CED) at each stage were recorded for each patient. Results: easurement Stage vg Time(min) vg CED(uSv), Observing patient injection .8 .26, Escorting patient to toilet .2 .39, Setting patient up for scan .0 .93, escorting patient to change room .8 .42. Total for all stages 1.8 .00. Discussion: This study found that 65% of a NMTs radiation exposure from a PET procedure occurred during scan setup, in proportion to their time spent with the patient. Strategies need to be implemented in PET departments to help minimise the exposure to MTs during each stage of a PET study.

  2. The role of 18F-fluoride PET-CT in the detection of bone metastases in patients with breast, lung and prostate carcinoma: a comparison with FDG PET/CT and 99mTc-MDP bone scan.

    Science.gov (United States)

    Damle, Nishikant Avinash; Bal, Chandrasekhar; Bandopadhyaya, G P; Kumar, Lalit; Kumar, Praveen; Malhotra, Arun; Lata, Sneh

    2013-04-01

    We aimed to compare the role of (18)F-fluoride PET/CT, FDG PET/CT and (99m)Tc-MDP bone scans in the detection of bone metastases in patients with lung, breast and prostate carcinoma. This was a prospective study including patients for staging (S) and restaging (R). Seventy-two patients (23S, 49R) with infiltrating ductal breast carcinoma, 49 patients (25S, 24R) with prostate adenocarcinoma and 30 patients (17S, 13R) with non-small-cell lung carcinoma (NSCLC), without known bone metastases but with high risk/clinical suspicion for the same, underwent a (99m)Tc-MDP bone scan, FDG PET/CT and (18)F-fluoride PET/CT within 2 weeks. All scans were reviewed by two experienced nuclear medicine physicians, and the findings were correlated with MRI/thin-slice CT/skeletal survey. Histological verification was done wherever feasible. Sensitivity and negative predictive value (NPV) of (18)F-fluoride PET/CT was 100 % in all three malignancies, while that of FDG PET/CT was 79 % and 73 % in NSCLC, 73 % and 80 % in breast cancer and 72 and 65 % in prostate cancer. Specificity and positive predictive value (PPV) of FDG PET/CT were 100 % in NSCLC and prostate and 97 % and 96 % in breast cancer. As compared to the (99m)Tc-MDP bone scan, all parameters were superior for (18)F-fluoride PET/CT in prostate and breast cancer, but sensitivity and NPV were equal in NSCLC. The MDP bone scan had superior sensitivity and NPV compared to FDG PET/CT but had low specificity and PPV. To rule out bone metastases in cases where there is a high index of suspicion, (18)F-fluoride PET/CT is the most reliable investigation. (18)F-fluoride PET/CT has the potential to replace the (99m)Tc-MDP bone scan for the detection of bone metastases.

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

    International Nuclear Information System (INIS)

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

    2016-01-01

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

  4. Statistical image reconstruction methods for simultaneous emission/transmission PET scans

    International Nuclear Information System (INIS)

    Erdogan, H.; Fessler, J.A.

    1996-01-01

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

  5. False positive and false negative FDG-PET scans in various thoracic diseases

    International Nuclear Information System (INIS)

    Chang, Jung Min; Lee, Hyun Ju; Goo, Jin Mo; Lee, Ho Young; Lee, Jong Jin; Chung, June Key; Im, Jung Gi

    2006-01-01

    Fluorodeoxygucose (FDG)-positron emission tomography (PET) is being used more and more to differentiate benign form malignant focal lesions and it has been shown to be more efficacious than conventional chest computed tomography (CT). However, FDG is not a cancer-specific agent, and false positive findings in benign diseases have been reported. Infectious diseases (mycobacterial, fungal, bacterial infection), sarcoidosis, radiation pneumonitis and post-operative surgical conditions have shown intense uptake on PET scan. On the other hand, tumors with low glycolytic activity such as adenomas, bronchioloalveolar carcinomas, carcinoid tumors, low grade lymphomas and small sized tumors have revealed false negative findings on PET scan, Furthermore, in diseases located near the physiologic uptake sites (heart, bladder, kidney, and liver), FDG-PET should be complemented with other imaging modalities to confirm results and to minimize false negative findings. Familiarity with these false positive and negative findings will help radiologists interpret PET scans more accurately and also will help to determine the significance of the findings. In this review, we illustrate false positive and negative findings of PET scan in a variety of diseases

  6. 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.)

  7. Clinical utility of 18 Fluorodeoxyglucose (FDG-PET/CT scans in patients with suspect ocular tuberculosis

    Directory of Open Access Journals (Sweden)

    Salil Mehta

    2013-01-01

    Full Text Available Systemic imaging of patients with suspect ocular tuberculosis include chest X-rays and computed tomography (CT scans. Reports have suggested a role for 18 fluorodeoxyglucose-positron emission tomography/CT (FDG-PET/CT scans. We report on the clinical utility of 18 FDG PET/CT in two patients. Case 1: A 38-year-old female patient presented with recurrent anterior uveitis. A 18 FDG-PET scan revealed metabolically active supraclavicular and chest lymph nodes. An aspiration cytology of the cervical lymph node revealed caseating granulomas suggestive of tuberculosis. Case 2: A 58-year-old female patient presented with recurrent anterior uveitis. A 18 FDG-PET scan revealed metabolically active lymph nodes in the neck. A biopsy of the cervical lymph node revealed epithelioid granulomas suggestive of tuberculosis. Both patients were started on standard antitubercular therapy with a subsequent marked reduction of activity. PET/CT scans may suggest the sites of safe high-yield biopsies.

  8. Unusual soft tissue uptake of F-18 sodium fluoride in three patients undergoing F-18 NaF PET/CT bone scans for prostate cancer

    Energy Technology Data Exchange (ETDEWEB)

    Hawkins, Andrew S.; Howard, Brandon A. [Div. of Nuclear Medicine, Dept. of Radiology, Duke University Medical Center, Durham (United States)

    2017-09-15

    Three males aged 71 to 80 years with known stage IV metastatic prostate cancer underwent F-18 sodium fluoride (NaF) PET/CT to assess osseous metastatic disease burden and stability. In addition to F-18 NaF avid known osseous metastases, each patient also exhibited increased F-18 NaF activity in soft tissues. The first patient exhibited multiple F-18 NaF avid enlarged retroperitoneal and pelvic lymph nodes on consecutive PET/CT scans. The second patient demonstrated an F-18 NaF avid thyroid nodule on consecutive PET/CT scans. The third patient exhibited increased F-18 NaF activity in a hepatic metastasis.

  9. 68Gallium-DOTATATE PET/CT Scanning Results in Patients with MEN1

    Science.gov (United States)

    Sadowski, Samira M; Millo, Corina; Cottle-Delisle, Candice; Merkel, Roxanne; Yang, Lily A; Herscovitch, Peter; Pacak, Karel; Simonds, William F; Marx, Stephen J; Kebebew, Electron

    2015-01-01

    Background Screening for neuroendocrine tumors (NETs) in patients with multiple endocrine neoplasia type 1 (MEN1) is recommended to detect primary and metastatic tumors, which can result in significant morbidity and mortality. The utility of somatostatin receptor imaging 68Gallium-DOTATATE PET/CT in patients with MEN1 is not known. The aim of this study was to prospectively determine the accuracy of 68Gallium-DOTATATE PET/CT versus 111In-pentetreotide SPECT/CT and anatomic imaging in patients with MEN1. Study design Prospective study comparing 68Gallium-DOTATATE PET/CT, 111In-pentetreotide SPECT/CT, and triphasic CT scan to clinical, biochemical and pathological data in 26 patients with MEN1. Results 68Gallium-DOTATATE PET/CT detected 107 lesions; 111In- pentetreotide SPECT/CT detected 33 lesions; and CT scan detected 48 lesions. Lesions detected on 68Gallium-DOTATATE PET/CT had high SUVmax (median SUVmax = 72.8 [range 19–191]). In 7 of the 26 patients (27%), 68Gallium-DOTATATE PET/CT was positive with a negative 111In-pentetreotide SPECT/CT, and in 10 patients (38.5%), additional metastases were detected (range 0.3 cm to 1.5 cm). In 8 of the 26 patients (31%), there was a change in management recommendations as a result of the findings on 68Gallium-DOTATATE PET/CT that were not seen on 111In- pentetreotide SPECT/CT and CT scan. Conclusions 68Gallium-DOTATATE PET/CT is more sensitive for detecting NETs than 111In-pentetreotide SPECT/CT and CT scan in patients with MEN1. This imaging technique should be integrated into radiologic screening and surveillance of patients with MEN1, as it can significantly alter management recommendations. PMID:26206648

  10. PET scans relate clinical picture to more specific nerve function

    International Nuclear Information System (INIS)

    Ziporyn, T.

    1985-01-01

    This article describes the historical development of the use of positron emission tomography in studies of brain chemistry and the specific pathways associated with specific disease states. Fluorine-18 is used to label dopa since dopa can cross the blood-brain barrier. This radiopharmaceutical has been used to study the role of dopamine in Parkinson's disease and other motor disorders. The new PET technologies may also allow insight into the cause of variable responses to levo-dopa therapy

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

    International Nuclear Information System (INIS)

    Suga, Kazuyoshi

    2008-01-01

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

  12. FDG PET scans as evaluation of clinical response to dendritic cell vaccination in patients with malignant melanoma

    DEFF Research Database (Denmark)

    Engell-Noerregaard, Lotte; Hendel, Helle W; Johannesen, Helle H

    2013-01-01

    . In this study it is investigated whether FDG-PET might add information on the efficacy of immune therapy. MATERIALS AND METHODS: In a retrospective analysis data from patients with advanced progressive melanoma, treated with DC vaccinations and evaluated by PET/CT scans at baseline as well as after 6...... vaccinations were analysed. If a patient achieved stable disease according to RECIST, additional vaccinations were given. The PET scans were evaluated according to EORTC guidelines. RESULTS: PET/CT scans from 13 patients were evaluated. According to RECIST 3 patients achieved stable disease and 10 patients...... PET scans to the CT evaluation of patients treated with DC vaccines, a more detailed picture of the single lesions was found. This seems to improve the clinical evaluation of the treatment. The lack of correlation between the PET and CT scans suggests that some of the increases in target lesions seen...

  13. 3D quantification of soil structure and functioning based on PET and CT scanning techniques

    DEFF Research Database (Denmark)

    Garbout, Amin

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

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

    Science.gov (United States)

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

    2017-09-01

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

  15. Evaluation of mediastinal lymph nodes using 18 F-FDG PET-CT scan and its histopathologic correlation

    Directory of Open Access Journals (Sweden)

    Kumar Arvind

    2011-01-01

    Full Text Available Aims and Objectives: To determine the efficacy of integrated 18 F-fluorodeoxy glucose positron emission tomography-computed tomography ( 18 F-FDG PET-CT in the evaluation and characterization of mediastinal lymph nodes into benign and malignant pathology. Methods: Thirty-five patients with mediastinal lymphadenopathies without primary neoplastic or infective lung pathologies were included in the study. The lymph nodes were detected on contrast-enhanced CT scan of the chest. All patients underwent 18 F-FDG PET-CT scan for evaluation of mediastinal lymph nodes. Results of PET-CT were compared with histopathology of the lymph nodes and sensitivity, specificity, positive predictive value, negative predictive value, and accuracy were calculated. Statistical Analysis: The data were collected prospectively and analyzed using (SPSS Inc., Chicago, IL 11.5 software. Results: Histopathology results in 35 patients revealed tuberculosis in 12, sarcoidosis in 8, and lymphoma in 15. Maximum standardized uptake value (SUVmax of the benign lymph nodes ranged from 2.3 to 11.8 with a mean±standard deviation (SD of 5.02±3.26. SUVmax of the malignant lymph nodes ranged from 2.4 to 34 with a mean±SD of 10.8±8.12. There was a statistically significant difference between benign and malignant pathology (P<0.0059. 18 F-FDG PET-CT has sensitivity of 93% and specificity of 40% with SUVmax 2.5 as the cutoff. We found the optimal SUVmax cutoff to be 6.2 as determined by the receiver-operator characteristic curve. With 6.2 as cutoff, the sensitivity, specificity, and accuracy were 87%, 70%, and 77%, respectively. Conclusion : In countries where tuberculosis and other granulomatous diseases are endemic, SUVmax cutoff value of 2.5 has low specificity. Increasing the cutoff value can improve the specificity, while maintaining an acceptable sensitivity.

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

    International Nuclear Information System (INIS)

    Seok, Ju Won; Chung, June Key

    2005-01-01

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

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

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Jong Hoon

    1999-12-01

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

  18. Comparison of absorbed dose of two protocols of tomographic scanning in PET/CT exams

    International Nuclear Information System (INIS)

    Paiva, F.G.

    2017-01-01

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

  19. Early interim PET scan in Hodgkin lymphoma: where do we stand?

    DEFF Research Database (Denmark)

    Gallamini, A.; Hutchings, M.; Avigdor, A.

    2008-01-01

    chemotherapy. However, it is unclear whether FDG-PET retains this role if therapy is changed as a consequence of the scan, or if performed during a more intensive chemotherapy regimen such as BEACOPPesc, which is used for HL. This brief review presents the up-to-date evidence for the use and interpretation...

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

    Directory of Open Access Journals (Sweden)

    Aruna Kaushik

    2015-01-01

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

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

    Science.gov (United States)

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

    2015-12-01

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

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

    Science.gov (United States)

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

    2015-01-01

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

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

    International Nuclear Information System (INIS)

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

    2011-01-01

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

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

    International Nuclear Information System (INIS)

    Kim, Jong Hoon

    2000-12-01

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

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

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Jong Hoon

    2000-12-01

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

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

    International Nuclear Information System (INIS)

    Senda, Michio; Ouchi, Yasuomi; Ishii, Kazunari

    2003-01-01

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

  7. FDG-PET and MDP scan findings in chronic osteomyelitis of the left femur

    Energy Technology Data Exchange (ETDEWEB)

    Park, Chan H.; Lee, Myoung Hoon [School of Medicine, Ajou Univ., Suwon (Korea, Republic of)

    2002-04-01

    A 49-year-old male patient with a carcinoma of the right pyriform sinus had a whole-body bone scan and gamma camera based F-18 FDG-PET for staging. Tc-99m MDP bone scan depicted diffuse increased uptake in the left femur due to chronic osteomyelitis but no skelectal metastasis. F-18-FDG-PET revealed increased focal bone uptake and uptake in the draining sinus due to chronic osteomyelitis in addition to visualization of the right pyriform sinus carcinoma and right neck nodal uptake. Fluorine-18 fluorodeoxyglucose-positron emission tomography is significantly more accurate than the bone scan in pinpointing chronic osteomyelitis focus and draining soft tissue infection.

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

    Science.gov (United States)

    Bai, Xia; Wang, Xuemei; Zhuang, Hongming

    2018-03-01

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

  9. Automated calculation of myocardial external efficiency from a single 11C-acetate PET/CT scan

    DEFF Research Database (Denmark)

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

    additional stroke volume (SV) and myocardial mass data, respectively, which are typically derived from a separate cardiovascular magnetic resonance (CMR) scan. Dual scanning is logistically problematic and different loading conditions during PET and CMR scans can cause errors in MEE estimates. The aim...

  10. Automated model-based quantitative analysis of phantoms with spherical inserts in FDG PET scans.

    Science.gov (United States)

    Ulrich, Ethan J; Sunderland, John J; Smith, Brian J; Mohiuddin, Imran; Parkhurst, Jessica; Plichta, Kristin A; Buatti, John M; Beichel, Reinhard R

    2018-01-01

    Quality control plays an increasingly important role in quantitative PET imaging and is typically performed using phantoms. The purpose of this work was to develop and validate a fully automated analysis method for two common PET/CT quality assurance phantoms: the NEMA NU-2 IQ and SNMMI/CTN oncology phantom. The algorithm was designed to only utilize the PET scan to enable the analysis of phantoms with thin-walled inserts. We introduce a model-based method for automated analysis of phantoms with spherical inserts. Models are first constructed for each type of phantom to be analyzed. A robust insert detection algorithm uses the model to locate all inserts inside the phantom. First, candidates for inserts are detected using a scale-space detection approach. Second, candidates are given an initial label using a score-based optimization algorithm. Third, a robust model fitting step aligns the phantom model to the initial labeling and fixes incorrect labels. Finally, the detected insert locations are refined and measurements are taken for each insert and several background regions. In addition, an approach for automated selection of NEMA and CTN phantom models is presented. The method was evaluated on a diverse set of 15 NEMA and 20 CTN phantom PET/CT scans. NEMA phantoms were filled with radioactive tracer solution at 9.7:1 activity ratio over background, and CTN phantoms were filled with 4:1 and 2:1 activity ratio over background. For quantitative evaluation, an independent reference standard was generated by two experts using PET/CT scans of the phantoms. In addition, the automated approach was compared against manual analysis, which represents the current clinical standard approach, of the PET phantom scans by four experts. The automated analysis method successfully detected and measured all inserts in all test phantom scans. It is a deterministic algorithm (zero variability), and the insert detection RMS error (i.e., bias) was 0.97, 1.12, and 1.48 mm for phantom

  11. Comparison of 18F fluoride PET/CT and 99mTc-MDP bone scan in the detection of skeletal metastases in urinary bladder carcinoma.

    Science.gov (United States)

    Chakraborty, Dhritiman; Bhattacharya, Anish; Mete, Uttam Kumar; Mittal, Bhagwant Rai

    2013-08-01

    The aim of this study was to compare (18)F-fluoride PET/CT and (99m)Tc-MDP bone scintigraphy in the detection of skeletal metastases in urinary bladder carcinoma. In this prospective study, 48 patients with urinary bladder carcinoma (44 male and 4 female patients, aged 35-80 years) underwent (99m)Tc-MDP planar and SPECT/CT bone scan (BS) followed by (18)F-fluoride PET/CT within 48 hours. Skeletal metastasis diagnosed on each of these techniques was compared against a final diagnosis based on contrast-enhanced CT, MRI, skeletal survey, clinical follow-up, and histological correlation. (18)F-fluoride PET/CT identified bony metastases and changed the management in 17 of 48 patients (35%). The sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of (99m)Tc-MDP planar BS were 82.35%, 64.51%, 56%, 86.95%, and 70.83%; of (99m)Tc-MDP SPECT/CT were 88.23%, 74.19%, 65.21%, 92%, and 79.16%; and of (18)F-fluoride PET/CT were 100%, 87.09%, 80.95%, 100%, and 91.66%, respectively. Fair agreement between (99m)Tc-MDP planar BS and F-fluoride PET/CT (κ = 0.42) and excellent agreement between SPECT/CT and (18)F-fluoride PET/CT (κ = 0.74) were found. ( 18)F-fluoride PET/CT has higher sensitivity, specificity, positive predictive value, negative predictive value, and accuracy in detecting bone metastases in urinary bladder carcinoma than conventional (99m)Tc-MDP planar BS. SPECT/CT improves all these parameters compared with planar BS and may serve as a cost-effective screening procedure for the detection of skeletal metastases in high-risk patients.

  12. Brown fat in breast cancer patients: analysis of serial {sup 18}F-FDG PET/CT scans

    Energy Technology Data Exchange (ETDEWEB)

    Rousseau, C.; Fleury, N.; Bridji, B.; Chatal, J.F.; Resche, I. [Rene Gauducheau Cancer Center, Nuclear Medicine Unit, Nantes-Saint Herblain (France); Bourbouloux, E.; Campone, M. [Rene Gauducheau Cancer Center, Medical Oncology Unit, Nantes-Saint Herblain (France); Campion, L. [Rene Gauducheau Cancer Center, Statistics Unit, Nantes-Saint Herblain (France)

    2006-07-15

    It has recently been suggested that FDG accumulation in the brown adipose tissue varies as a function of age, sex and outdoor temperature. The aim of this study was to assess changes in FDG uptake in brown fat in patients based on serial PET/CT scans and to compare our results with previous findings. Early response to neoadjuvant chemotherapy in 33 female breast cancer patients was assessed by FDG PET. Five PET/CT scans were performed for each patient. PET/CT images were analysed retrospectively. PET scans were considered positive when diffuse, symmetrical, abnormal ''USA'' (uptake in supraclavicular area) fat was detected. A total of 163 PET images were analysed. Seventy-four PET scans (45%) revealed abnormal FDG uptake in the supraclavicular area. These foci were present on uncorrected and attenuation-corrected images. FDG uptake was identical on all five scans in only five patients. No significant relationship was found between abnormal FDG uptake and outdoor temperature, age or time interval between chemotherapy and PET. Abnormal FDG uptake in the neck seemed to predominantly occur in patients with a low body mass index (p<0.05). Most significant changes in the PET/CT scan results were observed during chemotherapy with docetaxel (p<0.05). When observed, bilateral uptake in the neck was more intense than background uptake (p<0.00001). This study shows that FDG uptake in the neck varies as a function of time, that it is unrelated to age or outdoor temperature, and that bilateral uptake is generally intense. (orig.)

  13. Brown fat in breast cancer patients: analysis of serial 18F-FDG PET/CT scans

    International Nuclear Information System (INIS)

    Rousseau, C.; Fleury, N.; Bridji, B.; Chatal, J.F.; Resche, I.; Bourbouloux, E.; Campone, M.; Campion, L.

    2006-01-01

    It has recently been suggested that FDG accumulation in the brown adipose tissue varies as a function of age, sex and outdoor temperature. The aim of this study was to assess changes in FDG uptake in brown fat in patients based on serial PET/CT scans and to compare our results with previous findings. Early response to neoadjuvant chemotherapy in 33 female breast cancer patients was assessed by FDG PET. Five PET/CT scans were performed for each patient. PET/CT images were analysed retrospectively. PET scans were considered positive when diffuse, symmetrical, abnormal ''USA'' (uptake in supraclavicular area) fat was detected. A total of 163 PET images were analysed. Seventy-four PET scans (45%) revealed abnormal FDG uptake in the supraclavicular area. These foci were present on uncorrected and attenuation-corrected images. FDG uptake was identical on all five scans in only five patients. No significant relationship was found between abnormal FDG uptake and outdoor temperature, age or time interval between chemotherapy and PET. Abnormal FDG uptake in the neck seemed to predominantly occur in patients with a low body mass index (p<0.05). Most significant changes in the PET/CT scan results were observed during chemotherapy with docetaxel (p<0.05). When observed, bilateral uptake in the neck was more intense than background uptake (p<0.00001). This study shows that FDG uptake in the neck varies as a function of time, that it is unrelated to age or outdoor temperature, and that bilateral uptake is generally intense. (orig.)

  14. Brown fat in breast cancer patients: analysis of serial (18)F-FDG PET/CT scans.

    Science.gov (United States)

    Rousseau, C; Bourbouloux, E; Campion, L; Fleury, N; Bridji, B; Chatal, J F; Resche, I; Campone, M

    2006-07-01

    It has recently been suggested that FDG accumulation in the brown adipose tissue varies as a function of age, sex and outdoor temperature. The aim of this study was to assess changes in FDG uptake in brown fat in patients based on serial PET/CT scans and to compare our results with previous findings. Early response to neoadjuvant chemotherapy in 33 female breast cancer patients was assessed by FDG PET. Five PET/CT scans were performed for each patient. PET/CT images were analysed retrospectively. PET scans were considered positive when diffuse, symmetrical, abnormal "USA" (uptake in supraclavicular area) fat was detected. A total of 163 PET images were analysed. Seventy-four PET scans (45%) revealed abnormal FDG uptake in the supraclavicular area. These foci were present on uncorrected and attenuation-corrected images. FDG uptake was identical on all five scans in only five patients. No significant relationship was found between abnormal FDG uptake and outdoor temperature, age or time interval between chemotherapy and PET. Abnormal FDG uptake in the neck seemed to predominantly occur in patients with a low body mass index (p<0.05). Most significant changes in the PET/CT scan results were observed during chemotherapy with docetaxel (p<0.05). When observed, bilateral uptake in the neck was more intense than background uptake (p<0.00001). This study shows that FDG uptake in the neck varies as a function of time, that it is unrelated to age or outdoor temperature, and that bilateral uptake is generally intense.

  15. Singles transmission scans performed post-injection for quantitative whole body FDG-PET

    Energy Technology Data Exchange (ETDEWEB)

    Smith, R.J.; Benard, F.; Karp, J.S. [Univ. of Pennsylvania, Philadelphia, PA (United States)] [and others

    1996-12-31

    Post-injection singles transmission scanning has been implemented in the septumless PENN PET 240H scanner (prototype of the GE QUEST). The method uses a 6 mCi point transmission source of {sup 137}Cs at the axial center and 37 cm of transaxial center of the camera field of view. Singles transmission scans of 1.8 minutes per bed axial position provide similar scan count densities to 15 minute coincidence transmission scans with 0.5 mCi {sup 68}Ge rod transmission source. Scatter and emission contamination suppression are achieved by applying a narrow 662 keV transmission photopeak energy window. The residual 511 keV emission contamination constitutes a background of uniform spatial distribution. Accurate and low noise attenuation correction is achieved by segmenting the singles transmission images into lung and soft tissue volumes. Established 511 keV gamma ray attenuation coefficients are then applied and these images are forward projected for attenuation correction. Expectation maximisation or OS-EM reconstruction of the transmission and emission images is used to improve image quality. Both the segmentation and OS-EM reconstruction maintain quantitative accuracy in the fully corrected emission images compared to measured coincidence transmission correction. Thus, a clinical protocol involving 40 minutes of emission scans followed by 20 minutes of singles transmission scans allow the 60 cm of the human torso to be fully scanned within 60 minutes. These quantitative whole body FDG PET images may then be used for tumor grading and assessment of tumor response to treatment.

  16. 18F-FDG-PET Scanning Confirmed Infected Intracardiac Device-Leads with Abiotrophia defectiva

    Directory of Open Access Journals (Sweden)

    Sonja van Roeden

    2016-01-01

    Full Text Available Abiotrophia species are relatively slow growing pathogens, which may be present as commensal flora. However, invasive infections are frequently reported, like endocarditis, septic arthritis, osteomyelitis, and many other types of infection. In this case report we describe a 65-year-old male patient with an intracardiac device- (ICD- lead infection caused by Abiotrophia defectiva. Diagnosis was confirmed by 18F-FDG-PET scanning. This is remarkable, since Abiotrophia defectiva is a slow growing pathogen causing low-grade infections. This case demonstrates that although infection of ICD-leads cannot be excluded in case of 18F-FDG-PET-negative findings, positive findings are highly suggestive for infection.

  17. Diffuse occipital hypometabolism on [18 F]-FDG PET scans in patients with idiopathic REM sleep behavior disorder: prodromal dementia with Lewy bodies?

    Science.gov (United States)

    Fujishiro, Hiroshige; Iseki, Eizo; Murayama, Norio; Yamamoto, Ryoko; Higashi, Shinji; Kasanuki, Koji; Suzuki, Masaru; Arai, Heii; Sato, Kiyoshi

    2010-09-01

    Previous longitudinal studies have revealed that specific patterns on [(18) F]-fluoro-d-glucose (FDG) positron emission tomography (PET) scans in patients with amnesic mild cognitive impairment can predict Alzheimer's disease (AD). However, the significance of particular patterns on [(18) F]-FDG PET scans in prodromal patients with dementia with Lewy bodies (DLB) remains unclear. Based on the prevailing evidence that rapid eye movement (REM) sleep behavior disorder (RBD) often precedes the onset of DLB, [(18) F]-FDG PET scans of nine non-demented patients reporting recurrent nocturnal dream-enactment behavior in our memory clinic were compared with the normative database using three-dimensional stereotactic surface projection (3D-SSP) images. All patients underwent clinical and neuropsychological examinations as well as cardiac [(123) I]-metaiodobenzylguanidine ([(123) I]-MIBG) scintigraphy. Four patients were found to have diffuse areas of reduced cerebral metabolic rate of glucose (CMRglc), predominantly in the occipital lobe, which is the preferentially affected region in DLB patients. In contrast, five patients showed no such occipital hypometabolism; instead, these five patients showed hypometabolism in the left anterior cingulate gyrus (Broadmann area (BA) 24), right frontal lobe (BA 32) and right anterior temporal lobe (BA 38), which are the preferentially affected regions in Parkinson's disease rather than DLB. The extent of the reduction in CMRglc in the left occipital lobe was correlated with scores on the Bender Gestalt Test, which reflects visuospatial ability, but not with global cognitive measures. All patients showed reduced cardiac [(123) I]-MIBG levels, consistent with underlying Lewy body disease. These variations in [(18) F]-FDG PET scans raise the possibility that the specific pattern of CMRglc reduction may predict developing DLB in patients with idiopathic RBD. Further follow-up studies are needed, particularly on patients with diffuse

  18. Single-scan dual-tracer FLT+FDG PET tumor characterization.

    Science.gov (United States)

    Kadrmas, Dan J; Rust, Thomas C; Hoffman, John M

    2013-02-07

    Rapid multi-tracer PET aims to image two or more tracers in a single scan, simultaneously characterizing multiple aspects of physiology and function without the need for repeat imaging visits. Using dynamic imaging with staggered injections, constraints on the kinetic behavior of each tracer are applied to recover individual-tracer measures from the multi-tracer PET signal. The ability to rapidly and reliably image both (18)F-fluorodeoxyglucose (FDG) and (18)F-fluorothymidine (FLT) would provide complementary measures of tumor metabolism and proliferative activity, with important applications in guiding oncologic treatment decisions and assessing response. However, this tracer combination presents one of the most challenging dual-tracer signal-separation problems--both tracers have the same radioactive half-life, and the injection delay is short relative to the half-life and tracer kinetics. This work investigates techniques for single-scan dual-tracer FLT+FDG PET tumor imaging, characterizing the performance of recovering static and dynamic imaging measures for each tracer from dual-tracer datasets. Simulation studies were performed to characterize dual-tracer signal-separation performance for imaging protocols with both injection orders and injection delays of 10-60 min. Better performance was observed when FLT was administered first, and longer delays before administration of FDG provided more robust signal-separation and recovery of the single-tracer imaging measures. An injection delay of 30 min led to good recovery (R > 0.96) of static image values (e.g. SUV), K(net), and K(1) as compared to values from separate, single-tracer time-activity curves. Recovery of higher order rate parameters (k(2), k(3)) was less robust, indicating that information regarding these parameters was harder to recover in the presence of statistical noise and dual-tracer effects. Performance of the dual-tracer FLT(0 min)+FDG(32 min) technique was further evaluated using PET/CT imaging

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

    International Nuclear Information System (INIS)

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

    2006-01-01

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

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

    Energy Technology Data Exchange (ETDEWEB)

    Ryu, Sang Young

    1999-12-01

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

  1. Radiation injury vs. recurrent brain metastasis: combining textural feature radiomics analysis and standard parameters may increase {sup 18}F-FET PET accuracy without dynamic scans

    Energy Technology Data Exchange (ETDEWEB)

    Lohmann, Philipp; Stoffels, Gabriele; Stegmayr, Carina; Neumaier, Bernd [Forschungszentrum Juelich, Institute of Neuroscience and Medicine, Juelich (Germany); Ceccon, Garry [University of Cologne, Department of Neurology, Cologne (Germany); Rapp, Marion; Sabel, Michael; Kamp, Marcel A. [Heinrich Heine University Duesseldorf, Department of Neurosurgery, Duesseldorf (Germany); Filss, Christian P. [Forschungszentrum Juelich, Institute of Neuroscience and Medicine, Juelich (Germany); RWTH Aachen University Hospital, Department of Nuclear Medicine, Aachen (Germany); Shah, Nadim J. [Forschungszentrum Juelich, Institute of Neuroscience and Medicine, Juelich (Germany); RWTH Aachen University Hospital, Department of Neurology, Aachen (Germany); Juelich-Aachen Research Alliance (JARA) - Section JARA-Brain, Department of Neurology, Juelich (Germany); Langen, Karl-Josef [Forschungszentrum Juelich, Institute of Neuroscience and Medicine, Juelich (Germany); RWTH Aachen University Hospital, Department of Nuclear Medicine, Aachen (Germany); Juelich-Aachen Research Alliance (JARA) - Section JARA-Brain, Department of Neurology, Juelich (Germany); Galldiks, Norbert [Forschungszentrum Juelich, Institute of Neuroscience and Medicine, Juelich (Germany); University of Cologne, Department of Neurology, Cologne (Germany); University of Cologne, Center of Integrated Oncology (CIO), Cologne (Germany)

    2017-07-15

    We investigated the potential of textural feature analysis of O-(2-[{sup 18}F]fluoroethyl)-L-tyrosine ({sup 18}F-FET) PET to differentiate radiation injury from brain metastasis recurrence. Forty-seven patients with contrast-enhancing brain lesions (n = 54) on MRI after radiotherapy of brain metastases underwent dynamic {sup 18}F-FET PET. Tumour-to-brain ratios (TBRs) of {sup 18}F-FET uptake and 62 textural parameters were determined on summed images 20-40 min post-injection. Tracer uptake kinetics, i.e., time-to-peak (TTP) and patterns of time-activity curves (TAC) were evaluated on dynamic PET data from 0-50 min post-injection. Diagnostic accuracy of investigated parameters and combinations thereof to discriminate between brain metastasis recurrence and radiation injury was compared. Diagnostic accuracy increased from 81 % for TBR{sub mean} alone to 85 % when combined with the textural parameter Coarseness or Short-zone emphasis. The accuracy of TBR{sub max} alone was 83 % and increased to 85 % after combination with the textural parameters Coarseness, Short-zone emphasis, or Correlation. Analysis of TACs resulted in an accuracy of 70 % for kinetic pattern alone and increased to 83 % when combined with TBR{sub max}. Textural feature analysis in combination with TBRs may have the potential to increase diagnostic accuracy for discrimination between brain metastasis recurrence and radiation injury, without the need for dynamic {sup 18}F-FET PET scans. (orig.)

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

    DEFF Research Database (Denmark)

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

    2005-01-01

    PURPOSE: If the CT scan of a combined PET/CT study is performed as a full diagnostic quality CT scan including intravenous (IV) contrast agent, the quality of the joint PET/CT procedure is improved and a separate diagnostic CT scan can be avoided. CT with IV contrast can be used for PET attenuation...... correction, but this may result in a bias in the attenuation factors. The clinical significance of this bias has not been established. Our aim was to perform a prospective clinical study where each patient had CT performed with and without IV contrast agent to establish whether PET/CT with IV contrast can...... be used for PET attenuation without reducing the clinical value of the PET scan. METHODS: A uniform phantom study was used to document that the PET acquisition itself is not significantly influenced by the presence of IV contrast medium. Then, 19 patients referred to PET/CT with IV contrast underwent CT...

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

    International Nuclear Information System (INIS)

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

    2011-01-01

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

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

    International Nuclear Information System (INIS)

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

    1992-01-01

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

  5. Static Myocardial Perfusion Imaging using denoised dynamic Rb-82 PET/CT scans

    DEFF Research Database (Denmark)

    Petersen, Maiken N.M.; Hoff, Camilla; Harms, Hans

    Introduction: Relative and absolute measures of myocardial perfusion are derived from a single 82Rb PET/CT scan. However, images are inherently noising due to the short half-life of 82Rb. We have previously shown that denoising techniques can be applied to dynamic 82Rb series with excellent...... quantitative accuracy. In this study, we examine static images created by summing late frames of denoised dynamic series. Method: 47 random clinical 82Rb stress and rest scans (27 male, age 68+/- 12 y., BMI 27.9 +/- 5.5 kg/m2) performed on a GE Discovery 690 PET/CT scanner were included in the study....... Administered 82Rb dose was 1110 MBq. Denoising using HYPR-LR or Hotelling 3D algorithms was performed as post-processing on the dynamic images series. Static series were created by summing frames from 2.5-5 min. The image data was analysed in QPET (Cedars-Sinai). Relative segmental perfusion (normalized...

  6. Meditative music listening to reduce state anxiety in patients during the uptake phase before positron emission tomography (PET) scans.

    Science.gov (United States)

    Lee, Wen-Li; Sung, Huei-Chuan; Liu, Shu-Hsin; Chang, Shu-Min

    2017-02-01

    This study examines the effects of listening to meditative music on state anxiety and heart rate variability (HRV) of patients during the uptake phase before positron emission tomography (PET) scans. A two-group randomized experimental design was used. Eligible patients were randomly assigned to either the experimental or control group. All patients received baseline assessments of state anxiety using Spielberger State-Trait Anxiety Inventory (STAI-S) and HRV before receiving an intravenous injection of radiopharmaceutical fluorine-18 fludeoxyglucose in the uptake room. The experimental group (n = 35) listened individually to 30 min of meditative music, integrating Chinese "Chi" and western frequency resonation in the uptake room. The control group (n = 37) lay on bed quietly for 40 min in the uptake room without music. All patients were assessed for their anxiety level and HRV again, before receiving PET scanning as post-test. The results indicated that patients in the experimental group showed a significant reduction in state anxiety and heart rate, and increase on high frequency norm of HRV (p music as a non-invasive and cost-effective strategy can help maximize efforts to promote comfort and relaxation for patients awaiting stressful procedures, such as PET scans. Meditative music can be effective in alleviating state anxiety of patients during the uptake phase before PET scans. Advances in knowledge: The study provides scientific evidence of the effects of listening to meditative music for reducing state anxiety in patients during the uptake phase before PET scans. It may have the potential to lower the risk of unwanted false-positive fluorine-18 fludeoxyglucose uptake in normal organs and to further improve image quality and image interpretation. Listening to meditative music is a safe and inexpensive intervention which can be incorporated into routine procedures to reduce anxiety of patients undergoing PET scans.

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

    Science.gov (United States)

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

    2011-01-01

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

  8. Impact of Renal Failure on F18-FDG PET/CT Scans.

    Science.gov (United States)

    Kode, Vishwajit; Karsch, Holly; Osman, Medhat M; Muzaffar, Razi

    2017-01-01

    The current guidelines for 2-deoxy-2-[18F]fluoro-d-glucose PET/CT scanning do not address potential inaccuracies that may arise due to patients with renal failure. We report a retrospective analysis of standard uptake values (SUVs) in patients with and without renal failure in order to warrant a protocol adjustment. Patients were matched based on age, gender, and BMI all of which are potential effectors on observed SUV. Thirty patients were selected with clinically diagnosed renal failure, of which 12 were on dialysis. All 30 patients had age, gender, and BMI control matches. Blood urea nitrogen and creatinine levels were measured within 1 month of the scan to assess renal failure. PET/CT scans for both the renal failure patients and controls were performed 60 min after FDG injection. SUVs were measured by placing circular regions of interest in the right hepatic lobe (LSUV) and left psoas muscle (PSUV). For the 30 renal failure patients, the mean LSUV was 2.77 (SD = 0.57) and PSUV was 1.43 (SD = 0.30) while the controls had mean LSUV 2.74 (SD = 0.50) and PSUV 1.42 (SD = 0.37). The SUVs from both the liver and psoas muscle were not significantly different between the renal failure patients and the normal controls with p values >0.05. In addition, dialysis and gender also had no effect on SUVs. Our data suggest that renal failure patients do not require an adjustment in protocol and the standard protocol times should remain.

  9. Clinical importance of re-interpretation of PET/CT scanning in patients referred to a tertiary care medical centre

    DEFF Research Database (Denmark)

    Löfgren, Johan; Loft, Annika; Barbosa de Lima, Vinicius Araújo

    2017-01-01

    PURPOSE: To evaluate, in a controlled prospective manner with double-blind read, whether there are differences in interpretations of PET/CT scans at our tertiary medical centre, Rigshospitalet, compared to the external hospitals. METHODS: Ninety consecutive patients referred to our department who...... had an external F-18-FDG PET/CT scan were included. Only information that had been available at the time of the initial reading at the external hospital was available at re-interpretation. Teams with one radiologist and one nuclear medicine physician working side by side performed the re...

  10. Radiation injury vs. recurrent brain metastasis: combining textural feature radiomics analysis and standard parameters may increase18F-FET PET accuracy without dynamic scans.

    Science.gov (United States)

    Lohmann, Philipp; Stoffels, Gabriele; Ceccon, Garry; Rapp, Marion; Sabel, Michael; Filss, Christian P; Kamp, Marcel A; Stegmayr, Carina; Neumaier, Bernd; Shah, Nadim J; Langen, Karl-Josef; Galldiks, Norbert

    2017-07-01

    We investigated the potential of textural feature analysis of O-(2-[ 18 F]fluoroethyl)-L-tyrosine ( 18 F-FET) PET to differentiate radiation injury from brain metastasis recurrence. Forty-seven patients with contrast-enhancing brain lesions (n = 54) on MRI after radiotherapy of brain metastases underwent dynamic 18 F-FET PET. Tumour-to-brain ratios (TBRs) of 18 F-FET uptake and 62 textural parameters were determined on summed images 20-40 min post-injection. Tracer uptake kinetics, i.e., time-to-peak (TTP) and patterns of time-activity curves (TAC) were evaluated on dynamic PET data from 0-50 min post-injection. Diagnostic accuracy of investigated parameters and combinations thereof to discriminate between brain metastasis recurrence and radiation injury was compared. Diagnostic accuracy increased from 81 % for TBR mean alone to 85 % when combined with the textural parameter Coarseness or Short-zone emphasis. The accuracy of TBR max alone was 83 % and increased to 85 % after combination with the textural parameters Coarseness, Short-zone emphasis, or Correlation. Analysis of TACs resulted in an accuracy of 70 % for kinetic pattern alone and increased to 83 % when combined with TBR max . Textural feature analysis in combination with TBRs may have the potential to increase diagnostic accuracy for discrimination between brain metastasis recurrence and radiation injury, without the need for dynamic 18 F-FET PET scans. • Textural feature analysis provides quantitative information about tumour heterogeneity • Textural features help improve discrimination between brain metastasis recurrence and radiation injury • Textural features might be helpful to further understand tumour heterogeneity • Analysis does not require a more time consuming dynamic PET acquisition.

  11. Prediction of neoadjuvant radiation chemotherapy response and survival using pretreatment [{sup 18}F]FDG PET/CT scans in locally advanced rectal cancer

    Energy Technology Data Exchange (ETDEWEB)

    Bang, Ji-In; Ha, Seunggyun; Kim, Sang Eun [Seoul National University Bundang Hospital, Department of Nuclear Medicine, Seoul National University College of Medicine, Seongnam (Korea, Republic of); Kang, Sung-Bum; Oh, Heung-Kwon [Seoul National University Bundang Hospital, Department of Surgery, Seoul National University College of Medicine, Seongnam (Korea, Republic of); Lee, Keun-Wook [Seoul National University Bundang Hospital, Department of Internal Medicine, Seongnam (Korea, Republic of); Lee, Hye-Seung [Seoul National University Bundang Hospital, Department of Pathology, Seoul National University College of Medicine, Seongnam (Korea, Republic of); Kim, Jae-Sung [Seoul National University Bundang Hospital, Department of Radiation Oncology, Seongnam (Korea, Republic of); Lee, Ho-Young [Seoul National University Bundang Hospital, Department of Nuclear Medicine, Seoul National University College of Medicine, Seongnam (Korea, Republic of); Seoul National University, Cancer Research Institute, Seoul (Korea, Republic of)

    2016-03-15

    The aim of this study was to investigate metabolic and textural parameters from pretreatment [{sup 18}F]FDG PET/CT scans for the prediction of neoadjuvant radiation chemotherapy response and 3-year disease-free survival (DFS) in patients with locally advanced rectal cancer (LARC). We performed a retrospective review of 74 patients diagnosed with LARC who were initially examined with [{sup 18}F]FDG PET/CT, and who underwent neoadjuvant radiation chemotherapy followed by complete resection. The standardized uptake value (mean, peak, and maximum), metabolic volume (MV), and total lesion glycolysis of rectal cancer lesions were calculated using the isocontour method with various thresholds. Using three-dimensional textural analysis, about 50 textural features were calculated for PET images. Response to neoadjuvant radiation chemotherapy, as assessed by histological tumour regression grading (TRG) after surgery and 3-year DFS, was evaluated using univariate/multivariate binary logistic regression and univariate/multivariate Cox regression analyses. MVs calculated using the thresholds mean standardized uptake value of the liver + two standard deviations (SDs), and mean standard uptake of the liver + three SDs were significantly associated with TRG. Textural parameters from histogram-based and co-occurrence analysis were significantly associated with TRG. However, multivariate analysis revealed that none of these parameters had any significance. On the other hand, MV calculated using various thresholds was significantly associated with 3-year DFS, and MV calculated using a higher threshold tended to be more strongly associated with 3-year DFS. In addition, textural parameters including kurtosis of the absolute gradient (GrKurtosis) were significantly associated with 3-year DFS. Multivariate analysis revealed that GrKurtosis could be a prognostic factor for 3-year DFS. Metabolic and textural parameters from initial [{sup 18}F]FDG PET/CT scans could be indexes to assess

  12. Assessment of cerebral P-glycoprotein expression and function with PET by combined [11C]inhibitor and [11C]substrate scans in rats

    International Nuclear Information System (INIS)

    Müllauer, Julia; Karch, Rudolf; Bankstahl, Jens P.; Bankstahl, Marion; Stanek, Johann; Wanek, Thomas; Mairinger, Severin; Müller, Markus; Löscher, Wolfgang; Langer, Oliver; Kuntner, Claudia

    2013-01-01

    Introduction: The adenosine triphosphate-binding cassette (ABC) transporter P-glycoprotein (Pgp) protects the brain from accumulation of lipophilic compounds by active efflux transport across the blood–brain barrier. Changes in Pgp function/expression may occur in neurological disorders, such as epilepsy, Alzheimer’s or Parkinson’s disease. In this work we investigated the suitability of the radiolabeled Pgp inhibitors [ 11 C]elacridar and [ 11 C]tariquidar to visualize Pgp density in rat brain with PET. Methods: Rats underwent a first PET scan with [ 11 C]elacridar (n = 5) or [ 11 C]tariquidar (n = 6) followed by a second scan with the Pgp substrate (R)-[ 11 C]verapamil after administration of unlabeled tariquidar at a dose which half-maximally inhibits cerebral Pgp (3 mg/kg). Compartmental modeling using an arterial input function and Logan graphical analysis were used to estimate rate constants and volumes of distribution (V T ) of radiotracers in different brain regions. Results: Brain PET signals of [ 11 C]elacridar and [ 11 C]tariquidar were very low (∼ 0.5 standardized uptake value, SUV). There was a significant negative correlation between V T and K 1 (i.e. influx rate constant from plasma into brain) values of [ 11 C]elacridar or [ 11 C]tariquidar and V T and K 1 values of (R)-[ 11 C]verapamil in different brain regions which was consistent with binding of [ 11 C]inhibitors to Pgp and efflux of (R)-[ 11 C]verapamil by Pgp. Conclusion: The small Pgp binding signals obtained with [ 11 C]elacridar and [ 11 C]tariquidar limit the applicability of these tracers to measure cerebral Pgp density. PET tracers with higher (i.e. subnanomolar) binding affinities will be needed to visualize the low density of Pgp in brain

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

    International Nuclear Information System (INIS)

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

    2009-01-01

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

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

    Energy Technology Data Exchange (ETDEWEB)

    Han, Eun Ji; Choi, Woo Hee; Chung, Yong An; Kim, Ki Jun; Maeng, Lee So; Sohn, Kyung Myung; Jung, Hyun Suk; Sohn, Hyung Sun; Chung, Soo Kyo [College of Medicine, The Catholic University of Korea, Seoul (Korea, Republic of)

    2009-02-15

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

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

    DEFF Research Database (Denmark)

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

    2010-01-01

    BACKGROUND: The long-term neurological consequences of HIV infection and treatment are not yet completely understood. In this study we examined the prevalence of cerebral metabolic abnormalities among a cohort of neurologically intact HIV patients with fully suppressed HIV viral loads. Concomitant...... activator receptor (suPAR) were performed to correlate these abnormalities with potential signs of neurodegenerative processes. METHODS: The study population consisted of HIV-positive patients known to be infected for more than 5 years and on antiretroviral (ARV) treatment for a minimum of three years...... of optimally treated HIV patients exhibit cerebral FDG-PET scanning abnormalities and elevated TNF alpha and IL-6 levels, which may indicate imminent neuronal damage. The neuroprotective effect of early ARV treatment should be considered in future prospective follow-up studies....

  16. 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.

  17. FDG PET scan strategies and long-term outcomes after first-line therapy in Hodgkin's Disease

    Energy Technology Data Exchange (ETDEWEB)

    Poulou, Loukia S. [Department of Computed Tomography, ' Sotiria' General Hospital for Chest Diseases, Athens (Greece); Karianakis, George [Bone Marrow Transplantation Unit, ' Hygeia' Diagnostic and Therapeutic Centre, 4 Erythrou Stavrou Street, 151 23 Athens (Greece); Ziakas, Panayiotis D. [Bone Marrow Transplantation Unit, ' Hygeia' Diagnostic and Therapeutic Centre, 4 Erythrou Stavrou Street, 151 23 Athens (Greece)], E-mail: zpanos@otenet.gr

    2009-06-15

    Background: The use of positron emission tomography with fluoro-deoxy-glucose (FDG PET) in Hodgkin's disease (HD) is continuing to expand worldwide, with response assessment after completion of therapy being its most widely utilized application. A positive scan has been associated with high relapse rates and disease progression. Methods: A decision analysis was performed to determine the long-term impact of FDG PET restaging both with and without computed tomography (CT) in terms of the 5-year progression-free survival (5yrPFS). Outcomes and utilities were based on published data. The first strategy involved CT restaging after first-line therapy, with or without subsequent FDG PET, while Second strategy used FDG PET scan alone. All positive test required histological examination. Upon histological confirmation of active lymphoma, patients were considered candidates for autologous transplantation and long-term outcomes were retrieved. The expected clinical benefit of the two strategies was calculated and depicted, along with the mean costs. One-way and two-way sensitivity analyses were performed to ensure the validity of the results. Results: CT restaging plus FDG PET when residual mass is detected, results in a 2% benefit at 5yrPFS at baseline compared to FDG PET-alone restaging and remains positive for a wide range of probabilities. This strategy reduces the average cost by Euro 1863 per patient, including costs of biopsy and autologous transplantation. Conclusion: A more conservative approach that includes CT restaging after first-line therapy and FDG PET scan only on residual mass, is the preferred strategy in HD. Furthermore it appears to confer the maximal diagnostic yield along with a substantial reduction in the mean cost.

  18. Clinical Indications and Impact on Management: Fourth and Subsequent Posttherapy Follow-up18F-FDG PET/CT Scans in Oncology Patients.

    Science.gov (United States)

    Taghipour, Mehdi; Marcus, Charles; Sheikhbahaei, Sara; Mena, Esther; Prasad, Shwetha; Jha, Abhinav K; Solnes, Lilja; Subramaniam, Rathan M

    2017-05-01

    The Centers for Medicare and Medicaid Services coverage includes 3 posttherapy 18 F-FDG PET/CT scans per patient and per tumor type. Any additional follow-up 18 F-FDG PET/CT scans will be reimbursed at the discretion of a local Medicare administrator, if deemed medically necessary. This study aimed to investigate common clinical indications for performing a fourth or additional follow-up 18 F-FDG PET/CT scans that could affect the management of patients. Methods: This was a retrospective institutional review of 433 oncology patients (203 men; mean age, 55 y), including a total of 1,659 fourth or subsequent follow-up PET/CT scans after completion of primary treatment. Twelve indications for performing a fourth or subsequent follow-up PET/CT scan were determined, and the impact of each of the 12 indications on patients' management was evaluated. Results: The primary tumors were breast cancer (92 patients, 426 scans), non-Hodgkin lymphoma (77 patients, 208 scans), Hodgkin disease (41 patients, 182 scans), colorectal cancer (70 patients, 286 scans), melanoma (69 patients, 271 scans), and lung cancer (84 patients, 286 scans). The indications were categorized in 4 groups: PET/CT for diagnosis of tumor recurrence (303/1,659, 18.3%), PET/CT before starting therapy for tumor recurrence (64/1,659, 3.9%), PET/CT to assess therapy response for tumor recurrence (507/1,659, 30.6%), and follow-up PET/CT after completion of treatment for tumor recurrence (785/1,659, 47.3%). Overall, fourth and subsequent follow-up 18 F-FDG PET/CT scans resulted in change in management in 31.6% of the scans (356 of 1,128) when the scans were obtained for medical necessities (indications 1-11), and in 5.6% of the scans (30/531) when the scans were obtained without any medical necessity (indication 12). Conclusion: The fourth and subsequent PET/CT scans obtained after completion of primary treatment led to a change in management in 31.6% of the scans when acquired for appropriate clinical reasons

  19. Pulmonary aspergilloma: A rare differential diagnosis to lung cancer after positive FDG PET scan

    Directory of Open Access Journals (Sweden)

    Franziska Spycher

    2014-01-01

    Full Text Available Early diagnosis and treatment of lung cancer, one of the leading causes of cancer-related death, is important to improve morbidity and mortality. Therefore any suspect solitary pulmonary nodule should prompt the pursuit for a definitive histological diagnosis. We describe the case of a 55-years-old male ex-smoker, who was admitted to our hospital due to recurrent hemoptysis and dry cough. A CT scan showed an irregular nodule of increasing size (28 mm in diameter in the left lower lobe (LLL. A whole body PET-CT scan (643 MBq F-18 FDG i.v. was performed and confirmed an avid FDG uptake of the nodule in the LLL, highly suspicious of lung cancer, without any evidence of lymphogenic or hematogenic metastasis. Bronchoscopy was not diagnostic and due to severe adhesions after prior chest trauma and the central location of the nodule, a lobectomy of the LLL was performed. Surprisingly, histology showed a simple aspergilloma located in a circumscribed bronchiectasis with no evidence of malignancy. This is a report of an informative example of an aspergilloma, which presented with symptoms and radiological features of malignant lung cancer.

  20. False-positive 18-fluorodeoxyglucose positron emission tomography–computed tomography (FDG PET/CT scans mimicking malignancies

    Directory of Open Access Journals (Sweden)

    Zehra Yasar

    2015-02-01

    Full Text Available Aim 18-Fluorodeoxyglucose (FDG positron emission tomography–computed tomography (PET/CT is an imaging modality that is often used to help differentiate benign from malignant pulmonary lesions and it has been shown to be more efficacious than conventional chest computed tomography (CT. However, some benign lesions may also show increased metabolic activity which can lead to false-positive PET findings. We aim to illustrate false positive findings of PET scan that simulate lung cancer in a variety of diseases. Methods Patients referred to Yedikule Chest Diseases and Surgery Teaching and Research Hospital with increased FDG uptake for which histological results were available over a 2-year period (2013-2014 were reviewed. Seven patients with false-positive PET/CT findings were reported in this study. Results The majority of lesions showing increased metabolic activity were due to malignant diseases. However, increased 18 F-FDG uptake was also seen in benign lesions such as active pulmonary inflammation or infection, granulomatous processes and fibrotic lesions. Conclusion. The integration of clinical history, morphologic findings of lesions on the CT component, and metabolic activities of PET/CT scan can help reduce false interpretations. Interventional procedures.

  1. Role of fluorine-18 fluoride PET-CT scan in the assessment of unilateral condylar hyperplasia in faciomandibular asymmetry patients: a preliminary study.

    Science.gov (United States)

    Ahmed, Rais; Singh, Satinder P; Mittal, Bhagwant R; Rattan, Vidya; Parghane, Rahul; Utreja, Ashok

    2016-03-01

    This prospective study was aimed to determine and quantify the change in mandibular condylar hyperactivity over a period of time by using a fluorine-18 (18F) fluoride PET-computed tomography (CT) scan. Sixteen patients (age 19.50 ± 2.58 years) with noticeable faciomandibular asymmetry caused by unilateral condylar hyperplasia (UCH) were included in the test group and underwent an 18F-fluoride PET-CT scan at the beginning of the study (T0); these patients were then followed up for a minimum of 12 months, after which the 18F-fluoride PET-CT scan was repeated at first follow-up (T1). An age-matched control group consisted of 10 patients with apparently symmetrical faces whose PET-CT scans were acquired for some other medical conditions. Statistical analysis of maximum standardized uptake values (SUV max) obtained through 18F-fluoride PET-CT was performed using the paired t-test. Mean SUV max of the affected condyle at T0 and T1 was 9.18 ± 4.07 and 9.18 ± 3.88, respectively. The mean SUV max of the contralateral condyle at T0 and T1 was 6.21 ± 2.30 and 6.66 ± 2.64, respectively. The mean right-left difference in tracer uptake between the test and control groups both at T0 and T1 was statistically significant. Right-left percentage difference of isotope uptake of the test group was 16.87 ± 15.75% at T0 and 14.97 ± 12.72% at T1. Right-left percentage difference of isotope uptake of the control group was 5.51 ± 5.72%. Although these differences were statistically significant, their clinical relevance was insignificant. SUV max of the higher uptake side and the lower uptake side of the control group was 5.63 ± 1.85 and 5.09 ± 1.83, respectively. Great diversity exists in the clinical presentation of UCH. The growth trend of UCH is highly variable because of the age and sex of patients. The results of the present study show that the 18F-fluoride PET-CT scan may guide us in determining the right time and in making the right choice of surgico

  2. The Effects of Misalignment between PET and CT Scans on Brain PET Study Using CT-based Attenuation Correction: A Phantom Study.

    Science.gov (United States)

    Shimizu, Akihide; Terakawa, Yusuke; Morita, Naomi; Koshino, Kazuhiro; Iida, Hidehiro

    2016-01-01

    The aim of this study was to evaluate the effects of inaccurate attenuation correction due to the misalignment between the computed tomography (CT)-based μ-map and the positron emission tomography (PET) data on a brain PET. CT and PET scans were performed on a 3-dimension (3D) brain phantom, in which the grey matter region was filled with 18 F-fluorodeoxyglucose ( 18 F-FDG), and the skull region was filled with/without the bone-equivalent solution. The shifted PET images relative to the CT image were generated by the software-based translation of PET data in the cephalad/caudal and right directions, with a magnitude of the shift up to 30 mm and a step size of 5 mm. The regions of interest (ROIs) were drawn on the areas of the temporal lobes, parietal lobes, thalami, and cerebellums in the no-shifted image (reference). For each ROI, the radioactivity concentrations in the shifted images were compared with those of the reference. The errors in the radioactivity concentrations were increased with the increasing magnitude of the shift in all brain regions except for thalamus. For a 5 mm shift in the right direction, ± 10% errors were observed in the left/right temporal lobes. The accuracy of the radioactivity concentration in the temporal lobe was very sensitive to misalignment in the right directions. The misalignment between CT-based μ-map and PET data had larger effects on the surface regions of the brain rather than on deep brain structures.

  3. Segmentation-free direct tumor volume and metabolic activity estimation from PET scans.

    Science.gov (United States)

    Taghanaki, Saeid Asgari; Duggan, Noirin; Ma, Hillgan; Hou, Xinchi; Celler, Anna; Benard, Francois; Hamarneh, Ghassan

    2018-01-01

    Tumor volume and metabolic activity are two robust imaging biomarkers for predicting early therapy response in F-fluorodeoxyglucose (FDG) positron emission tomography (PET), which is a modality to image the distribution of radiotracers and thereby observe functional processes in the body. To date, estimation of these two biomarkers requires a lesion segmentation step. While the segmentation methods requiring extensive user interaction have obvious limitations in terms of time and reproducibility, automatically estimating activity from segmentation, which involves integrating intensity values over the volume is also suboptimal, since PET is an inherently noisy modality. Although many semi-automatic segmentation based methods have been developed, in this paper, we introduce a method which completely eliminates the segmentation step and directly estimates the volume and activity of the lesions. We trained two parallel ensemble models using locally extracted 3D patches from phantom images to estimate the activity and volume, which are derivatives of other important quantification metrics such as standardized uptake value (SUV) and total lesion glycolysis (TLG). For validation, we used 54 clinical images from the QIN Head and Neck collection on The Cancer Imaging Archive, as well as a set of 55 PET scans of the Elliptical Lung-Spine Body Phantom™with different levels of noise, four different reconstruction methods, and three different background activities, namely; air, water, and hot background. In the validation on phantom images, we achieved relative absolute error (RAE) of 5.11 % ±3.5% and 5.7 % ±5.25% for volume and activity estimation, respectively, which represents improvements of over 20% and 6% respectively, compared with the best competing methods. From the validation performed using clinical images, we found that the proposed method is capable of obtaining almost the same level of agreement with a group of trained experts, as a single trained

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

    Directory of Open Access Journals (Sweden)

    James C. Patterson

    2011-01-01

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

  5. PET

    DEFF Research Database (Denmark)

    Mariager, Rasmus Mølgaard; Schmidt, Regin; Heiberg, Morten Rievers

    PET handler om den hemmelige tjenestes arbejde under den kolde krig 1945-1989. Her fortæller Regin Schmidt, Rasmus Mariager og Morten Heiberg om de mest dramatiske og interessante sager fra PET's arkiv. PET er på flere måder en udemokratisk institution, der er sat til at vogte over demokratiet....... Dens virksomhed er skjult for offentligheden, den overvåger borgernes aktiviteter, og den registrerer følsomme personoplysninger. Historien om PET rejser spørgsmålet om, hvad man skal gøre, når befolkningen i et demokrati er kritisk indstillet over for overvågningen af lovlige politiske aktiviteter......, mens myndighederne mener, at det er nødvendigt for at beskytte demokratiet. PET er på en gang en fortælling om konkrete aktioner og begivenheder i PET's arbejde og et stykke Danmarkshistorie. Det handler om overvågning, spioner, politisk ekstremisme og international terrorisme.  ...

  6. 18F-DOPA PET/CT and 68Ga-DOTANOC PET/CT scans as diagnostic tools in focal congenital hyperinsulinism

    DEFF Research Database (Denmark)

    Christiansen, Charlotte Dahl; Petersen, Henrik; Nielsen, Anne Lerberg

    2018-01-01

    (68Ga-DOTANOC) PET/CT as diagnostic tools in focal CHI. Methods: PET/CT scans of children with CHI admitted to Odense University Hospital between August 2005 and June 2016 were retrospectively evaluated visually and by their maximal standardized uptake values (SUVmax) by two independent examiners...... in 34 patients, no surgery in 21 patients. Fifty-one patients had a classifiable outcome, either by histology (n = 33, 22 focal lesions, 11 non-focal) or by genetics (n = 18, all non-focal). The predictive performance of 18F-DOPA PET/CT to identify focal CHI was identical by visual- and cut......Purpose: Focal congenital hyperinsulinism (CHI) is curable by surgery, which is why identification of the focal lesion is crucial. We aimed to determine the use of 18F–fluoro-dihydroxyphenylalanine (18F-DOPA) PET/CT vs. 68Ga-1,4,7,10-tetraazacyclododecane-1,4,7,10-tetraacetic-acid-1-Nal3-octreotide...

  7. Is FDG PET/CT scan superior to Ca-125 levels in management of recurrent ovarian carcinoma

    International Nuclear Information System (INIS)

    Gupta, Khushboo; Krishna, B.A.; Singh, Natasha; Mishra, Rohini; Shivdasani, D.; Moyade, P.

    2010-01-01

    Full text: In the post-operative surveillance of ovarian carcinoma patients, the CA-125 levels play an important role. However there is no direct relationship between the level of CA-125 and the metastatic volume. Hence FDG-PET scan would play a major role in the detection and quantification of the metastatic disease burden. We present our retrospective analysis of 30 ovarian carcinoma patients in this context. Totally 30 patient were included in the study. All patients had CA-125 estimation as part of regular follow up after initial surgery. All those patients who had elevated CA-125 levels were further investigated with either CT/MRI/USG initially followed by PET-CT scan in those patients where focal disease was detected by one of the 3 anatomical modalities. For purpose of analysis patients were grouped into 3 categories based on CA-125 levels: Group A: CA-125 - 0 to 35 IU/ml (n=10), Group B: CA-125 35 to 70 IU/ml (n=6), Group C: CA-125->70 IU/ml (n=14). The volume of disease detected on PET/CT scan was correlated with CA-125 levels and also its impact on treatment approach was analysed. In Group A - 3 patients had no disease (no treatment given), 6 had distant metastasis (chemotherapy) and 1 had localized disease (surgical excision). Group B - 2 patients had localized disease (surgery + chemotherapy in one patient) and 4 had distant metastasis (chemotherapy). Group C - 13 patients had distant metastasis including lungs (2 patients) and bones (4 patients) (chemotherapy + radiotherapy), and 1 patient had localized disease (surgical removal). Out of 30 patients, there were 8 patients (26.6%) who showed solitary lesions on CT scan, however in 3 of these 8 patients PET/CT scans showed multiple sites resulting in 37.5% upstaging and thereby change of therapy in the form of surgery to systemic chemotherapy. From our analysis we conclude that the CA-125 levels correlated well with volume of metastatic disease on PET/CT in higher range (CA-125: >70 IU/ml) while in the

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

    Directory of Open Access Journals (Sweden)

    Saima Riaz

    2017-06-01

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

  9. The 3-D alignment of objects in dynamic PET scans using filtered sinusoidal trajectories of sinogram

    International Nuclear Information System (INIS)

    Kostopoulos, Aristotelis E.; Happonen, Antti P.; Ruotsalainen, Ulla

    2006-01-01

    In this study, our goal is to employ a novel 3-D alignment method for dynamic positron emission tomography (PET) scans. Because the acquired data (i.e. sinograms) often contain noise considerably, filtering of the data prior to the alignment presumably improves the final results. In this study, we utilized a novel 3-D stackgram domain approach. In the stackgram domain, the signals along the sinusoidal trajectory signals of the sinogram can be processed separately. In this work, we performed angular stackgram domain filtering by employing well known 1-D filters: the Gaussian low-pass filter and the median filter. In addition, we employed two wavelet de-noising techniques. After filtering we performed alignment of objects in the stackgram domain. The local alignment technique we used is based on similarity comparisons between locus vectors (i.e. the signals along the sinusoidal trajectories of the sinogram) in a 3-D neighborhood of sequences of the stackgrams. Aligned stackgrams can be transformed back to sinograms (Method 1), or alternatively directly to filtered back-projected images (Method 2). In order to evaluate the alignment process, simulated data with different kinds of additive noises were used. The results indicated that the filtering prior to the alignment can be important concerning the accuracy

  10. Role of FDG-PET scans in staging, response assessment, and follow-up care for non-small cell lung cancer

    Directory of Open Access Journals (Sweden)

    John eCuaron

    2013-01-01

    Full Text Available The role PET in the staging of non-small cell lung cancer (NSCLC is well established. Evidence is emerging for the role of PET in response assessment to neoadjuvant therapy, combined-modality therapy, and early detection of recurrence. Here, we review the current literature on these aspects of PET in the management of NSCLC. FDG-PET, particularly integrated 18F-FDG-PET/CT, scans have become a standard test in the staging of local tumor extent, mediastinal lymph node involvement, and distant metastatic disease in NSCLC. FDG-PET sensitivity is generally superior to computed tomography (CT scans alone. Local tumor extent and T stage can be more accurately determined with FDG-PET in certain cases. FDG-PET sensitivity is decreased in tumors <1 cm, at least in part due to respiratory motion. False-negative results can occur in areas of low tumor burden. FDG-PET-CT nodal staging is more accurate than CT alone. FDG-PET scans have widely replaced bone scintography for assessing distant metastases, except for the brain, which still warrants dedicated brain imaging. FDG uptake has also been shown to vary between histologies, with adenocarcinomas generally being less FDG avid than squamous cell carcinomas. FDG-PET scans are useful to detect recurrences, but are currently not recommended for routine follow-up. Typically, patients are followed with chest CT scans every 3-6 months, using FDG-PET to evaluate equivocal CT findings. As high FDG uptake can occur in infectious, inflammatory, and other non-neoplastic conditions, PET-positive findings require pathological confirmation. There is increased interest in the prognostic and predictive role of FDG-PET scans. Studies show that absence of metabolic response to neoadjuvant therapy correlates with poor pathologic response, and a favorable FDG-PET response appears to be associated with improved survival. Further work is underway to identify subsets of patients that might benefit individualized management based

  11. Diagnostic value of blood thiamine metabolites in Alzheimer's disease examined by11C-PiB PET scanning.

    Science.gov (United States)

    Chen, Zhichun; Pan, Xiaoli; Fei, Guoqiang; Pan, Shumei; Bao, Weiqi; Ren, Shuhua; Guan, Yihui; Zhong, Chunjiu

    2017-06-01

    We evaluated the diagnostic value of blood thiamine metabolites for Alzheimer's disease (AD) by using positron emission tomography with 11 C-Pittsburgh compound B ( 11 C-PiB PET) scanning. Thirty-eight clinically diagnosed AD patients were voluntarily recruited. Blood thiamine metabolites were measured by high-performance liquid chromatography. All the patients received 11 C-PiB PET scanning for the measurement of cerebral amyloid deposition. Thiamine diphosphate (TDP) had 66.7% sensitivity and 80.0% specificity for AD diagnosis, while the γ-value representing the best combination of thiamine metabolites and age had 24.2% sensitivity and 100.0% specificity according to the cut-off value of our previous study. Blood TDP but not γ-value exhibited results significant for AD diagnosis.

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

    International Nuclear Information System (INIS)

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

    2013-01-01

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

  13. Pilot study of propranolol premedication to reduce FDG uptake in brown adipose tissue on PET scans of adolescent and young adult oncology patients.

    Science.gov (United States)

    George, Anil; Sinha, Partha; Conrad, Gary; Memon, Aum A; Dressler, Emily V; Wagner, Lars M

    2017-04-01

    Physiologic uptake of 18 F-fluorodeoxyglucose (FDG) in brown adipose tissue (adipose tissue) of cancer patients may confound interpretation of positron emission tomography (PET) scans. Uptake in adipose tissue occurs in up to half of pediatric oncology patients undergoing PET scans, and is especially common in adolescents. adipose tissue is innervated by the sympathetic nervous system, and beta blockers such as propranolol have shown efficacy in reducing adipose tissue uptake on PET scans done in older adult oncology patients. Because propranolol may cause hypoglycemia or other side effects in fasting patients, we prospectively assessed the safety of a single dose of 20 mg propranolol in adolescent and young adult oncology patients undergoing FDG-PET imaging. Ten patients (median age 18 years, range 14-24) received propranolol premedication prior to FDG-PET. No adverse effects or clinically significant changes in serum glucose, heart rate, or blood pressure were observed. Five of the 10 patients had adipose tissue identified on previous PET scans. However, following propranolol administration only, one patient had persistent uptake in adipose tissue. Propranolol was convenient and safe in fasting adolescent and young adult oncology patients undergoing PET scans. Larger studies are warranted to better define the effectiveness of this approach.

  14. Preoperative F-18-FDG PET for the detection of metastatic cervical lymph nodes in recurrent papillary thyroid carcinoma patients with negative I-131 whole body scans

    International Nuclear Information System (INIS)

    Byun, Byung Hyun; Urn, Sang Moo; Cheon, Gi Jeong; Choi, Chang Woon; Lee, Byeong Cheol; Lee, Guk Haeng; Lee, Yong Sik; Shim, Youn Sang

    2007-01-01

    We evaluated the diagnostic performance of FDG-PET for the detection of metastatic cervical lymph nodes in recurrent papillary thyroid carcinoma patients with negative I-131 scan. All patients had total thyroidectomy and following I-131 ablation therapy. In the follow-up period, FDG-PET showed suspected cervical lymph nodes metastases and neck dissection was performed within 3 months after FDG-PET. It had shown for all patients the negative I-131 scan within 3 months before FDG-PET or negative I-131 scan during the period of cervical lymph nodes metastases suspected on the basis of FDG-PET, CT, or ultrasonography until the latest FDG-PET. Preoperative FDG-PET results were compared with the pathologic findings of lymph nodes specimens of 19 papillary thyroid carcinoma patients. Serum Tg, TSH, and Tg antibody levels at the time of latest I-131 scan were reviewed. The size of lymph node was measured by preoperative CT or ultrasonography. In 45 cervical lymph node groups dissected, 31 lymph node groups revealed metastasis. The sensitivity and specificity of FDG-PET for metastasis were 74.2% (23 of 31) and 50.0% (7 of 14), respectively. Except for patients with elevated Tg antibody levels, all patients showed the elevated serum Tg levels than normal limits at the TSH of =30uIU/ml. 8 lesions without suspected metastatic findings on FDG-PET revealed metastasis (false negative), and none of them exceeded 8mm in size (4 to 8mm, median= 6mm). On the other hand, 23 true positive lesions on FDG-PET were variable in size (6 to 17mm, median=9mm). FDG-PET is suitable for the detection of metastatic cervical lymph nodes in patients with recurrent papillary thyroid carcinoma. However, false positive or false negative should be considered according to the size of lymph node

  15. Value of fourth and subsequent post-therapy follow-up 18F-FDG PET/CT scans in patients with breast cancer.

    Science.gov (United States)

    Taghipour, Mehdi; Sheikhbahaei, Sara; Trahan, Tyler J; Subramaniam, Rathan M

    2016-06-01

    To evaluate the accuracy and value of the fourth and subsequent post-therapy follow-up fluorine-18 fluorodeoxyglucose (F-FDG) PET/computed tomography (CT) scans in the clinical assessment of breast cancer patients. Ninety-two female patients, with a total of 426 fourth and subsequent follow-up PET/CT scans, were retrospectively included. Patients were followed for a median of 23.7 months (range, 0.7-124.4) from the fourth follow-up PET/CT. The diagnostic accuracy of PET/CT, its impact on clinical assessment, patients' management, and survival outcome were established. Of the 426 follow-up PET/CT scans, 264 (62%) were interpreted as positive and 162 (38%) were interpreted as negative. The sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of the fourth and subsequent follow-up PET/CT scans were 97.7, 98.1, 98.8, 96.3, and 97.9%, respectively. Fourth and subsequent follow-up PET/CT were useful in excluding a tumor in 13.4% (39/292) of patients with a clinical suspicion of recurrence and identifying suspected recurrence in 10.5% (14/134) of patients without previous clinical suspicion. A change in management was noted in 6.7% (9/134) of scan times when the scans were performed without previous clinical suspicion of recurrence or therapy response and was 27.7% (81/292) when the scans were performed with clinical suspicion. Overall survival differed significantly between patients with all negative follow-up scans (n=23) and those who had at least one positive follow-up scan (n=69) (hazard ratio of 4.65, Pchange in management in 27.7% of patients when the scans were performed with clinical suspicion and only in 6.7% of patients when performed without clinical suspicion or context.

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2012-11-15

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

  17. Markers of D(2) and D(3) receptor activity in vivo: PET scan and prolactin.

    Science.gov (United States)

    Thomasson-Perret, Nitza; Pénélaud, Pierre-François; Théron, David; Gouttefangeas, Sylvie; Mocaër, Elisabeth

    2008-01-01

    Positrons Emission Tomography (PET) allows to evaluate the dopaminergic activity of antipsychotic, by measuring post synaptic D(2) dopaminergic receptors occupancy. A good correlation was brought forward between a rate of occupancy of 80% of striatal D(2) receptors and the occurrence of extrapyramidal effects. These PET studies have also established that at least 60% D(2) receptors occupancy was predictive of clinical antipsychotic response. The PET studies in healthy volunteers can then be used to help choose doses to be tested during the clinical trials of new antipsychotic drugs. The increase in prolactin level is one other of the markers of the antagonist dopaminergic activity which concerns D(2) receptors of the pituitary gland. The example of S 33138, a potential antipsychotic, preferential D(3) versus D(2) receptor antagonist will be given to illustrate these data. The results of two PET studies as well as the effects on prolactin and extrapyramidal signs will be presented.

  18. Brain FDG-PET Scan and Brain Perfusion SPECT in the Diagnosis of Neuroacanthocytosis Syndromes

    Directory of Open Access Journals (Sweden)

    Eylem Değirmenci

    2015-06-01

    Full Text Available Neuroacanthocytosis syndromes (NA include autosomal recessive chorea-acanthocytosis and X-linked McLeod syndrome consisting of a choreatic movement disorder, psychiatric manifestations and cognitive decline, and additional multi-system features including myopathy and axonal neuropathy. Fluor 18 -2-fluoro-2-deoxyglucose (18F-FDG-PET positron emission tomography (PET and technetium 99m -d, l-hexamethyl-propylene amine oxime (99mTc-HMPAO brain single photon emission computed tomography (SPECT have been increasingly used for the detection of neurologic disorders, such as dementia, epilepsy, and movement disorders. In this case report, we report two patients with neuroacanthocytosis syndromes with the imaging features of brain metabolism by PET and brain perfusion by SPECT. Brain PET and brain SPECT findings of patients with neuroacanthocytosis syndromes were also reviewed.

  19. Retrospective analysis for the false positive diagnosis of PET-CT scan in lung cancer patients.

    Science.gov (United States)

    Feng, Mingxia; Yang, Xuemei; Ma, Qiang; He, Yong

    2017-10-01

    Early diagnosis is pivotal for prognosis of lung cancer patients. Positron emission tomography/computed tomography (PET-CT) is a useful method for human cancer diagnosis. In this study, we aimed to explore the false positive diagnosis of PET-CT in lung cancerIn total, 754 patients diagnosed with lung cancer via PET-CT were retrospectively collected in this study. Histopathological detection served as gold standard. The diagnostic accuracy of PET-CT was defined as the proportion of lung cancer cases confirmed by pathological diagnosis in the study subjects, and the percentages of misdiagnosed cases represented the false positive diagnosis of PET-CT. Chi-square test and logistic regression analysis were used to analyze the association of pathologically confirmed result with clinical characteristics.Among all the patients, 705 cases were pathologically confirmed with lung cancer. The diagnostic accuracy of PET-CT was 93.5%, and the false positive rate was 6.50%. Among the false positive patients, inflammatory pseudotumor (42.86%) and tuberculoma (36.74%) were the most pathological types. In the positive detection group, adenocarcinoma (57.16%) and squamous carcinoma (33.19%) were the main pathological types, and 68.09% of the lung cancer patients were at the advanced stages. The false positive rate were related with age, diabetes, interleukin-6 (IL-6) level, and T-spot test (all P < .05).PET-CT could be a good diagnostic method for lung cancer, but the false positive cases could appear. Detection of inflammatory indicators such as IL-6 and T-spot TB test may help improve the diagnostic accuracy of PET-CT.

  20. Interim FDG-PET Scan in Hodgkin's Lymphoma: Hopes and Caveats

    Directory of Open Access Journals (Sweden)

    M. André

    2011-01-01

    Full Text Available FDG-PET has recently emerged as an important tool for the management of Hodgkins lymphoma. Although its use for initial staging and response evaluation at the end of treatment is well established, the place of interim PET for response assessment and subsequent treatment tailoring is still quite controversial. The use of interim PET after a few cycles of chemotherapy may allow treatment reduction for good responders, leading to lesser treatment toxicities as well as early treatment adaptation for bad responders with a potential higher chance for cure. Interpretation of interim PET is a rapidly moving field. Actually, visual interpretation is preferred over quantitative interpretation in this situation. The notion of minimal residual uptake emerged for faint persisting FDG uptake, but has evolved during the recent years. Guidelines using mediastinum and liver as references have been proposed at the expert meeting in Deauville 2009. Actually, several trials are ongoing both for localised and advanced disease to evaluate the FDG-PET potential for early treatment monitoring and tailoring. Until the results of these prospective randomized trials become available, treatment changes according to the interim PET results should remain inappropriate and limited to well-conducted clinical trials.

  1. Qualitative interpretation of PET scans using a Likert scale to assess neck node response to radiotherapy in head and neck cancer

    Energy Technology Data Exchange (ETDEWEB)

    Sjoevall, Johanna; Wahlberg, Peter [Lund University, Department of Otorhinolaryngology (ORL)-Head and Neck Surgery, Skane University Hospital, Lund (Sweden); Bitzen, Ulrika [Lund University, Department of Clinical Physiology and Nuclear Medicine, Skane University Hospital, Lund (Sweden); Kjellen, Elisabeth; Nilsson, Per; Brun, Eva [Lund University, Department of Oncology and Radiation Physics, Skane University Hospital, Lund (Sweden)

    2016-04-15

    The aim of this study was to determine whether PET scans after radiotherapy (RT), visually interpreted as equivocal regarding metabolic neck node response can be used to accurately categorize patients as responders or nonresponders using a Likert scale and/or maximum standardized uptake value (SUVmax). Other aims were to determine the performance of different methods for assessing post-RT PET scans (visual inspection, a Likert scale and SUVmax) and to establish whether any method is superior in predicting regional control (RC) and overall survival (OS). In 105 patients with neck node-positive head and neck cancer, the neck node response was evaluated by FDG PET/CT 6 weeks after RT. The scans were clinically assessed by visual inspection and, for the purposes of this analysis, re-evaluated using the Deauville criteria, a five-point Likert scale previously used in lymphoma studies. In addition, SUVmax was determined. All assessment methods were able to significantly predict RC but not OS. The methods were also able to significantly predict remission of tumour after completion of RT. Of the 105 PET scans, 19 were judged as equivocal on visual inspection. The Likert scale was preferable to SUVmax for grouping patients as responders or nonresponders. All methods (visual inspection, SUVmax and the Likert scale) identified responders and nonresponders and predicted RC. A Likert scale is a promising tool to reduce to a minimum the problem of PET scans judged as equivocal. Consensus regarding qualitative assessment would facilitate PET reporting in clinical practice. (orig.)

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2017-08-15

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

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

    Science.gov (United States)

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

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

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

    Directory of Open Access Journals (Sweden)

    Takeshi Hara

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

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

    Science.gov (United States)

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

    2018-02-09

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

  6. Influence of Arm Movement on Lesion Detection in PET/CT Imaging: Case Report

    Directory of Open Access Journals (Sweden)

    Yasemin Parlak

    2015-06-01

    Full Text Available Arm movement after the CT scan is a common artifact in PET/CT scanning. Motion artifacts may lead to difficulties in interpreting PET/CT images accurately. We report a 66 year old male patient with gastric cancer who underwent PET/CT for primary staging. He had a previous history of papillary thyroid cancer. In PET scan, there were striking cold artifacts at the level of arms. This is a classical sign of an accidental arm motion. A second scan was performed with the arms down due to the history of papillary thyroid cancer. The results were discussed.

  7. PET Scanning Protocols for In-Situ Dose Delivery Verification of Proton Therapy

    NARCIS (Netherlands)

    Buitenhuis, H.J.T.; Dendooven, P.; Biegun, A.K.; van der Borden, A.J.; Diblen, F.; van Goethem, M.-J.; van der Schaaf, A.A.; van t Veld, Aart; Brandenburg, S.

    2016-01-01

    Positron emission tomography is so far the only method for in-vivo dose delivery verification in hadron therapy that is in clinical use. A PET scanner placed in the treatment position (in-situ) will be able to obtain the highest number of counts, as it minimizes the decay of the positron emitting

  8. Utility of 18 F-FDG PET/CT scan to diagnose the etiology of fever of unknown origin in patients on dialysis.

    Science.gov (United States)

    Tek Chand, Kalawat; Chennu, Krishna Kishore; Amancharla Yadagiri, Lakshmi; Manthri Gupta, Ranadheer; Rapur, Ram; Vishnubotla, Siva Kumar

    2017-04-01

    Studies on fever of unknown origin (FUO) in patients of chronic kidney disease and end stage renal disease patients on dialysis were not many. In this study, we used 18 F-FDG PET/CT scan whole body survey for detection of hidden infection, in patients on dialysis, labelled as FUO. In this retrospective study, 20 patients of end stage renal disease on dialysis were investigated for the cause of FUO using 18F-FDG PET/CT scan. All these patients satisfied the definition of FUO as defined by Petersdorf and Beeson. Any focal abnormal site of increased FDG concentration detected by PET/CT, either a solitary or multiple lesions was documented and at least one of the detected abnormal sites of radio tracer concentration was further examined for histopathology. All patients were on renal replacement therapy. Of these, 18 were on hemodialysis and two were on peritoneal dialysis. 18F-FDG PET/CT scan showed metabolically active lesions in 15 patients and metabolically quiescent in five patients. After 18F-FDG PET/CT scan all, but one patient had a change in treatment for fever. Anti-tuberculous treatment was given in 15 patients, antibiotics in four patients and anti-malaria treatment in one patient. The present study is first study of 18F-FDG PET/CT scan in patients of end stage renal disease on dialysis with FUO. The study showed that the 18 F FDG PET/CT scan may present an opportunity to attain the diagnosis in end stage renal disease patients on dialysis with FUO. © 2016 International Society for Hemodialysis.

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

    Science.gov (United States)

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

    2015-07-20

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

  10. F-18 FDG-PET/CT evaluation of patients with differentiated thyroid cancer with negative I-131 total body scan and high thyroglobulin level.

    Science.gov (United States)

    Bertagna, Francesco; Bosio, Giovanni; Biasiotto, Giorgio; Rodella, Carlo; Puta, Erinda; Gabanelli, Sara; Lucchini, Silvia; Merli, Giuseppe; Savelli, Giordano; Giubbini, Raffaele; Rosenbaum, Joshua; Alavi, Abass

    2009-11-01

    The aim was to evaluate the incremental diagnostic rate of F-18 fluoro-fluorodeoxygulose positron emission tomography/computed tomography (F-18 FDG-PET/CT) in patients with negative I-131 whole body scans and high Tg levels. The secondary end points were correlations between F-18 FDG-PET/CT positive results and Tg levels and comparison between F-18 FDG-PET/CT accuracy in patients "on-therapy" with suppressed thyroid stimulating hormone (TSH) and those with high TSH levels. We studied 52 patients who had undergone total thyroidectomy and remnant ablation; they had high Tg levels (average = 156 ng/mL; SD +/- 274) after 3 weeks of levothyroxine withdrawal and negative I-131 total body scans after therapeutic doses. We noted a statistically significant positive correlation between F-18 FDG-PET/CT positive results and Tg levels, irrespective of levothyroxine therapy regimen. Tg levels between F-18 FDG-PET/CT positive/negative groups were significantly different and we did not note any statistically significant correlation between F-18 FDG-PET/CT results and TSH levels, tumor size, and combination of Tg/TSH levels. Our results indicate that F-18 FDG-PET/CT is a useful diagnostic tool in patients with differentiated thyroid carcinoma and with negative I-131 total body scans and high Tg levels. The levothyroxine therapy regimen does not influence F-18 FDG-PET/CT results and the rate of F-18 FDG-PET/CT positive results appears to correlate with the Tg levels. The highest accuracy is reached when the study is performed for patients with Tg levels higher than 21 ng/mL.

  11. Influence of scanning time window on the binding potentials of dopamine transporter in the brain of healthy volunteers with 11C-CFT PET imaging

    International Nuclear Information System (INIS)

    Qiu Chun; Zuo Chuantao; Zhang Zhengwei; Wu Ping; Zhang Huiwei; Guan Yihui

    2013-01-01

    Objective: To find the optimal scanning time window and then set up the normal binding potentials (BPs) of 2β-carbomethoxy-3β-(4-fluorophenyl)-(N- 11 C-methyl) tropane ( 11 C-CFT) DAT PET/CT imaging. Methods: Thirty-one healthy volunteers (20 males, 11 females, average age: (55.7±2.3) years), who all gave written informed consent, were divided into three age and gender-matched groups according to block randomization. Each group underwent static PET/CT scan in different time windows from 40-60 min, 60-80 min to 80-100 min after 11 C-CFT injection. To determine the best scanning time window, the ratios of caudate and putamen of all volunteers were analyzed using automatic ROI method (caudate (putamen)/parieto-occipital cotex-1) and compared by one-way analysis of variance and the least significant difference (LSD) t test. The ratio of the same area between different age-groups and gender-groups was compared with independent two-sample t test. Results: Ratios of left caudate (2.08±0.06, 1.75±0.07 and 1.77±0.12 respectively), right anterior putamen (2.33±0.06, 1.95±0.09 and 2.08±0.12 respectively) and bilateral posterior putamen (left: 1.88±0.66, 1.55±0.88 and 1.72±0.09; right: 1.98±0.07, 1.61±0.09 and 1.69±0.12) were all different in three time windows (F=3.588, 3.345, 4.479, 3.557, all P<0.05). There were significant differences in ratios of left caudate, right anterior and bilateral posterior putamen between 40-60 min and the 60-80 min (all P<0.05), as well as the ratios of left caudate between 40-60 min and the 80-100 min group (P<0.05). While no valid differences in ratios of those areas were shown between the groups of 60-80 min and 80-100 min scanning time window (all P>0.05). DAT densities in right and left side of caudate, anterior and posterior putamen were significantly lower in the group over 60 years of age than those under 60 years (t=-3.260, -3.090, -3.270, -3.190, -2.270, -3.110, all P<0.05), but were not different between gender

  12. Direct Test for Neuroinflammation with [11C]DAP-713-PET Scanning

    Science.gov (United States)

    2015-10-01

    Investigator Description of Goals: The overall goal is to have a fully validated probe ready for human administration and to file a FDA...1/2011-8/31/2015 Level of Funding: $249,274 Description of Goals: The goal is to develop a new nicotinic receptor-based PET agent that enables...systemic administration . New Title: PSMA Directed Imaging of Prostate Cancer Focus on Androgen Receptor Dynamics Time Commitments: 1.35 Supporting

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

    Directory of Open Access Journals (Sweden)

    Emel TOKMAK

    2011-08-01

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

  14. Direct Test for Neuroinflammation with [11C]DAP-713-PET Scanning

    Science.gov (United States)

    2016-10-01

    patient cohort. What was the impact on other disciplines ? Better analysis of TSPO imaging has arisen. This is spreading to other work, such as TSPO...guide stereotactic body radiation treatment (SBRT) in patients with oligometastatic disease. Aim 4. Imaging CRPC with the second-generation, PSMA...University and the University of Texas Southwestern Medical Center, where a carefully vetted population of individuals with GWI exists. PET imaging

  15. Common causes of false positive F18 FDG PET/CT scans in oncology

    Directory of Open Access Journals (Sweden)

    Kevin R. Carter

    2007-09-01

    Full Text Available PET/CT is a common imaging modality used in the evaluation of oncology patients. While being extremely sensitive to identifying sights of malignancy F18FDG is very non-specific. We attempted to provide a brief review of some of the more common processes that a nuclear radiology physician may encounter in daily clinical practice that could result in a false positive diagnosis with F18FDG PET/CT. A fundamental understanding of the limitations of this technology by the interpreting physician is necessary to avoid making inaccurate diagnosis and potentially limiting important treatments for our patients.PET/CT é uma modalidade de imagem usada para avaliação de pacientes oncológicos. Embora seja extremamente sensível para identificar sinais de malignidade, o F18FDG não é ainda muito específico. Nós buscamos mostrar uma breve revisão de alguns dos processos mais comuns que um médico nuclear pode encontrar na prática clínica diária que poderia resultar em um diagnóstico falso positivo com a F18FDG PET/CT. Uma melhor compreensão das limitações dessa tecnologia é necessária para que a interpretação pelo médico não possibiite diagnósticos imprecisos, que potencialmente podem limitar os tratamentos dos pacientes.

  16. The role of F18-FDG PET scans in predicting micropapillary thyroid cancer aggressiveness

    International Nuclear Information System (INIS)

    Cho, E. H.; Cho, H. J.; Kim, T. S.; Kang, W. J.; Yun, M. J.; Lee, J. D.

    2007-01-01

    The purpose is to evaluate F18-FDG PET in predicting micropapillary thyroid cancer aggressiveness. 41 patients (38 female, mean age 50y) who had PET before total thyroidectomy between 2002.1∼2007.8 were reviewed. Patients with thyroiditis and multiple nodules were excluded. Thyroid nodules were visually analyzed into groups with increased and no FDG uptake. Peak SUV ratio of liver-to-nodule (pSUV ratio) was taken. pSUV ratio was correlated with nodule size and micropapillary cancer aggressiveness. Perithyroid extension and/or LN metastasis was used as an indicator of micropapillary cancer aggressiveness 20 patients had 0.89 and nodules with increased FDG uptake, with an average pSUV ratio of 1.67 0.15. 21 patients had nodules that were not visible, average size of 0.66 cm 0.24. FDG uptake and nodule size correlation was with an average size of 0.52 cm significant (p=0.051). The nodules were divided into two groups using a cut-off value of pSUV ratio of 0.9. 19 patients had nodules with a pSUV ratio of 0.9 or higher, and 15 of the 19 patients had perithyroid extension and/or LN metastasis. 22 patients had nodules with pSUV ratio lower than 0.9 and 7 of these patients had perithyroid extension and/or LN metastasis. Patients with higher pSUV ratio showed more perithyroid extension or LN metastasis than those with lower pSUV ratio (p=0.01). A total of 8 patients had LN metastasis, but none were visualized on PET. Higher FDG uptake seems to be significantly correlated with tumor aggressiveness in micropapillary thyroid carcinomas. But FDG uptakes in primary tumors were also correlated with tumor size. In other words, larger nodules tend to show aggressive behavior in micropapillary thyroid carcinomas and FDG it self may not be an independent factor for tumor aggressiveness. Also, PET shows an extremely poor sensitivity for the detection of LN metastasis. Therefore, PET may not have any role in the evaluation of patients with micropapillary thyroid carcinomas

  17. Automatic extraction of forward stroke volume using dynamic PET/CT

    DEFF Research Database (Denmark)

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

    2015-01-01

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

  18. qPET - a quantitative extension of the Deauville scale to assess response in interim FDG-PET scans in lymphoma

    Energy Technology Data Exchange (ETDEWEB)

    Hasenclever, Dirk [University of Leipzig, Institute for Medical Informatics, Statistics and Epidemiology (IMISE), Leipzig (Germany); Kurch, Lars; Georgi, Thomas; Sabri, Osama; Kluge, Regine [University Hospital Leipzig, Department of Nuclear Medicine, Leipzig (Germany); Mauz-Koerholz, Christine; Koerholz, Dieter [University Hospital Halle, Department of Pediatrics, Halle (Germany); Elsner, Andreas [Hermes Medical Solutions AB, Stockholm (Sweden); Wallace, Hamish [Royal Hospital for Sick Children, Edinburgh, Scotland (United Kingdom); Landman-Parker, Judith [Hopital d' Enfants Armand Trousseau, Paris (France); Moryl-Bujakowska, Angelina [Jagiellonian University Medical College, Department of Pediatric Oncology and Hematology, Polish-American Institute of Pediatrics, Krakow (Poland); Cepelova, Michaela [Department of Pediatric Hematology and Oncology, Faculty Hospital Motol, Prague (Czech Republic); Karlen, Jonas [Karolinska University Hospital, Pediatric Cancer Unit, Astrid Lindgrens Childrens Hospital, Stockholm (Sweden); Alvarez Fernandez-Teijeiro, Ana [University Hospital Virgen Macarena Avda, Department of Pediatric Oncology and Hematology, Sevilla (Spain); Attarbaschi, Andishe [Medical University of Vienna, Department of Pediatric Hematology and Oncology, St. Anna Children' s Hospital, Vienna (Austria); Fossaa, Alexander [Department of Medical Oncology and Radiotherapy, Rikshospitalet - Radiumhospitalet HF, Oslo (Norway); Pears, Jane [Our Lady' s Children' s Hospital, Crumlin, Dublin (Ireland); Hraskova, Andrea [University Children' s Hospital, Clinic of Pediatric Oncology, Bratislava (Slovakia); Bergstraesser, Eva [University Children' s Hospital, Department Oncology, Zurich (Switzerland); Beishuizen, Auke [MC - Sophia Children' s Hospital, Department of Pediatric Oncology/Hematology, Rotterdam (Netherlands); Uyttebroeck, Anne [University Hospitals of Leuven, Department of Pediatric Hemato-Oncology, Leuven (Belgium); Schomerus, Eckhard [University of Odense (OUH), Department of Pediatric Oncology and Hematology, H. C. Andersen Children' s Hospital, Odense (Denmark)

    2014-07-15

    Interim FDG-PET is used for treatment tailoring in lymphoma. Deauville response criteria consist of five ordinal categories based on visual comparison of residual tumor uptake to physiological reference uptakes. However, PET-response is a continuum and visual assessments can be distorted by optical illusions. With a novel semi-automatic quantification tool we eliminate optical illusions and extend the Deauville score to a continuous scale. SUV{sub peak} of residual tumors and average uptake of the liver is measured with standardized volumes of interest. The qPET value is the quotient of these measurements. Deauville scores and qPET-values were determined in 898 pediatric Hodgkin's lymphoma patients after two OEPA chemotherapy cycles. Deauville categories translate to thresholds on the qPET scale: Categories 3, 4, 5 correspond to qPET values of 0.95, 1.3 and 2.0, respectively. The distribution of qPET values is unimodal with a peak representing metabolically normal responses and a tail of clearly abnormal outliers. In our patients, the peak is at qPET = 0.95 coinciding with the border between Deauville 2 and 3. qPET cut values of 1.3 or 2 (determined by fitting mixture models) select abnormal metabolic responses with high sensitivity, respectively, specificity. qPET methodology provides semi-automatic quantification for interim FDG-PET response in lymphoma extending ordinal Deauville scoring to a continuous scale. Deauville categories correspond to certain qPET cut values. Thresholds between normal and abnormal response can be derived from the qPET-distribution without need for follow-up data. In our patients, qPET < 1.3 excludes abnormal response with high sensitivity. (orig.)

  19. qPET - a quantitative extension of the Deauville scale to assess response in interim FDG-PET scans in lymphoma

    International Nuclear Information System (INIS)

    Hasenclever, Dirk; Kurch, Lars; Georgi, Thomas; Sabri, Osama; Kluge, Regine; Mauz-Koerholz, Christine; Koerholz, Dieter; Elsner, Andreas; Wallace, Hamish; Landman-Parker, Judith; Moryl-Bujakowska, Angelina; Cepelova, Michaela; Karlen, Jonas; Alvarez Fernandez-Teijeiro, Ana; Attarbaschi, Andishe; Fossaa, Alexander; Pears, Jane; Hraskova, Andrea; Bergstraesser, Eva; Beishuizen, Auke; Uyttebroeck, Anne; Schomerus, Eckhard

    2014-01-01

    Interim FDG-PET is used for treatment tailoring in lymphoma. Deauville response criteria consist of five ordinal categories based on visual comparison of residual tumor uptake to physiological reference uptakes. However, PET-response is a continuum and visual assessments can be distorted by optical illusions. With a novel semi-automatic quantification tool we eliminate optical illusions and extend the Deauville score to a continuous scale. SUV peak of residual tumors and average uptake of the liver is measured with standardized volumes of interest. The qPET value is the quotient of these measurements. Deauville scores and qPET-values were determined in 898 pediatric Hodgkin's lymphoma patients after two OEPA chemotherapy cycles. Deauville categories translate to thresholds on the qPET scale: Categories 3, 4, 5 correspond to qPET values of 0.95, 1.3 and 2.0, respectively. The distribution of qPET values is unimodal with a peak representing metabolically normal responses and a tail of clearly abnormal outliers. In our patients, the peak is at qPET = 0.95 coinciding with the border between Deauville 2 and 3. qPET cut values of 1.3 or 2 (determined by fitting mixture models) select abnormal metabolic responses with high sensitivity, respectively, specificity. qPET methodology provides semi-automatic quantification for interim FDG-PET response in lymphoma extending ordinal Deauville scoring to a continuous scale. Deauville categories correspond to certain qPET cut values. Thresholds between normal and abnormal response can be derived from the qPET-distribution without need for follow-up data. In our patients, qPET < 1.3 excludes abnormal response with high sensitivity. (orig.)

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

    Science.gov (United States)

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

    2001-08-01

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

  1. Objective functions for tomographic reconstruction from randoms-precorrected PET scans

    International Nuclear Information System (INIS)

    Yavuz, M.; Fessler, J.A.

    1996-01-01

    In PET, usually the data are precorrected for accidental coincidence (AC) events by real-time subtraction of the delayed window coincidences. Randoms subtraction compensates in mean for AC events but destroys the Poisson statistics. Furthermore, for transmission tomography the weighted least-squares (WLS) method leads to systematic biases, especially at low count rates. We propose a new open-quotes shiftedclose quotes Poisson (SP) model for precorrected PET data, which properly matches the first and second order moments of the measurement statistics. Using simulations and analytic approximations, we show that estimators based on the open-quotes ordinaryclose quotes Poisson (OP) model for the precorrected data lead to higher standard deviations than the proposed method. Moreover, if one zero-thresholds the data before applying the maximization algorithm, the OP model results in systematic bias. It is shown that the proposed SP model leads to penalized-likelihood estimates free of systematic bias, even for zero-thresholded data. The proposed SP model does not increase the computation requirements compared to OP model and it is robust to errors in the estimates of the AC event rates

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

    International Nuclear Information System (INIS)

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

    2007-01-01

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

  3. Semiautomated segmentation of head and neck cancers in 18F-FDG PET scans: A just-enough-interaction approach

    Science.gov (United States)

    Beichel, Reinhard R.; Van Tol, Markus; Ulrich, Ethan J.; Bauer, Christian; Chang, Tangel; Plichta, Kristin A.; Smith, Brian J.; Sunderland, John J.; Graham, Michael M.; Sonka, Milan; Buatti, John M.

    2016-01-01

    Purpose: The purpose of this work was to develop, validate, and compare a highly computer-aided method for the segmentation of hot lesions in head and neck 18F-FDG PET scans. Methods: A semiautomated segmentation method was developed, which transforms the segmentation problem into a graph-based optimization problem. For this purpose, a graph structure around a user-provided approximate lesion centerpoint is constructed and a suitable cost function is derived based on local image statistics. To handle frequently occurring situations that are ambiguous (e.g., lesions adjacent to each other versus lesion with inhomogeneous uptake), several segmentation modes are introduced that adapt the behavior of the base algorithm accordingly. In addition, the authors present approaches for the efficient interactive local and global refinement of initial segmentations that are based on the “just-enough-interaction” principle. For method validation, 60 PET/CT scans from 59 different subjects with 230 head and neck lesions were utilized. All patients had squamous cell carcinoma of the head and neck. A detailed comparison with the current clinically relevant standard manual segmentation approach was performed based on 2760 segmentations produced by three experts. Results: Segmentation accuracy measured by the Dice coefficient of the proposed semiautomated and standard manual segmentation approach was 0.766 and 0.764, respectively. This difference was not statistically significant (p = 0.2145). However, the intra- and interoperator standard deviations were significantly lower for the semiautomated method. In addition, the proposed method was found to be significantly faster and resulted in significantly higher intra- and interoperator segmentation agreement when compared to the manual segmentation approach. Conclusions: Lack of consistency in tumor definition is a critical barrier for radiation treatment targeting as well as for response assessment in clinical trials and in

  4. Staging PET-CT Scanning Provides Superior Detection of Lymph Nodes and Distant Metastases than Traditional Imaging in Locally Advanced Breast Cancer.

    Science.gov (United States)

    Garg, Pankaj Kumar; Deo, Suryanarayana V S; Kumar, Rakesh; Shukla, Nootan Kumar; Thulkar, Sanjay; Gogia, Ajay; Sharma, Daya Nand; Mathur, Sandeep R

    2016-08-01

    This study was designed to evaluate the role of a single 18-FDG positron emission tomography and computed tomography (PET-CT) scan in comparison to multiple organ-directed conventional investigations (CI) as a staging tool in locally advanced breast cancer (LABC) to detect regional and distant metastasis. All eligible patients were subjected to CI (chest X-ray, abdominal sonography, and bone scintigraphy) followed by a single 18-FDG PET-CT scan. Standard imaging criteria were used for diagnosis of metastasis. Histopathological confirmation was undertaken for suspicious lesions. An exploratory analysis was done to assess the impact of PET-CT on the staging of LABC and how it resulted in a change in management. The study included 79 patients of LABC. PET-CT detected distant metastasis in 36 (45.5 %) patients while CI could identify distant metastasis in 20 (25.3 %) patients. Two of the 36 patients in whom PET-CT detected distant metastasis were false positive. Overall PET-CT upstaged the disease in 38 (48.1 %) patients as compared to CI: stage III to stage IV migration in 14 (17.7 %) patients due to identification of additional sites of distant metastasis, and within stage III upstaging in 24 (30.3 %) patients due to identification of additional regional lymphadenopathy. PET-CT led to a change in management plan in 14 (17.7 %) patients. PET-CT has a role in identifying additional sites of regional lymphadenopathy and distant metastasis to upstage the disease in a significant number of LABC patients in comparison to CI; this would help in accurate staging, selecting optimal treatment, and better prognostication of disease.

  5. Pyelo-cystic Reflux in F-18 FDG PET Scan Due to Ureteral Obstruction

    Energy Technology Data Exchange (ETDEWEB)

    Reyhan, Mehmet [Baskent Univ., Adana (Turkmenistan)

    2013-09-15

    A 72-year-old woman with a history of cervical cancer was treated with brachytherapy and chemotherapy. Combined F-18 FDG PET/CT performed for restaging demonstrated increased FDG uptake in a hypodense cystic lesion at the posterior part of the right renal cortex and a hypermetabolic soft tissue mass at the right parailiac region suggestive of a metastatic lymph node causing ureteral obstruction. There had been no FDG uptake in the cystic lesion on the FDG PET/CT study performed 1 year before. These findings suggest that the increased FDG uptake in the cystic lesion was caused by pyelocystic reflux due to ureteral obstruction secondary to parailiac lymph node metastasis (Figs. 1 and 2). Several renal lesions may have increased metabolism, such as renal cell carcinoma, lymphoma, oncocytoma, adult Wilms' tumor, angiomyolipoma, metastatic lesions, xanthogranulo-matous pyelonephritis and infected cyst. Most of these lesions are solid. Some infected renal cysts may be FDG avid, but in this situation increased FDG uptake is observed on the wall of the cyst. In our case, FDG uptake was seen in the entire cystic lesion. The patient had no symptoms or laboratory findings related to infection. Cysts are the most common space-occupying lesions of the kidney. The vast majority of these are simple cysts that are usually unilateral and solitary. Simple cysts are asymptomatic, except when complications exist such as hemorrhage, infection or rupture. There have been a few reports on spontaneous communications between renal cysts and the pyelocaliceal system, in most cases involving ruptures of the cysts into the pyelocaliceal system due to increased intracystic pressure caused by bleeding or infection of the cyst. In the present case, the cause of the connection between the cystic cavity and the pyelocaliceal system is the increased pressure in the renal pelvic cavity due to the ureteral obstruction secondary to parailiac lymph node metastasis.

  6. Evaluation of a short dynamic 18F-fluoride PET/CT scanning method to assess bone metabolic activity in spinal orthopedics

    OpenAIRE

    Peters, Marloes J. M.; Wierts, Roel; Jutten, Elisabeth M. C.; Halders, Serv? G. E. A.; Willems, Paul C. P. H.; Brans, Boudewijn

    2015-01-01

    Objective A complication after spinal fusion surgery is pseudarthrosis, but its radiological diagnosis is of limited value. 18F-fluoride PET with its ability to assess bone metabolism activity could be of value. The goal of this study was to assess the clinical feasibility of calculating the static standardized uptake value (SUV) from a short dynamic scan without the use of blood sampling, thereby obtaining all dynamic and static parameters in a scan of only 30?min. This approach was tested o...

  7. TU-C-12A-12: Differentiating Bone Lesions and Degenerative Joint Disease in NaF PET/CT Scans Using Machine Learning

    International Nuclear Information System (INIS)

    Perk, T; Bradshaw, T; Muzahir, S; Jeraj, R; Meyer, E

    2014-01-01

    Purpose: [F-18]NaF PET can be used to image bone metastases; however, tracer uptake in degenerative joint disease (DJD) often appears similar to metastases. This study aims to develop and compare different machine learning algorithms to automatically identify regions of [F-18]NaF scans that correspond to DJD. Methods: 10 metastatic prostate cancer patients received whole body [F-18]NaF PET/CT scans prior to treatment. Image segmentation resulted in 852 ROIs, 69 of which were identified by a nuclear medicine physician as DJD. For all ROIs, various PET and CT textural features were computed. ROIs were divided into training and testing sets used to train eight different machine learning classifiers. Classifiers were evaluated based on receiver operating characteristics area under the curve (AUC), sensitivity, specificity, and positive predictive value (PPV). We also assessed the added value of including CT features in addition to PET features for training classifiers. Results: The training set consisted of 37 DJD ROIs with 475 non-DJD ROIs, and the testing set consisted of 32 DJD ROIs with 308 non-DJD ROIs. Of all classifiers, generalized linear models (GLM), decision forests (DF), and support vector machines (SVM) had the best performance. AUCs of GLM (0.929), DF (0.921), and SVM (0.889) were significantly higher than the other models (p<0.001). GLM and DF, overall, had the best sensitivity, specificity, and PPV, and gave a significantly better performance (p<0.01) than all other models. PET/CT GLM classifiers had higher AUC than just PET or just CT. GLMs built using PET/CT information had superior or comparable sensitivities, specificities and PPVs to just PET or just CT. Conclusion: Machine learning algorithms trained with PET/CT features were able to identify some cases of DJD. GLM outperformed the other classification algorithms. Using PET and CT information together was shown to be superior to using PET or CT features alone. Research supported by the Prostate

  8. A quantitative comparison of gross tumor volumes delineated on [18F]-FDG-PET/CT scan and contrast-enhanced computed tomography scan in locally advanced head and neck carcinoma treated with Intensity Modulated Radiotherapy

    Directory of Open Access Journals (Sweden)

    Nagarjuna Burela

    2017-05-01

    Full Text Available Accurate tumor diagnosis is important in highly conformal techniques such as Intensity Modulated Radiotherapy (IMRT, which aims for high therapeutic ratio. We compared Gross Tumor Volume (GTV (primary and nodal delineated on 18F-fluorodeoxyglucose positron emission tomography ([18F]-FDG-PET scan to those delineated on contrast-enhanced computed tomography (CECT scan and its impact on staging treated by IMRT. A total of 30 consecutive patients with locally advanced squamous cell carcinoma of head and neck were included in this study. FDG-PET and CECT scans were performed with dedicated positron emission tomography–computed tomography (PET/CT scanner in a single session as part of radiotherapy treatment planning for IMRT. After treatment with concurrent chemoradiotherapy, all patients were followed for one year. Three out of 30 patients were excluded from the final analysis, as there was complete remission in PET/CT after neoadjuvant chemotherapy. For remaining 27 cases, the primary sites were 17 oropharynx, 2 hypopharynx, 7 larynx and 1 unknown primary with secondary neck node. PET–CT resulted in changes of CT-based staging in 25% patients (up-staged in 3 and down-staged in 4. GTV delineated on PET vs CT scan was GTV-PET (primary of 20.15 cm3 vs GTV-CT (primary of 18.75 cm3, p = 0.803; and GTV-PET (nodes of 28.45 cm3 vs GTV-CT (nodes of 21.56 cm3, p = 0.589. The mismatch between two target volumes was statistically insignificant (p = 0.635 for GTV primary, p = 0.187 for nodes. The mean GTV-PET outside CT for primary was 5.83 cm3, and for node was 8.47 cm3. Median follow-up was 12 months. One-year loco-regional control was 92%. The target delineation of GTV can be improved with functional imaging [18F]-FDG-PET/CT.

  9. Influence of scan duration on the accuracy of {beta}-amyloid PET with florbetaben in patients with Alzheimer's disease and healthy volunteers

    Energy Technology Data Exchange (ETDEWEB)

    Tiepolt, Solveig; Barthel, Henryk; Butzke, Daniel; Hesse, Swen; Patt, Marianne; Sabri, Osama [University of Leipzig, Department of Nuclear Medicine, Leipzig (Germany); Gertz, Hermann-Josef [University of Leipzig, Department of Psychiatry, Leipzig (Germany); Reininger, Cornelia [Bayer Pharma AG, Global Clinical Development, Berlin (Germany)

    2013-02-15

    Florbetaben is a {beta}-amyloid-targeted PET tracer with significant potential for augmenting the toolbox in the clinical diagnosis of Alzheimer's disease (AD). In dementia imaging, shortening of scan duration may simplify future clinical use. The aim of this retrospective study was to investigate the effect of scan duration on diagnostic accuracy. PET scans obtained from 25 AD patients and 25 healthy volunteers (HVs) were analysed. In each subject, scans of three different durations (5, 10 and 20 min; all starting 90 min after injection) were obtained, randomized, and visually assessed by three experts blinded to the subject's identity and group affiliation. Presence/absence of {beta}-amyloid and diagnostic confidence (0-100 %) were scored, and 10 % of the scans were re-read. Further, randomly selected datasets of ten AD patients and ten HVs were quantified using an established VOI-based approach and using a voxel-based approach. The sensitivity and specificity of the blinded read were 80 % and 96 %, respectively, for all scan durations. Diagnostic confidence was high (97 {+-} 6 %, 97 {+-} 6 % and 95 {+-} 8 % for the 20-min, 10-min and 5-min scans, respectively; n.s.), as was interreader agreement (kappa{sub 20} {sub min} = 0.94, kappa{sub 10} {sub min} = 0.94, kappa{sub 5} {sub min} = 0.89; n.s.). Intrareader agreement was highest for the 20-min scan (kappa = 1.00) and lower for the 10-min scan (kappa = 0.71) and 5-min scan (kappa = 0.80; p = 0.002 and 0.003 vs. the 20-min scan). For all scan durations, composite SUVRs (Cohen's d effect size 4.5, 3.9 and 4.8 for the 5-min, 10-min and 20-min scans; p < 0.0001 each) and individual brain volumes affected by {beta}-amyloid (Cohen's d effect size 1.6, 1.8 and 2.0 for the 5-min, 10-min and 20-min scans; p < 0.005 each) were significantly higher in AD patients than in HVs. Reduction in scan duration did not relevantly affect the accuracy of florbetaben PET scans in discriminating between AD patients

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

    Energy Technology Data Exchange (ETDEWEB)

    Jaruskova, M.; Belohlavek, O. [Na Homolce Hospital, PET Center, Prague 5 (Czech Republic)

    2006-08-15

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

  11. Detection of nodular pulmonary amyloid by PET positive scan—Deception for lung cancer

    Directory of Open Access Journals (Sweden)

    A.M. Khan

    2012-11-01

    pulmão tanto em formas localizadas como sistémicas da doença. As manifestações da doença pulmonar relacionadas com a AL variam desde nódulos identificados em incidências de raio-X do tórax até à deposição septal, simulando malignidade, e/ou em danos difusos alveolares. Keywords: Amyloidosis, Nodular, Local, PET scan, Tracheobronchial amyloidosis, Lung diseases, Palavras-chave: Amiloidose, Nodular, Local, Tomografia de emissão positrónica (TEP, Amiloidose traqueobrônquica, Doenças pulmonares

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2016-06-15

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

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

    DEFF Research Database (Denmark)

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

    2013-01-01

    A custom designed markerless tracking system was demonstrated to be applicable for positron emission tomography (PET) brain imaging. Precise head motion registration is crucial for accurate motion correction (MC) in PET imaging. State-of-the-art tracking systems applied with PET brain imaging rel...

  14. Simulation of PET scan timings for receptor occupancy studies of CNS drugs: a simple fixed-time design performed as well as scattered time point designs.

    Science.gov (United States)

    Lee, Jongtae; Jeon, Sangil; Hong, Taegon; Han, Seunghoon; Yim, Dong-Seok

    2015-11-01

    This study aimed to determine the effect of PET scan timings on the reliability of occupancy parameter estimates and to identify the scan timing design that gives the most reliable occupancy parameter estimates. We compared the performance of designs with various sets of sampling time points using the stochastic simulation and estimation method in Perl-speaks-NONMEM. Biases, relative standard errors, relative estimation errors, and root mean square errors were used to compare the performance of designs. Unlike the results of a previous report, we found that rather complicated designs where each subject or group of subjects are allocated to different scan timings were not superior to the simple, conventional fixed-time designs regardless of whether effect compartment or receptor binding models were used. We conclude that the conventional fixed-time designs that have been used so far may give robust PD parameter estimates for occupancy data obtained from human PET studies of CNS drugs.

  15. Comparison of standardized uptake values measured on 18F-NaF PET/CT scans using three different tube current intensities

    OpenAIRE

    Agnes Araujo Valadares; Paulo Schiavom Duarte; Eduardo Bechtloff Woellner; George Barberio Coura-Filho; Marcelo Tatit Sapienza; Carlos Alberto Buchpiguel

    2015-01-01

    Objective: To analyze standardized uptake values (SUVs) using three different tube current intensities for attenuation correction on 18FNaF PET/CT scans. Materials and Methods: A total of 254 18F-NaF PET/CT studies were analyzed using 10, 20 and 30 mAs. The SUVs were calculated in volumes of interest (VOIs) drawn on three skeletal regions, namely, right proximal humeral diaphysis (RH), right proximal femoral diaphysis (RF), and first lumbar vertebra (LV1) in a total of 712 VOIs. The analyses ...

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2016-06-15

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

  17. Automatic extraction of forward stroke volume using dynamic PET/CT

    DEFF Research Database (Denmark)

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

    Background: Dynamic PET can be used to extract forward stroke volume (FSV) by the indicator dilution principle. The technique employed can be automated and is in theory independent on the tracer used and may therefore be added to any dynamic cardiac PET protocol. The aim of this study was to vali......Background: Dynamic PET can be used to extract forward stroke volume (FSV) by the indicator dilution principle. The technique employed can be automated and is in theory independent on the tracer used and may therefore be added to any dynamic cardiac PET protocol. The aim of this study...... was to validate automated methods for extracting FSV directly from dynamic PET studies for two different tracers and to examine potential scanner hardware bias. Methods: 21 subjects underwent a dynamic 27 min 11C-acetate PET scan on a Siemens Biograph TruePoint 64 PET/CT scanner (scanner I). In addition, 8...... subjects underwent a dynamic 6 min 15O-water PET scan followed by a 27 min 11C-acetate PET scan on a GE Discovery ST PET/CT scanner (scanner II). The LV-aortic time-activity curve (TAC) was extracted automatically from dynamic PET data using cluster analysis. The first-pass peak was isolated by automatic...

  18. {sup 11}C-Choline PET/CT for restaging prostate cancer. Results from 4,426 scans in a single-centre patient series

    Energy Technology Data Exchange (ETDEWEB)

    Graziani, Tiziano; Ceci, Francesco; Polverari, Giulia; Lima, Giacomo Maria; Lodi, Filippo; Fanti, Stefano [S. Orsola-Malpighi Hospital, University of Bologna, Service of Nuclear Medicine, Bologna (Italy); Castellucci, Paolo [S. Orsola-Malpighi Hospital, University of Bologna, Service of Nuclear Medicine, Bologna (Italy); Azienda Ospedaliero-Universitaria di Bologna, Policlinico S. Orsola-Malpighi, UO Medicina Nucleare, Bologna (Italy); Morganti, Alessio Giuseppe [S. Orsola-Malpighi Hospital, University of Bologna, Department of Radiotherapy, Bologna (Italy); Ardizzoni, Andrea [S. Orsola-Malpighi Hospital, University of Bologna, Department of Oncology, Bologna (Italy); Schiavina, Riccardo [S. Orsola-Malpighi Hospital, University of Bologna, Department of Urology, Bologna (Italy)

    2016-10-15

    To evaluate {sup 11}C-choline PET/CT as a diagnostic tool for restaging prostate cancer (PCa), in a large, homogeneous and clinically relevant population of patients with biochemical recurrence (BCR) of PCa after primary therapy. The secondary aim was to assess the best timing for performing {sup 11}C-choline PET/CT during BCR. We retrospectively analysed 9,632 {sup 11}C-choline PET/CT scans performed in our institution for restaging PCa from January 2007 to June 2015. The inclusion criteria were: (1) proven PCa radically treated with radical prostatectomy (RP) or with primary external beam radiotherapy (EBRT); (2) PSA serum values available; (3) proven BCR (PSA >0.2 ng/mL after RP or PSA >2 ng/mL above the nadir after primary EBRT with rising PSA levels). Finally, 3,203 patients with recurrent PCa matching all the inclusion criteria were retrospectively enrolled and 4,426 scans were analysed. Overall, 52.8 % of the {sup 11}C-choline PET/CT scans (2,337/4,426) and 54.8 % of the patients (1,755/3,203) were positive. In 29.4 % of the scans, at least one distant finding was observed. The mean and median PSA values were, respectively, 4.9 and 2.1 ng/mL at the time of the scan (range 0.2 - 50 ng/mL). In our series, 995 scans were performed in patients with PSA levels between 1 and 2 ng/mL. In this subpopulation the positivity rate in the 995 scans was 44.7 %, with an incidence of distant findings of 19.2 % and an incidence of oligometastatic disease (one to three lesions) of 37.7 %. The absolute PSA value at the time of the scan and ongoing androgen deprivation therapy were associated with an increased probability of a positive {sup 11}C-choline PET/CT scan (p < 0.0001). In the ROC analysis, a PSA value of 1.16 ng/mL was the optimal cut-off value. In patients with a PSA value <1.16 ng/mL, 26.8 % of 1,426 {sup 11}C-choline PET/CT scans were positive, with oligometastatic disease in 84.7 % of positive scans. In a large cohort of patients, the feasibility of {sup 11}C

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

    Directory of Open Access Journals (Sweden)

    Wendy A. McDougald

    2017-10-01

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

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

    International Nuclear Information System (INIS)

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

    2005-01-01

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

  1. Count-rate analysis from clinical scans in PET with LSO detectors

    International Nuclear Information System (INIS)

    Bonutti, F.; Cattaruzzi, E.; Cragnolini, E.; Floreani, M.; Foti, C.; Malisan, M. R.; Moretti, E.; Geatti, O.; Padovani, R.

    2008-01-01

    The purpose of optimising the acquisition parameters in positron emission tomography is to improve the quality of the diagnostic images. Optimisation can be done by maximising the noise equivalent count rate (NECR) that in turn depends on the coincidence rate. For each bed position the scanner records coincidences and singles rates. For each patient, the true, random and scattered coincidences as functions of the single count rate(s) are determined by fitting the NEMA (National Electrical Manufacturers Association) 70 cm phantom count rate curves to measured clinical points. This enables analytical calculation of the personalised PNECR [pseudo NECR(s)] curve, linked to the NECR curve. For central bed positions, missing activity of ∼70% is estimated to get maximum PNECR (PNECR max ), but the improvement in terms of signal-to-noise ratio would be ∼15%. The correlation between patient weight and PNECR max is also estimated to determine the optimal scan duration of a single bed position as a function of patient weight at the same PNEC. Normalising the counts at PNECR max for the 70 kg patient, the bed duration for a 90 kg patient should be 230 s, which is ∼30% longer. Although the analysis indicates that the fast scanner electronics allow using higher administered activities, this would involve poor improvement in terms of NECR. Instead, attending to higher bed duration for heavier patients may be more useful. (authors)

  2. Rapid computation of single PET scan rest-stress myocardial blood flow parametric images by table look up.

    Science.gov (United States)

    Guehl, Nicolas J; Normandin, Marc D; Wooten, Dustin W; Rozen, Guy; Ruskin, Jeremy N; Shoup, Timothy M; Woo, Jonghye; Ptaszek, Leon M; Fakhri, Georges El; Alpert, Nathaniel M

    2017-09-01

    We have recently reported a method for measuring rest-stress myocardial blood flow (MBF) using a single, relatively short, PET scan session. The method requires two IV tracer injections, one to initiate rest imaging and one at peak stress. We previously validated absolute flow quantitation in ml/min/cc for standard bull's eye, segmental analysis. In this work, we extend the method for fast computation of rest-stress MBF parametric images. We provide an analytic solution to the single-scan rest-stress flow model which is then solved using a two-dimensional table lookup method (LM). Simulations were performed to compare the accuracy and precision of the lookup method with the original nonlinear method (NLM). Then the method was applied to 16 single scan rest/stress measurements made in 12 pigs: seven studied after infarction of the left anterior descending artery (LAD) territory, and nine imaged in the native state. Parametric maps of rest and stress MBF as well as maps of left (f LV ) and right (f RV ) ventricular spill-over fractions were generated. Regions of interest (ROIs) for 17 myocardial segments were defined in bull's eye fashion on the parametric maps. The mean of each ROI was then compared to the rest (K 1r ) and stress (K 1s ) MBF estimates obtained from fitting the 17 regional TACs with the NLM. In simulation, the LM performed as well as the NLM in terms of precision and accuracy. The simulation did not show that bias was introduced by the use of a predefined two-dimensional lookup table. In experimental data, parametric maps demonstrated good statistical quality and the LM was computationally much more efficient than the original NLM. Very good agreement was obtained between the mean MBF calculated on the parametric maps for each of the 17 ROIs and the regional MBF values estimated by the NLM (K 1map LM  = 1.019 × K 1 ROI NLM  + 0.019, R 2  = 0.986; mean difference = 0.034 ± 0.036 mL/min/cc). We developed a table lookup method for fast

  3. Optimization of transmission-scan time for the FixER method: a MR-based PET attenuation correction with a weak fixed-position external radiation source

    Energy Technology Data Exchange (ETDEWEB)

    Kawaguchi, Hiroshi; Hirano, Yoshiyuki; Kershaw, Jeff; Yoshida, Eiji [Molecular Imaging Center, National Institute of Radiological Sciences, Chiba (Japan); Shiraishi, Takahiro [Molecular Imaging Center, National Institute of Radiological Sciences, Chiba (Japan); Research Center for Charged Particle Therapy, National Institute of Radiological Sciences, Chiba (Japan); Suga, Mikio [Molecular Imaging Center, National Institute of Radiological Sciences, Chiba (Japan); Center for Frontier Medical Engineering, Chiba University (Japan); Obata, Takayuki [Molecular Imaging Center, National Institute of Radiological Sciences, Chiba (Japan); Research Center for Charged Particle Therapy, National Institute of Radiological Sciences, Chiba (Japan); Ito, Hiroshi; Yamaya, Taiga [Molecular Imaging Center, National Institute of Radiological Sciences, Chiba (Japan)

    2014-07-29

    In recent work, we proposed an MRI-based attenuation-coefficient (μ-value) estimation method that uses a weak fixed-position external radiation source to construct an attenuation map for PET/MRI. In this presentation we refer to this method as FixER, and perform a series of simulations to investigate the duration of the transmission scan required to accurately estimate μ-values.

  4. (18)F-FDG-PET/CT, (123)I-MIBG and (99m)Tc-MDP whole-body scans, in detecting recurrence of an adult adrenal neuroblastoma.

    Science.gov (United States)

    Skoura, Evangelia; Oikonomopoulos, Georgios; Vasileiou, Spyridon; Kyprianou, Diogenis; Koumakis, Georgios; Datseris, Ioannis E

    2014-01-01

    Neuroblastoma is the most common extracranial solid malignancy in children, but is rare in adults. We report the case of a 33 year old man with recurrence of neuroblastoma, 2 years after the excision of the primary tumor in the right adrenal gland. The iodine-123-radioiodinated metaiodobenzylguanidine ((123)I-MIBG) and (99m)Tc-methylene diphosphonate ((99m)Tc-MDP) bone scans and the fluorine-18-fluorodeoxyglucose-positron computed tomography ((18)F-FDG PET/CT) findings in this patient are presented. First, we applied (123)I-MIBG scintigraphy that detected increased uptake at the right adrenal gland region and probably at liver lesions and in several bones. Then, the (99m)Tc-MDP bone scan revealed also increased uptake of the radiopharmaceutical in bones, but there was a discrepancy between these two studies concerning the number and location of the lesions. Then, (18)F-FDG PET/CT scan was performed, which showed increased uptake of (18)F-FDG at the right adrenal gland region with extension to the liver and also in multiple bones. Additionally, an aortocaval lymph node was detected. In conclusion, this case indicated that (18)F-FDG PET/CT has defined the extent of the recurrence of neuroblastoma in a better way than (123)I-MIBG and (99m)Tc-MDP together.

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

    International Nuclear Information System (INIS)

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

    2009-01-01

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

  6. Evaluation of the dependence of the exposure dose on the attenuation correction in brain PET/CT scans using 18F-FDG

    Science.gov (United States)

    Choi, Eun-Jin; Jeong, Moon-Taeg; Jang, Seong-Joo; Choi, Nam-Gil; Han, Jae-Bok; Yang, Nam-Hee; Dong, Kyung-Rae; Chung, Woon-Kwan; Lee, Yun-Jong; Ryu, Young-Hwan; Choi, Sung-Hyun; Seong, Kyeong-Jeong

    2014-01-01

    This study examined whether scanning could be performed with minimum dose and minimum exposure to the patient after an attenuation correction. A Hoffman 3D Brain Phantom was used in BIO_40 and D_690 PET/CT scanners, and the CT dose for the equipment was classified as a low dose (minimum dose), medium dose (general dose for scanning) and high dose (dose with use of contrast medium) before obtaining the image at a fixed kilo-voltage-peak (kVp) and milliampere (mA) that were adjusted gradually in 17-20 stages. A PET image was then obtained to perform an attenuation correction based on an attenuation map before analyzing the dose difference. Depending on tube current in the range of 33-190 milliampere-second (mAs) when BIO_40 was used, a significant difference in the effective dose was observed between the minimum and the maximum mAs (p effective dose was increased by approximately 5.26-fold. Depending on the change in the tube current in the range of 10-200 mA when D_690 was used, a significant difference in the effective dose was observed between the minimum and the maximum of mA (p effective exposure dose increases with increasing operating current, it is possible to reduce the exposure limit in a brain scan can be reduced if the CT dose can be minimized for a transmission scan.

  7. Subject-specific bone attenuation correction for brain PET/MR: can ZTE-MRI substitute CT scan accurately?

    Science.gov (United States)

    Khalifé, Maya; Fernandez, Brice; Jaubert, Olivier; Soussan, Michael; Brulon, Vincent; Buvat, Irène; Comtat, Claude

    2017-10-01

    In brain PET/MR applications, accurate attenuation maps are required for accurate PET image quantification. An implemented attenuation correction (AC) method for brain imaging is the single-atlas approach that estimates an AC map from an averaged CT template. As an alternative, we propose to use a zero echo time (ZTE) pulse sequence to segment bone, air and soft tissue. A linear relationship between histogram normalized ZTE intensity and measured CT density in Hounsfield units (HU ) in bone has been established thanks to a CT-MR database of 16 patients. Continuous AC maps were computed based on the segmented ZTE by setting a fixed linear attenuation coefficient (LAC) to air and soft tissue and by using the linear relationship to generate continuous μ values for the bone. Additionally, for the purpose of comparison, four other AC maps were generated: a ZTE derived AC map with a fixed LAC for the bone, an AC map based on the single-atlas approach as provided by the PET/MR manufacturer, a soft-tissue only AC map and, finally, the CT derived attenuation map used as the gold standard (CTAC). All these AC maps were used with different levels of smoothing for PET image reconstruction with and without time-of-flight (TOF). The subject-specific AC map generated by combining ZTE-based segmentation and linear scaling of the normalized ZTE signal into HU was found to be a good substitute for the measured CTAC map in brain PET/MR when used with a Gaussian smoothing kernel of 4~mm corresponding to the PET scanner intrinsic resolution. As expected TOF reduces AC error regardless of the AC method. The continuous ZTE-AC performed better than the other alternative MR derived AC methods, reducing the quantification error between the MRAC corrected PET image and the reference CTAC corrected PET image.

  8. Primary mediastinal large B-cell lymphoma: Clinical features, prognostic factors and survival with RCHOP in Arab patients in the PET scan era

    Directory of Open Access Journals (Sweden)

    Salem Al Shemmari

    2014-01-01

    Full Text Available Objective: PMBCL is a distinct type of nonhodgkins lymphoma with specific clinicopathological features. To clarify clinical features, treatment alternatives and outcomes, we evaluated 28 Arab patients treated with chemotherapy or radiotherapy between 2006 and 2011. Patients and Methods: PMBCL lymphoma patients identified according to WHO classification and treated at KCCC between 2006 and 2011 were included in this study. Demographic and clinical data are presented as means or medians. Overall survival was estimated using the Kaplan-Meier method. Survival rates were compared using the log-rank test. A P < 0.05 was considered significant. Results: The median age of the patients was 31 years and the male to female ratio was 2:1. Majority of the patients (75% presented with stage I/II disease. Most had features of local extension like pleural effusion (18% and SVCO (39%. Only 11% of the patients had bone marrow involvement at presentation. 96% of the patients required biopsy from the mediastinal mass either by image guided core biopsy (75% or by surgical biopsy. Most patients were treated by RCHOP and involved field radiotherapy. Patients with positive PET scan after RCHOP chemotherapy received salvage chemotherapy and BEAM autologous marrow transplant. The five year OS for the entire group was 85% while the PFS was 73%. Patients who had PET scan for response evaluation had better OS [P = 0.013] and PFS [P = 0.039] when compared with those patients who received only radiotherapy based on CT scan evaluation. Conclusion: PMBCL is a specific lymphoma entity seen in the young with good survival. The role of PET scan for response evaluation and the type of consolidation therapy needs to be further clarified

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

    International Nuclear Information System (INIS)

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

    2003-01-01

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

  10. [18F]FDG PET/CT outperforms [18F]FDG PET/MRI in differentiated thyroid cancer

    International Nuclear Information System (INIS)

    Vrachimis, Alexis; Wenning, Christian; Weckesser, Matthias; Stegger, Lars; Burg, Matthias Christian; Allkemper, Thomas; Schaefers, Michael

    2016-01-01

    To evaluate the diagnostic potential of PET/MRI with [ 18 F]FDG in comparison to PET/CT in patients with differentiated thyroid cancer suspected or known to have dedifferentiated. The study included 31 thyroidectomized and remnant-ablated patients who underwent a scheduled [ 18 F]FDG PET/CT scan and were then enrolled for a PET/MRI scan of the neck and thorax. The datasets (PET/CT, PET/MRI) were rated regarding lesion count, conspicuity, diameter and characterization. Standardized uptake values were determined for all [ 18 F]FDG-positive lesions. Histology, cytology, and examinations before and after treatment served as the standards of reference. Of 26 patients with a dedifferentiated tumour burden, 25 were correctly identified by both [ 18 F]FDG PET/CT and PET/MRI. Detection rates by PET/CT and PET/MRI were 97 % (113 of 116 lesions) and 85 % (99 of 113 lesions) for malignant lesions, and 100 % (48 of 48 lesions) and 77 % (37 of 48 lesions) for benign lesions, respectively. Lesion conspicuity was higher on PET/CT for both malignant and benign pulmonary lesions and in the overall rating for malignant lesions (p < 0.001). There was a difference between PET/CT and PET/MRI in overall evaluation of malignant lesions (p < 0.01) and detection of pulmonary metastases (p < 0.001). Surgical evaluation revealed three malignant lesions missed by both modalities. PET/MRI additionally failed to detect 14 pulmonary metastases and 11 benign lesions. In patients with thyroid cancer and suspected or known dedifferentiation, [ 18 F]FDG PET/MRI was inferior to low-dose [ 18 F]FDG PET/CT for the assessment of pulmonary status. However, for the assessment of cervical status, [ 18 F]FDG PET/MRI was equal to contrast-enhanced neck [ 18 F]FDG PET/CT. Therefore, [ 18 F]FDG PET/MRI combined with a low-dose CT scan of the thorax may provide an imaging solution when high-quality imaging is needed and high-energy CT is undesirable or the use of a contrast agent is contraindicated. (orig.)

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

    DEFF Research Database (Denmark)

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

    2018-01-01

    of the radiotherapy planning. 'A major change of treatment strategy' was defined as either including more lesions in the gross tumour volume (GTV) distant from the primary tumour or a change in treatment modalities. METHODS: The study includes 581 consecutive patients who underwent an FDG PET/CT scan for radiotherapy...... GTV (GTV-PET). RESULTS: For 63 of the patients (11%), the PET/CT simulation scans resulted in a major change in treatment strategy because of the additional diagnostic information. Changes were most frequently observed in patients with lung cancer (20%) or upper gastrointestinal cancer (12%). In 65......BACKGROUND: (18) F-FDG PET/CT (FDG PET/CT) used in radiotherapy planning for extra-cerebral malignancy may reveal metastases to distant sites that may affect the choice of therapy. AIM: To investigate the role of FDG PET/CT on treatment strategy changes induced by the use of PET/CT as part...

  12. Automatic extraction of forward stroke volume using dynamic PET/CT

    DEFF Research Database (Denmark)

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

    subjects underwent a dynamic 6 min 15O-water PET scan followed by a 27 min 11C-acetate PET scan on a GE Discovery ST PET/CT scanner (scanner II). The LV-aortic time-activity curve (TAC) was extracted automatically from dynamic PET data using cluster analysis. The first-pass peak was isolated by automatic......Background: Dynamic PET can be used to extract forward stroke volume (FSV) by the indicator dilution principle. The technique employed can be automated and is in theory independent on the tracer used and may therefore be added to any dynamic cardiac PET protocol. The aim of this study...... was to validate automated methods for extracting FSV directly from dynamic PET studies for two different tracers and to examine potential scanner hardware bias. Methods: 21 subjects underwent a dynamic 27 min 11C-acetate PET scan on a Siemens Biograph TruePoint 64 PET/CT scanner (scanner I). In addition, 8...

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

    International Nuclear Information System (INIS)

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

    2012-01-01

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

  14. 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.

  15. Methods for Motion Correction Evaluation Using 18F-FDG Human Brain Scans on a High-Resolution PET Scanner

    DEFF Research Database (Denmark)

    Keller, Sune H.; Sibomana, Merence; Olesen, Oline Vinter

    2012-01-01

    by the optical motion tracking system) were selected from F-18-FDG scans acquired on a PET scanner. The motion was measured as the maximum displacement of the markers attached to the subject's head and was considered to be major if larger than 4 mm and minor if less than 2 mm. After allowing a 40- to 60-min...... uptake time after tracer injection, we acquired a 6-min transmission scan, followed by a 40-min emission list-mode scan. Each emission list-mode dataset was divided into 8 frames of 5 min. The reconstructed time-framed images were aligned to a selected reference frame using either EMT or the AIR...

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2017-07-15

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

  17. O uso de FDG-PET/TC scan no planejamento da radioterapia em câncer do pulmão não de pequenas células Use of FDG-PET/CT scan in the planning of radiation therapy for non-small cell lung cancer

    Directory of Open Access Journals (Sweden)

    Sergio L. Faria

    2007-10-01

    Full Text Available Radioterapia é uma importante alternativa de tratamento curativo em pacientes com câncer do pulmão não de pequenas células. Entretanto, pulmões são muito sensíveis à radiação e isto aumenta a importância em se delimitar o volume a ser irradiado com precisão. Ultimamente, a tomografia por emissão de pósitron (PET e a tomografia computadorizada (TC são feitas de forma combinada, e a literatura sugere que seu impacto no planejamento da radioterapia é significativo. Ao se utilizar exames de PET/TC no planejamento da radioterapia é importante reconhecer e adaptar-se às diferenças entre os equipamentos de diagnóstico e de tratamento. Este texto discute alguns dos problemas técnicos que devem ser resolvidos quando se incorpora PET no planejamento radioterápico.Radiation therapy represents an important alternative for curative treatment of patients with nonsmall cell lung cancer. However, an accurate definition of the volume to be irradiated becomes even more important, considering that lungs are highly sensitive to radiation. Most recently, combined FDG-PET/CT scan has been utilized, and the literature reports its significant role in the planning of radiation therapy, since it seems to influence the target-volume delineation in cases of lung cancer. Differences between diagnostic and treatment equipments must be taken into consideration when FDG-PET/CT scan is utilized in the planning of radiation therapy. The present study discusses some of the many technical problems that must be solved when PET is incorporated into the planning of radiation therapy for non-small cell lung cancer.

  18. The role of FDG-PET/CT in differentiated thyroid cancer patients with negative iodine-131 whole-body scan and elevated anti-Tg level.

    Science.gov (United States)

    Asa, Sertac; Aksoy, Sabire Yılmaz; Vatankulu, Betül; Aliyev, Anar; Uslu, Lebriz; Ozhan, Meftune; Sager, Sait; Halac, Metin; Sonmezoglu, Kerim

    2014-12-01

    In the follow-up of differentiated thyroid cancer (DTC) after a successful total-near total thyroidectomy and I-131 ablation therapy, anti-thyroglobulin antibodies (anti-Tg) may be persistently or progressively increased in the patients with an undetectable serum thyroglobulin (Tg) level. In these cases, further investigation was performed to search for recurrence/metastases. The aim of our study was clarifying the role of FDG-PET/CT in detecting recurrence/metastasis in patients with DTC with negative serum Tg and elevated anti-Tg level. A total of 40 patients (32 female, 8 male; mean age: 43.15 years (22-65); mean age at diagnosis: 39.08 (16-64)) with DTC who had undetectable serum Tg and elevated anti-Tg level after a successful initial therapy were included in the study. All of the patients had serum anti-Tg of >40 IU/ml and underwent FDG-PET/CT to search for recurrence/metastasis. Twenty patients (50 %) had recurrence/metastasis on FDG-PET/CT while the other 20 had no pathologic findings. Of the 20 patients who had positive FDG-PET/CT, 12 had a histopathological final diagnosis of which 11 were true positive (TP) and 1 was false positive (FP). On the other hand, 16 of the 40 patients had a histopathological final diagnosis of which 11/16 had TP, 1/16 FP, 3/16 false negative (FN) and 1/16 true negative (TN) findings by PET/CT. The final diagnosis was made by clinical follow-up in the remaining 24 patients. Of these, 8 patients were PET positive, and in 1 (12.5 %) of 8 patients a decrease in serum anti-Tg level, in 2 (25 %) patients a saw-toothed pattern and in 5 (62.5 %) a progressive increase in the serum anti-Tg level were noted during the follow-up. Of the 16 of 24 patients who were diagnosed by clinical follow-up, in 8 a (50 %) decrease in serum anti-Tg level, in 6 (37.5 %) a saw-toothed pattern, and in 2 (12.5 %) a progressively increased anti-Tg level was seen. Of the 40 patients, 14 (35 %) had a diagnosis of recurrence/metastasis finally, with

  19. Development and Validation of the Suprathreshold Stochastic Resonance-Based Image Processing Method for the Detection of Abdomino-pelvic Tumor on PET/CT Scans.

    Science.gov (United States)

    Saroha, Kartik; Pandey, Anil Kumar; Sharma, Param Dev; Behera, Abhishek; Patel, Chetan; Bal, Chandrashekhar; Kumar, Rakesh

    2017-01-01

    The detection of abdomino-pelvic tumors embedded in or nearby radioactive urine containing 18F-FDG activity is a challenging task on PET/CT scan. In this study, we propose and validate the suprathreshold stochastic resonance-based image processing method for the detection of these tumors. The method consists of the addition of noise to the input image, and then thresholding it that creates one frame of intermediate image. One hundred such frames were generated and averaged to get the final image. The method was implemented using MATLAB R2013b on a personal computer. Noisy image was generated using random Poisson variates corresponding to each pixel of the input image. In order to verify the method, 30 sets of pre-diuretic and its corresponding post-diuretic PET/CT scan images (25 tumor images and 5 control images with no tumor) were included. For each sets of pre-diuretic image (input image), 26 images (at threshold values equal to mean counts multiplied by a constant factor ranging from 1.0 to 2.6 with increment step of 0.1) were created and visually inspected, and the image that most closely matched with the gold standard (corresponding post-diuretic image) was selected as the final output image. These images were further evaluated by two nuclear medicine physicians. In 22 out of 25 images, tumor was successfully detected. In five control images, no false positives were reported. Thus, the empirical probability of detection of abdomino-pelvic tumors evaluates to 0.88. The proposed method was able to detect abdomino-pelvic tumors on pre-diuretic PET/CT scan with a high probability of success and no false positives.

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

    Energy Technology Data Exchange (ETDEWEB)

    Aalto, Sargo [University of Turku and Turku University Hospital, Turku PET Centre, Turku (Finland); Aabo Akademi University, Department of Psychology, Turku (Finland); University of Turku, Turku PET Centre, P.O. Box 52, Turku (Finland); Scheinin, Noora M.; Naagren, Kjell; Rinne, Juha O. [University of Turku and Turku University Hospital, Turku PET Centre, Turku (Finland); Kemppainen, Nina M. [University of Turku and Turku University Hospital, Turku PET Centre, Turku (Finland); Turku University Hospital, Department of Neurology, Turku (Finland); Kailajaervi, Marita [University of Turku, Department of Pharmacology and Clinical Research Services Turku (CRST), Turku (Finland); GE Healthcare, Turku Imanet, Turku (Finland); Leinonen, Mika [4-Pharma Ltd, Turku (Finland); Scheinin, Mika [University of Turku, Department of Pharmacology and Clinical Research Services Turku (CRST), Turku (Finland)

    2009-10-15

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

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

    International Nuclear Information System (INIS)

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

    2009-01-01

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

  2. SU-F-I-31: Reproducibility of An Automatic Exposure Control Technique in the Low-Dose CT Scan of Cardiac PET/CT Exams

    International Nuclear Information System (INIS)

    Park, M; Rosica, D; Agarwal, V; Di Carli, M; Dorbala, S

    2016-01-01

    Purpose: Two separate low-dose CT scans are usually performed for attenuation correction of rest and stress N-13 ammonia PET/CT myocardial perfusion imaging (PET/CT). We utilize an automatic exposure control (AEC) technique to reduce CT radiation dose while maintaining perfusion image quality. Our goal is to assess the reproducibility of displayed CT dose index (CTDI) on same-day repeat CT scans (CT1 and CT2). Methods: Retrospectively, we reviewed CT images of PET/CT studies performed on the same day. Low-dose CT utilized AEC technique based on tube current modulation called Smart-mA. The scan parameters were 64 × 0.625mm collimation, 5mm slice thickness, 0.984 pitch, 1-sec rotation time, 120 kVp, and noise index 50 with a range of 10–200 mA. The scan length matched with PET field of view (FOV) with the heart near the middle of axial FOV. We identified the reference slice number (RS) for an anatomical landmark (carina) and used it to estimate axial shift between two CTs. For patient size, we measured an effective diameter on the reference slice. The effect of patient positioning to CTDI was evaluated using the table height. We calculated the absolute percent difference of the CTDI (%diff) for estimation of the reproducibility. Results: The study included 168 adults with an average body-mass index of 31.72 ± 9.10 (kg/m 2 ) and effective diameter was 32.72 ± 4.60 cm. The average CTDI was 1.95 ± 1.40 mGy for CT1 and 1.97 ± 1.42mGy for CT2. The mean %diff was 7.8 ± 6.8%. Linear regression analysis showed a significant correlation between the table height and %diff CTDI. (r=0.82, p<0.001) Conclusion: We have shown for the first time in human subjects, using two same-day CT images, that the AEC technique in low-dose CT is reproducible within 10% and significantly depends on the patient centering.

  3. SU-F-I-31: Reproducibility of An Automatic Exposure Control Technique in the Low-Dose CT Scan of Cardiac PET/CT Exams

    Energy Technology Data Exchange (ETDEWEB)

    Park, M; Rosica, D; Agarwal, V; Di Carli, M; Dorbala, S [Brigham and Women’s Hospital and Harvard Medical School, Boston, MA (United States)

    2016-06-15

    Purpose: Two separate low-dose CT scans are usually performed for attenuation correction of rest and stress N-13 ammonia PET/CT myocardial perfusion imaging (PET/CT). We utilize an automatic exposure control (AEC) technique to reduce CT radiation dose while maintaining perfusion image quality. Our goal is to assess the reproducibility of displayed CT dose index (CTDI) on same-day repeat CT scans (CT1 and CT2). Methods: Retrospectively, we reviewed CT images of PET/CT studies performed on the same day. Low-dose CT utilized AEC technique based on tube current modulation called Smart-mA. The scan parameters were 64 × 0.625mm collimation, 5mm slice thickness, 0.984 pitch, 1-sec rotation time, 120 kVp, and noise index 50 with a range of 10–200 mA. The scan length matched with PET field of view (FOV) with the heart near the middle of axial FOV. We identified the reference slice number (RS) for an anatomical landmark (carina) and used it to estimate axial shift between two CTs. For patient size, we measured an effective diameter on the reference slice. The effect of patient positioning to CTDI was evaluated using the table height. We calculated the absolute percent difference of the CTDI (%diff) for estimation of the reproducibility. Results: The study included 168 adults with an average body-mass index of 31.72 ± 9.10 (kg/m{sup 2}) and effective diameter was 32.72 ± 4.60 cm. The average CTDI was 1.95 ± 1.40 mGy for CT1 and 1.97 ± 1.42mGy for CT2. The mean %diff was 7.8 ± 6.8%. Linear regression analysis showed a significant correlation between the table height and %diff CTDI. (r=0.82, p<0.001) Conclusion: We have shown for the first time in human subjects, using two same-day CT images, that the AEC technique in low-dose CT is reproducible within 10% and significantly depends on the patient centering.

  4. Postmortem Autopsy-Confirmation of Antemortem [F-18]FDDNP-PET Scans in a Football Player With Chronic Traumatic Encephalopathy.

    Science.gov (United States)

    Omalu, Bennet; Small, Gary W; Bailes, Julian; Ercoli, Linda M; Merrill, David A; Wong, Koon-Pong; Huang, Sung-Cheng; Satyamurthy, Nagichettiar; Hammers, Jennifer L; Lee, John; Fitzsimmons, Robert P; Barrio, Jorge R

    2018-02-01

    Currently, only presumptive diagnosis of chronic traumatic encephalopathy (CTE) can be made in living patients. We present a modality that may be instrumental to the definitive diagnosis of CTE in living patients based on brain autopsy confirmation of [F-18]FDDNP-PET findings in an American football player with CTE. [F-18]FDDNP-PET imaging was performed 52 mo before the subject's death. Relative distribution volume parametric images and binding values were determined for cortical and subcortical regions of interest. Upon death, the brain was examined to identify the topographic distribution of neurodegenerative changes. Correlation between neuropathology and [F-18]FDDNP-PET binding patterns was performed using Spearman rank-order correlation. Mood, behavioral, motor, and cognitive changes were consistent with chronic traumatic myeloencephalopathy with a 22-yr lifetime risk exposure to American football. There were tau, amyloid, and TDP-43 neuropathological substrates in the brain with a differential topographically selective distribution. [F-18]FDDNP-PET binding levels correlated with brain tau deposition (rs = 0.59, P = .02), with highest relative distribution volumes in the parasagittal and paraventricular regions of the brain and the brain stem. No correlation with amyloid or TDP-43 deposition was observed. [F-18]FDDNP-PET signals may be consistent with neuropathological patterns of tau deposition in CTE, involving areas that receive the maximal shearing, angular-rotational acceleration-deceleration forces in American football players, consistent with distinctive and differential topographic vulnerability and selectivity of CTE beyond brain cortices, also involving midbrain and limbic areas. Future studies are warranted to determine whether differential and selective [F-18]FDDNP-PET may be useful in establishing a diagnosis of CTE in at-risk patients. Copyright © 2017 by the Congress of Neurological Surgeons.

  5. Rapid dual-injection single-scan 13N-ammonia PET for quantification of rest and stress myocardial blood flows

    International Nuclear Information System (INIS)

    Rust, T C; DiBella, E V R; McGann, C J; Christian, P E; Hoffman, J M; Kadrmas, D J

    2006-01-01

    Quantification of myocardial blood flows at rest and stress using 13 N-ammonia PET is an established method; however, current techniques require a waiting period of about 1 h between scans. The objective of this study was to test a rapid dual-injection single-scan approach, where 13 N-ammonia injections are administered 10 min apart during rest and adenosine stress. Dynamic PET data were acquired in six human subjects using imaging protocols that provided separate single-injection scans as gold standards. Rest and stress data were combined to emulate rapid dual-injection data so that the underlying activity from each injection was known exactly. Regional blood flow estimates were computed from the dual-injection data using two methods: background subtraction and combined modelling. The rapid dual-injection approach provided blood flow estimates very similar to the conventional single-injection standards. Rest blood flow estimates were affected very little by the dual-injection approach, and stress estimates correlated strongly with separate single-injection values (r = 0.998, mean absolute difference = 0.06 ml min -1 g -1 ). An actual rapid dual-injection scan was successfully acquired in one subject and further demonstrates feasibility of the method. This study with a limited dataset demonstrates that blood flow quantification can be obtained in only 20 min by the rapid dual-injection approach with accuracy similar to that of conventional separate rest and stress scans. The rapid dual-injection approach merits further development and additional evaluation for potential clinical use

  6. Dual-phase (18)F-fluorocholine PET/CT to detect locoregional recurrence of prostate cancer: comparison between each time point of imaging and a summation scan.

    Science.gov (United States)

    Tong, Aaron Kian Ti; Zhang, Zoe Xiaozhu; Zaheer, Sumbul; Yan, Xuexian Sean

    2016-01-01

    Prostate carcinoma is a major health problem, and routine imaging shows only modest results in detecting and restaging clinically localized prostate cancer recurrence. Recent studies have shown promise of radiolabeled analogues of choline for positron emission tomography (PET) scans in patients of biochemical recurrence and that sequentially incremental Fluorocholine (FCH) uptake is associated with malignancy, whereas decreasing tracer activity suggests a benign aetiology. However, this pattern of tracer uptake has not been fully validated, and no standardized (18)F-Fluorocholine ((18)F-FCH) scan protocol is in place yet. This study aimed to better define the role of dual-phase (18)F-FCH PET/computed tomography (CT) imaging using retrospective masked reading focusing on detection of locoregional recurrence/metastasis in patients with biochemical failure after definitive local primary treatment. A total of 32 subjects were enrolled during the period 04/2010 to 05/2014 with histologically proven prostate cancer that was treated with curative intent and had biochemical recurrence. Early scans and delayed imaging of the pelvis were graded separately by blinded readers. Final evaluation using the combination of information from dual-phase studies as a "summation scan" was also performed. Maximum standardized uptake value was computed using regions of interest constructed over focal hyperactivity. Calculations were performed using Statistical Product and Service Solutions, Version 20 for Windows. A composite reference consisting of histopathology, correlation with other imaging, or serum prostate specific antigen (PSA) trend with clinical follow-up of at least 6months was used to determine the true disease status of the patient. Early-phase pelvis imaging sensitivity and specificity were calculated to be 73.1% and 90.9%, respectively. Late-phase pelvis imaging sensitivity and specificity were 80.8% and 100%, respectively. Summation scan sensitivity and specificity were

  7. Quantitative myocardial blood flow imaging with integrated time-of-flight PET-MR.

    Science.gov (United States)

    Kero, Tanja; Nordström, Jonny; Harms, Hendrik J; Sörensen, Jens; Ahlström, Håkan; Lubberink, Mark

    2017-12-01

    The use of integrated PET-MR offers new opportunities for comprehensive assessment of cardiac morphology and function. However, little is known on the quantitative accuracy of cardiac PET imaging with integrated time-of-flight PET-MR. The aim of the present work was to validate the GE Signa PET-MR scanner for quantitative cardiac PET perfusion imaging. Eleven patients (nine male; mean age 59 years; range 46-74 years) with known or suspected coronary artery disease underwent 15 O-water PET scans at rest and during adenosine-induced hyperaemia on a GE Discovery ST PET-CT and a GE Signa PET-MR scanner. PET-MR images were reconstructed using settings recommended by the manufacturer, including time-of-flight (TOF). Data were analysed semi-automatically using Cardiac VUer software, resulting in both parametric myocardial blood flow (MBF) images and segment-based MBF values. Correlation and agreement between PET-CT-based and PET-MR-based MBF values for all three coronary artery territories were assessed using regression analysis and intra-class correlation coefficients (ICC). In addition to the cardiac PET-MR reconstruction protocol as recommended by the manufacturer, comparisons were made using a PET-CT resolution-matched reconstruction protocol both without and with TOF to assess the effect of time-of-flight and reconstruction parameters on quantitative MBF values. Stress MBF data from one patient was excluded due to movement during the PET-CT scanning. Mean MBF values at rest and stress were (0.92 ± 0.12) and (2.74 ± 1.37) mL/g/min for PET-CT and (0.90 ± 0.23) and (2.65 ± 1.15) mL/g/min for PET-MR (p = 0.33 and p = 0.74). ICC between PET-CT-based and PET-MR-based regional MBF was 0.98. Image quality was improved with PET-MR as compared to PET-CT. ICC between PET-MR-based regional MBF with and without TOF and using different filter and reconstruction settings was 1.00. PET-MR-based MBF values correlated well with PET-CT-based MBF values and

  8. Self-reported fatigue common among optimally treated HIV patients: no correlation with cerebral FDG-PET scanning abnormalities

    DEFF Research Database (Denmark)

    Andersen, Ase B; Law, Ian; Ostrowski, Sisse R

    2006-01-01

    but tended to correlate with a short HIV history (p = 0.058), a low CD4 nadir (p = 0.082) and elevated tumour necrosis factor-alpha levels (p = 0.074). CONCLUSION: Fatigue is common among optimally treated HIV patients. FDG-PET-described signs of imminent neurodegeneration among HIV patients who had a low CD...

  9. What Is the Best Way to Contour Lung Tumors on PET Scans? Multiobserver Validation of a Gradient-Based Method Using a NSCLC Digital PET Phantom

    International Nuclear Information System (INIS)

    Werner-Wasik, Maria; Nelson, Arden D.; Choi, Walter; Arai, Yoshio; Faulhaber, Peter F.; Kang, Patrick; Almeida, Fabio D.; Xiao, Ying; Ohri, Nitin; Brockway, Kristin D.; Piper, Jonathan W.; Nelson, Aaron S.

    2012-01-01

    Purpose: To evaluate the accuracy and consistency of a gradient-based positron emission tomography (PET) segmentation method, GRADIENT, compared with manual (MANUAL) and constant threshold (THRESHOLD) methods. Methods and Materials: Contouring accuracy was evaluated with sphere phantoms and clinically realistic Monte Carlo PET phantoms of the thorax. The sphere phantoms were 10–37 mm in diameter and were acquired at five institutions emulating clinical conditions. One institution also acquired a sphere phantom with multiple source-to-background ratios of 2:1, 5:1, 10:1, 20:1, and 70:1. One observer segmented (contoured) each sphere with GRADIENT and THRESHOLD from 25% to 50% at 5% increments. Subsequently, seven physicians segmented 31 lesions (7–264 mL) from 25 digital thorax phantoms using GRADIENT, THRESHOLD, and MANUAL. Results: For spheres 20 mm (p < 0.065) and <20 mm (p < 0.015). For digital thorax phantoms, GRADIENT was the most accurate (p < 0.01), with a mean absolute % error in volume of 10.99% (11.9% SD), followed by 25% THRESHOLD at 17.5% (29.4% SD), and MANUAL at 19.5% (17.2% SD). GRADIENT had the least systematic bias, with a mean % error in volume of –0.05% (16.2% SD) compared with 25% THRESHOLD at –2.1% (34.2% SD) and MANUAL at –16.3% (20.2% SD; p value <0.01). Interobserver variability was reduced using GRADIENT compared with both 25% THRESHOLD and MANUAL (p value <0.01, Levene’s test). Conclusion: GRADIENT was the most accurate and consistent technique for target volume contouring. GRADIENT was also the most robust for varying imaging conditions. GRADIENT has the potential to play an important role for tumor delineation in radiation therapy planning and response assessment.

  10. Non-small-cell lung cancer resectability: diagnostic value of PET/MR

    International Nuclear Information System (INIS)

    Fraioli, Francesco; Menezes, Leon; Kayani, Irfan; Syed, Rizwan; O'Meara, Celia; Barnes, Anna; Bomanji, Jamshed B.; Punwani, Shonit; Groves, Ashley M.; Screaton, Nicholas J.; Janes, Samuel M.; Win, Thida; Zaccagna, Fulvio

    2015-01-01

    To assess the diagnostic performance of PET/MR in patients with non-small-cell lung cancer. Fifty consecutive consenting patients who underwent routine 18 F-FDG PET/CT for potentially radically treatable lung cancer following a staging CT scan were recruited for PET/MR imaging on the same day. Two experienced readers, unaware of the results with the other modalities, interpreted the PET/MR images independently. Discordances were resolved in consensus. PET/MR TNM staging was compared to surgical staging from thoracotomy as the reference standard in 33 patients. In the remaining 17 nonsurgical patients, TNM was determined based on histology from biopsy, imaging results (CT and PET/CT) and follow-up. ROC curve analysis was used to assess accuracy, sensitivity and specificity of the PET/MR in assessing the surgical resectability of primary tumour. The kappa statistic was used to assess interobserver agreement in the PET/MR TNM staging. Two different readers, without knowledge of the PET/MR findings, subsequently separately reviewed the PET/CT images for TNM staging. The generalized kappa statistic was used to determine intermodality agreement between PET/CT and PET/MR for TNM staging. ROC curve analysis showed that PET/MR had a specificity of 92.3 % and a sensitivity of 97.3 % in the determination of resectability with an AUC of 0.95. Interobserver agreement in PET/MR reading ranged from substantial to perfect between the two readers (Cohen's kappa 0.646 - 1) for T stage, N stage and M stage. Intermodality agreement between PET/CT and PET/MR ranged from substantial to almost perfect for T stage, N stage and M stage (Cohen's kappa 0.627 - 0.823). In lung cancer patients PET/MR appears to be a robust technique for preoperative staging. (orig.)

  11. Evaluation of a short dynamic 18F-fluoride PET/CT scanning method to assess bone metabolic activity in spinal orthopedics.

    Science.gov (United States)

    Peters, Marloes J M; Wierts, Roel; Jutten, Elisabeth M C; Halders, Servé G E A; Willems, Paul C P H; Brans, Boudewijn

    2015-11-01

    A complication after spinal fusion surgery is pseudarthrosis, but its radiological diagnosis is of limited value. (18)F-fluoride PET with its ability to assess bone metabolism activity could be of value. The goal of this study was to assess the clinical feasibility of calculating the static standardized uptake value (SUV) from a short dynamic scan without the use of blood sampling, thereby obtaining all dynamic and static parameters in a scan of only 30 min. This approach was tested on a retrospective patient population with persisting pain after spinal fusion surgery. In 16 patients, SUVs (SUV max, SUV mean) and kinetic parameters (K 1, k 2, k 3, v b, K i,NLR, K 1/k 2, k 3/(k 2 + k 3), K i,patlak) were derived from static and dynamic PET/CT scans of operated and control regions of the spine, after intravenous administration of 156-214 MBq (18)F-fluoride. Parameter differences between control and operated regions, as well as between pseudarthrosis and fused segments were evaluated. SUVmean at 30 and 60 min was calculated from kinetic parameters obtained from the dynamic data set (SUV mean,2TCM). Agreement between measured and calculated SUVs was evaluated through Bland-Altman plots. Overall, statistically significant differences between control and operated regions were observed for SUV max, SUV mean, K i,NLR, K i,patlak, K 1/k 2 and k 3/(k 2 + k 3). Diagnostic CT showed pseudarthrosis in 6/16 patients, while in 10/16 patients, segments were fused. Of all parameters, only those regarding the incorporation of bone [K i,NLR, K i,patlak, k 3/(k 2 + k 3)] differed statistically significant in the intervertebral disc space between the pseudarthrosis and fused patients group. The mean values of the patient-specific blood clearance rate [Formula: see text] differed statistically significant between the pseudarthrosis and the fusion group, with a p value of 0.011. This may correspond with the lack of statistical significance of the SUV values between pseudarthrosis and

  12. Early interim {sup 18}F-FDG PET in Hodgkin's lymphoma: evaluation on 304 patients

    Energy Technology Data Exchange (ETDEWEB)

    Zinzani, Pier Luigi; Stefoni, Vittorio; Broccoli, Alessandro; Argnani, Lisa; Baccarani, Michele [University of Bologna, Institute of Hematology and Medical Oncology ' ' L. e A. Seragnoli' ' , Policlinico ' ' Sant' Orsola-Malpighi' ' , Bologna (Italy); Rigacci, Luigi; Puccini, Benedetta [Azienda Ospedaliero Universitaria ' ' Careggi' ' , Hematology Department, Florence (Italy); Castagnoli, Antonio [Ospedale ' ' Misericordia e Dolce' ' , Nuclear Medicine, Prato (Italy); Vaggelli, Luca [Azienda Ospedaliero Universitaria ' ' Careggi' ' , Nuclear Medicine, Florence (Italy); Zanoni, Lucia; Fanti, Stefano [Policlinico ' ' Sant' Orsola-Malpighi' ' , Department of Nuclear Medicine, Bologna (Italy)

    2012-01-15

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

  13. Strategies to reduce radiation dose in cardiac PET/CT

    Energy Technology Data Exchange (ETDEWEB)

    Wu, Tung Hsin; Wu, Nien-Yun [Department of Biomedical Imaging and Radiological Sciences, National Yang-Ming University, Taipei, Taiwan (China); Wang, Shyh-Jen [Department of Biomedical Imaging and Radiological Sciences, National Yang-Ming University, Taipei, Taiwan (China); Department of Nuclear Medicine, Taipei Veterans General Hospital, Taipei, Taiwan (China); Wu, Jay [Institute of Radiological science, Central Taiwan University of Science and Technology, Taichung, Taiwan (China); Mok, Greta S.P. [Department of Electrical and Electronics Engineering, Faculty of Science and Technology, University of Macau, Macau (China); Yang, Ching-Ching, E-mail: g39220003@yahoo.com.tw [Department of Radiological Technology, Tzu Chi College of Technology, 880, Sec.2, Chien-kuo Rd. Hualien 970, Taiwan (China); Huang, Tzung-Chi, E-mail: tzungchi.huang@mail.cmu.edu.tw [Department of Biomedical Imaging and Radiological Science, China Medical University, No.91 Hsueh-Shih Road, Taichung 40402, Taiwan (China)

    2011-08-21

    Background: Our aim was to investigate CT dose reduction strategies on a hybrid PET/CT scanner for cardiac applications. Materials: Image quality and dose estimation of different CT scanning protocols for CT coronary angiography (CTCA), and CT-based attenuation correction for PET imaging were investigated. Fifteen patients underwent CTCA, perfusion PET imaging at rest and under stress, and FDG PET for myocardial viability. These patients were divided into three groups based on the CTCA technique performed: retrospectively gated helical (RGH), ECG tube current modulation (ETCM), and prospective gated axial (PGA) acquisitions. All emission images were corrected for photon attenuation using CT images obtained by default setting and an ultra-low dose CT (ULDCT) scan. Results: Radiation dose in RGH technique was 22.2{+-}4.0 mSv. It was reduced to 10.95{+-}0.82 and 4.13{+-}0.31 mSv using ETCM and PGA techniques, respectively. Radiation dose in CT transmission scan was reduced by 96.5% (from 4.53{+-}0.5 to 0.16{+-}0.01 mSv) when applying ULDCT as compared to the default CT. No significant difference in terms of image quality was found among various protocols. Conclusion: The proposed CT scanning strategies, i.e. ETCM or PGA for CTCA and ULDCT for PET attenuation correction, could reduce radiation dose up to 47% without degrading imaging quality in an integrated cardiac PET/CT coronary artery examination.

  14. FDG PET-CT Finding in Bilateral Renal and Bone Involvement of Diffuse Large B-Cell Lymphoma

    Directory of Open Access Journals (Sweden)

    Yusuf Ziya Tan

    2014-10-01

    Full Text Available Thirty-six year old male patient with pathological fracture of the left tibia underwent intramedullary and soft tissue curettage. The histopathological examination revealed diffuse large B cell lymphoma. The patient underwent F18-FDG PET-CT scanning for initial staging. FDG PET-CT scan revealed hypermetabolic lesions at the left tibia and in bilateral kidneys. After the systemic chemotherapy and local radiotherapy to the tibia, repeated FDG PET/CT scan showed improvement of the previous hypermetabolic lesions, suggesting good response to therapy. Bone and renal involvement is an uncommon variant of diffuse large B-cell lymphoma and FDG PET-CT is an useful whole body imaging modality in these cases.

  15. Semiquantitative Assessment of18F-FDG Uptake in the Normal Skeleton: Comparison Between PET/CT and Time-of-Flight Simultaneous PET/MRI.

    Science.gov (United States)

    Minamimoto, Ryogo; Xu, Guofan; Jamali, Mehran; Holley, Dawn; Barkhodari, Amir; Zaharchuk, Greg; Iagaru, Andrei

    2017-11-01

    Differences in the attenuation correction methods used in PET/CT scanners versus the newly introduced whole-body simultaneous PET/MRI reportedly result in differences in standardized uptake values (SUVs) in the normal skeleton. The aim of the study was to compare the semiquantitative FDG uptake in the normal skeleton using time-of-flight (TOF) PET/MRI versus PET/CT with and without TOF. Participants received a single FDG injection and underwent non-TOF and TOF PET/CT (n = 23) or non-TOF PET/CT and TOF PET/MRI (n = 50). Mean SUV (SUV mean ) and maximum SUV (SUV max ) were measured from all PET scans for nine normal regions of the skeleton. Pearson correlation coefficients (r) were used to evaluate the SUV max and SUV mean of normal skeleton between non-TOF and TOF PET/CT, as well as between non-TOF PET/CT and TOF PET/MRI. In addition, percentage differences in SUV max and SUV mean of the normal skeleton between non-TOF and TOF PET/CT and between non-TOF PET/CT and TOF PET/MRI were evaluated. The SUV max and SUV mean in the normal skeleton significantly increased between non-TOF and TOF PET/CT, but they significantly decreased between non-TOF PET/CT and TOF PET/MRI. The SUV max and SUV mean in normal skeleton showed good correlation between non-TOF PET/CT and TOF PET/MRI (SUV max , r = 0.88; SUV mean , r = 0.91) and showed a similar trend between non-TOF and TOF PET/CT (SUV max , r = 0.88; SUV mean , r = 0.94). In the normal skeleton, SUV max and SUV mean showed high correlations between PET/MRI and PET/CT. The MRI attenuation correction used in TOF PET/MRI provides reliable semiquantitative measurements in the normal skeleton.

  16. Female patients dosimetry in brain exams with PET/CT scan for diagnosis of Mild Cognitive Impairment (MCI)

    Energy Technology Data Exchange (ETDEWEB)

    Santana, P.C.; Mamede, M.; Carvalho, F.M.V., E-mail: pridili@gmail.com [Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG (Brazil); Mourao, A.P., E-mail: apratabhz@gmail.com [Centro Federal de Educacao Tecnologica, Belo Horionte, MG (Brazil). Dept. de Engenharia Eletrica; Oliveira, P.M.C.; Silva, T.A. da, E-mail: pmco@cdtn.br [Centro de Desenvolvimento da Tecnologia Nuclear (CDTN/CNEN-MG), Belo Horizonte, MG (Brazil)

    2013-07-01

    Dementia affects over 35 million people worldwide, with strong personal, social and financial impacts. Alzheimer's disease is the most common form of dementia, accounting for 60-70% of cases, affecting mostly females. Recent technological innovations, using methods of anatomical and functional neuroimaging, with particular emphasis on PET / CT (positron emission tomography with computed tomography associated), have shown excellent prospects for early diagnosis of Alzheimer's disease represented by Mild Cognitive Impairment (MCI). The use of PET / CT helps diagnosis, but the patients effective dose is higher and directly dependent on the radiopharmaceutical activity and the computed tomographic (CT) protocol used. The aim of this study was evaluated the organs absorbed doses and effective doses in 59 female patients undergoing the PET/CT diagnostic technique. For the measurements of radiation levels from the CT was used TLD100 (LiF:Mg, Ti) Rod detectors inserted in Alderson Randon ® anthropomorphic phantom, which simulates a female pattern, of 155 cm and weight 50 kg, subjected to the same clinical protocol of acquiring patients images. The effective dose resulting from the radiopharmaceutical injected activity was estimated by ICRP106 model using the weight of the patients undergoing to the procedure. The average effective dose due was (7.65 ± 2.22) mSv. The effective dose contribution to the brain and the thyroid due to CT were (2.21 ± 0.38) and (0.72 ± 0.14) mSv, respectively. The use of CT optimized protocols can assist in reducing the dose in this type of procedure. (author)

  17. Female patients dosimetry in brain exams with PET/CT scan for diagnosis of Mild Cognitive Impairment (MCI)

    International Nuclear Information System (INIS)

    Santana, P.C.; Mamede, M.; Carvalho, F.M.V.; Mourao, A.P.

    2013-01-01

    Dementia affects over 35 million people worldwide, with strong personal, social and financial impacts. Alzheimer's disease is the most common form of dementia, accounting for 60-70% of cases, affecting mostly females. Recent technological innovations, using methods of anatomical and functional neuroimaging, with particular emphasis on PET / CT (positron emission tomography with computed tomography associated), have shown excellent prospects for early diagnosis of Alzheimer's disease represented by Mild Cognitive Impairment (MCI). The use of PET / CT helps diagnosis, but the patients effective dose is higher and directly dependent on the radiopharmaceutical activity and the computed tomographic (CT) protocol used. The aim of this study was evaluated the organs absorbed doses and effective doses in 59 female patients undergoing the PET/CT diagnostic technique. For the measurements of radiation levels from the CT was used TLD100 (LiF:Mg, Ti) Rod detectors inserted in Alderson Randon ® anthropomorphic phantom, which simulates a female pattern, of 155 cm and weight 50 kg, subjected to the same clinical protocol of acquiring patients images. The effective dose resulting from the radiopharmaceutical injected activity was estimated by ICRP106 model using the weight of the patients undergoing to the procedure. The average effective dose due was (7.65 ± 2.22) mSv. The effective dose contribution to the brain and the thyroid due to CT were (2.21 ± 0.38) and (0.72 ± 0.14) mSv, respectively. The use of CT optimized protocols can assist in reducing the dose in this type of procedure. (author)

  18. Evaluation of the ICS and DEW scatter correction methods for low statistical content scans in 3D PET

    International Nuclear Information System (INIS)

    Sossi, V.; Oakes, T.R.; Ruth, T.J.

    1996-01-01

    The performance of the Integral Convolution and the Dual Energy Window scatter correction methods in 3D PET has been evaluated over a wide range of statistical content of acquired data (1M to 400M events) The order in which scatter correction and detector normalization should be applied has also been investigated. Phantom and human neuroreceptor studies were used with the following figures of merit: axial and radial uniformity, sinogram and image noise, contrast accuracy and contrast accuracy uniformity. Both scatter correction methods perform reliably in the range of number of events examined. Normalization applied after scatter correction yields better radial uniformity and fewer image artifacts

  19. [{sup 18}F]FDG PET/CT outperforms [{sup 18}F]FDG PET/MRI in differentiated thyroid cancer

    Energy Technology Data Exchange (ETDEWEB)

    Vrachimis, Alexis; Wenning, Christian; Weckesser, Matthias; Stegger, Lars [University Hospital Muenster, Department of Nuclear Medicine, Muenster (Germany); Burg, Matthias Christian; Allkemper, Thomas [University Hospital Muenster, Department of Clinical Radiology, Muenster (Germany); Schaefers, Michael [University Hospital Muenster, Department of Nuclear Medicine, Muenster (Germany); Westfaelische Wilhelms University Muenster, European Institute for Molecular Imaging, Muenster (Germany)

    2016-02-15

    To evaluate the diagnostic potential of PET/MRI with [{sup 18}F]FDG in comparison to PET/CT in patients with differentiated thyroid cancer suspected or known to have dedifferentiated. The study included 31 thyroidectomized and remnant-ablated patients who underwent a scheduled [{sup 18}F]FDG PET/CT scan and were then enrolled for a PET/MRI scan of the neck and thorax. The datasets (PET/CT, PET/MRI) were rated regarding lesion count, conspicuity, diameter and characterization. Standardized uptake values were determined for all [{sup 18}F]FDG-positive lesions. Histology, cytology, and examinations before and after treatment served as the standards of reference. Of 26 patients with a dedifferentiated tumour burden, 25 were correctly identified by both [{sup 18}F]FDG PET/CT and PET/MRI. Detection rates by PET/CT and PET/MRI were 97 % (113 of 116 lesions) and 85 % (99 of 113 lesions) for malignant lesions, and 100 % (48 of 48 lesions) and 77 % (37 of 48 lesions) for benign lesions, respectively. Lesion conspicuity was higher on PET/CT for both malignant and benign pulmonary lesions and in the overall rating for malignant lesions (p < 0.001). There was a difference between PET/CT and PET/MRI in overall evaluation of malignant lesions (p < 0.01) and detection of pulmonary metastases (p < 0.001). Surgical evaluation revealed three malignant lesions missed by both modalities. PET/MRI additionally failed to detect 14 pulmonary metastases and 11 benign lesions. In patients with thyroid cancer and suspected or known dedifferentiation, [{sup 18}F]FDG PET/MRI was inferior to low-dose [{sup 18}F]FDG PET/CT for the assessment of pulmonary status. However, for the assessment of cervical status, [{sup 18}F]FDG PET/MRI was equal to contrast-enhanced neck [{sup 18}F]FDG PET/CT. Therefore, [{sup 18}F]FDG PET/MRI combined with a low-dose CT scan of the thorax may provide an imaging solution when high-quality imaging is needed and high-energy CT is undesirable or the use of a contrast

  20. 18 F-FDG PET/CT for planning external beam radiotherapy alters therapy in 11% of 581 patients.

    Science.gov (United States)

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

    2018-03-01

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

  1. Comparison of standardized uptake values measured on 18F-NaF PET/CT scans using three different tube current intensities

    International Nuclear Information System (INIS)

    Valadares, Agnes Araujo; Woellner, Eduardo Bechtloff; Sapienza, Marcelo Tatit; Buchpiguel, Carlos Alberto

    2015-01-01

    Objective: to analyze standardized uptake values (SUVs) using three different tube current intensities for attenuation correction on 18 FNaF PET/CT scans. Materials and methods: a total of 254 18 F-NaF PET/CT studies were analyzed using 10, 20 and 30 mAs. The SUVs were calculated in volumes of interest (VOIs) drawn on three skeletal regions, namely, right proximal humeral diaphysis (RH), right proximal femoral diaphysis (RF), and first lumbar vertebra (LV1) in a total of 712 VOIs. The analyses covered 675 regions classified as normal (236 RH, 232 RF, and 207 LV1). Results: mean SUV for each skeletal region was 3.8, 5.4 and 14.4 for RH, RF, and LV1, respectively. As the studies were grouped according to mAs value, the mean SUV values were 3.8, 3.9 and 3.7 for 10, 20 and 30 mAs, respectively, in the RH region; 5.4, 5.5 and 5.4 for 10, 20 and 30 mAs, respectively, in the RF region; 13.8, 14.9 and 14.5 for 10, 20 and 30 mAs, respectively, in the LV1 region. Conclusion: the three tube current values yielded similar results for SUV calculation. (author)

  2. Comparison of standardized uptake values measured on F-NaF PET/CT scans using three different tube current intensities.

    Science.gov (United States)

    Valadares, Agnes Araujo; Duarte, Paulo Schiavom; Woellner, Eduardo Bechtloff; Coura-Filho, George Barberio; Sapienza, Marcelo Tatit; Buchpiguel, Carlos Alberto

    2015-01-01

    To analyze standardized uptake values (SUVs) using three different tube current intensities for attenuation correction on (18)FNaF PET/CT scans. A total of 254 (18)F-NaF PET/CT studies were analyzed using 10, 20 and 30 mAs. The SUVs were calculated in volumes of interest (VOIs) drawn on three skeletal regions, namely, right proximal humeral diaphysis (RH), right proximal femoral diaphysis (RF), and first lumbar vertebra (LV1) in a total of 712 VOIs. The analyses covered 675 regions classified as normal (236 RH, 232 RF, and 207 LV1). Mean SUV for each skeletal region was 3.8, 5.4 and 14.4 for RH, RF, and LV1, respectively. As the studies were grouped according to mAs value, the mean SUV values were 3.8, 3.9 and 3.7 for 10, 20 and 30 mAs, respectively, in the RH region; 5.4, 5.5 and 5.4 for 10, 20 and 30 mAs, respectively, in the RF region; 13.8, 14.9 and 14.5 for 10, 20 and 30 mAs, respectively, in the LV1 region. The three tube current values yielded similar results for SUV calculation.

  3. Comparison of standardized uptake values measured on {sup 18}F-NaF PET/CT scans using three different tube current intensities

    Energy Technology Data Exchange (ETDEWEB)

    Valadares, Agnes Araujo; Woellner, Eduardo Bechtloff; Sapienza, Marcelo Tatit; Buchpiguel, Carlos Alberto, E-mail: agnesvaladares@me.com [Universidade de Sao Paulo (HC/FMUSP), Sao Paulo, SP (Brazil). Fac. de Medicina. Hospital das Clinicas; Duarte, Paulo Schiavom; Coura-Filho, George Barberio [Instituto do Cancer do Estado de Sao Paulo Octavio Frias de Oliveira (ICESP), Sao Paulo, SP (Brazil)

    2015-01-15

    Objective: to analyze standardized uptake values (SUVs) using three different tube current intensities for attenuation correction on {sup 18}FNaF PET/CT scans. Materials and methods: a total of 254 {sup 18}F-NaF PET/CT studies were analyzed using 10, 20 and 30 mAs. The SUVs were calculated in volumes of interest (VOIs) drawn on three skeletal regions, namely, right proximal humeral diaphysis (RH), right proximal femoral diaphysis (RF), and first lumbar vertebra (LV1) in a total of 712 VOIs. The analyses covered 675 regions classified as normal (236 RH, 232 RF, and 207 LV1). Results: mean SUV for each skeletal region was 3.8, 5.4 and 14.4 for RH, RF, and LV1, respectively. As the studies were grouped according to mAs value, the mean SUV values were 3.8, 3.9 and 3.7 for 10, 20 and 30 mAs, respectively, in the RH region; 5.4, 5.5 and 5.4 for 10, 20 and 30 mAs, respectively, in the RF region; 13.8, 14.9 and 14.5 for 10, 20 and 30 mAs, respectively, in the LV1 region. Conclusion: the three tube current values yielded similar results for SUV calculation. (author)

  4. Prognostic role of metabolic parameters of {sup 18}F-FDG PET-CT scan performed during radiation therapy in locally advanced head and neck squamous cell carcinoma

    Energy Technology Data Exchange (ETDEWEB)

    Min, Myo; Forstner, Dion [Liverpool Hospital, Cancer Therapy Centre, Liverpool, NSW (Australia); University of New South Wales, Sydney, NSW (Australia); Ingham Institute of Applied Medical Research, Liverpool, NSW (Australia); Lin, Peter; Shon, Ivan Ho; Lin, Michael [University of New South Wales, Sydney, NSW (Australia); Liverpool Hospital, Department of Nuclear Medicine and Positron Emission Tomography, Liverpool, NSW (Australia); University of Western Sydney, Sydney, NSW (Australia); Lee, Mark T. [Liverpool Hospital, Cancer Therapy Centre, Liverpool, NSW (Australia); University of New South Wales, Sydney, NSW (Australia); Bray, Victoria; Fowler, Allan [Liverpool Hospital, Cancer Therapy Centre, Liverpool, NSW (Australia); Chicco, Andrew [Liverpool Hospital, Department of Nuclear Medicine and Positron Emission Tomography, Liverpool, NSW (Australia); Tieu, Minh Thi [Calvary Mater Newcastle, Department of Radiation Oncology, Newcastle, NSW (Australia); University of Newcastle, Newcastle, NSW (Australia)

    2015-12-15

    To evaluate the prognostic value of {sup 18}F-FDG PET-CT performed in the third week (iPET) of definitive radiation therapy (RT) in patients with newly diagnosed locally advanced mucosal primary head and neck squamous-cell-carcinoma (MPHNSCC). Seventy-two patients with MPHNSCC treated with radical RT underwent staging PET-CT and iPET. The maximum standardised uptake value (SUV{sub max}), metabolic tumour volume (MTV) and total lesional glycolysis (TLG) of primary tumour (PT) and index node (IN) [defined as lymph node(s) with highest TLG] were analysed, and results were correlated with loco-regional recurrence-free survival (LRFS), disease-free survival (DFS), metastatic failure-free survival(MFFS) and overall survival (OS), using Kaplan-Meier analysis. Optimal cutoffs (OC) were derived from receiver operating characteristic curves: SUV{sub max-PT} = 4.25 g/mL, MTV{sub PT} = 3.3 cm{sup 3}, TLG{sub PT} = 9.4 g, for PT, and SUV{sub max-IN} = 4.05 g/mL, MTV{sub IN} = 1.85 cm{sup 3} and TLG{sub IN} = 7.95 g for IN. Low metabolic values in iPET for PT below OC were associated with statistically significant better LRFS and DFS. TLG was the best predictor of outcome with 2-year LRFS of 92.7 % vs. 71.1 % [p = 0.005, compared with SUV{sub max} (p = 0.03) and MTV (p = 0.022)], DFS of 85.9 % vs. 60.8 % [p = 0.005, compared with SUV{sub max} (p = 0.025) and MTV (p = 0.018)], MFFS of 85.9 % vs. 83.7 % [p = 0.488, compared with SUV{sub max} (p = 0.52) and MTV (p = 0.436)], and OS of 81.1 % vs. 75.0 % [p = 0.279, compared with SUV{sub max} (p = 0.345) and MTV (p = 0.512)]. There were no significant associations between the percentage reduction of primary tumour metabolic parameters and outcomes. In patients with nodal disease, metabolic parameters below OC (for both PT and IN) were significantly associated with all oncological outcomes, while TLG was again the best predictor: LRFS of 84.0 % vs. 55.3 % (p = 0.017), DFS of 79.4 % vs. 38.6 % (p = 0.001), MFFS 86.4 % vs. 68.2 % (p = 0

  5. FDG PET/MR for lymph node staging in head and neck cancer

    Energy Technology Data Exchange (ETDEWEB)

    Platzek, Ivan, E-mail: ivan.platzek@uniklinikum-dresden.de [Dresden University Hospital, Department of Radiology, Fetscherstr. 74, 01307 Dresden (Germany); Beuthien-Baumann, Bettina, E-mail: bettina.beuthien-baumann3@uniklinikum-dresden.de [Dresden University Hospital, Department of Nuclear Medicine, Fetscherstr. 74, 01307 Dresden (Germany); Schneider, Matthias, E-mail: m.schneider@mkgdresden.de [Dresden University Hospital, Department of Oral and Maxillofacial Surgery, Fetscherstr. 74, 01307 Dresden (Germany); Gudziol, Volker, E-mail: volker.gudziol@uniklinikum-dresden.de [Dresden University Hospital, Department of Otolaryngology, Fetscherstr. 74, 01307 Dresden (Germany); Kitzler, Hagen H., E-mail: hagen.kitzler@uniklinikum-dresden.de [Dresden University Hospital, Department of Neuroradiology, Fetscherstr. 74, 01307 Dresden (Germany); Maus, Jens, E-mail: j.maus@hzdr.de [Helmholtz-Zentrum Dresden-Rossendorf, Institute of Radiopharmaceutical Cancer Research, Bautzner Landstr. 400, 01328 Dresden (Germany); Schramm, Georg, E-mail: g.schramm@hzdr.de [Helmholtz-Zentrum Dresden-Rossendorf, Institute of Radiopharmaceutical Cancer Research, Bautzner Landstr. 400, 01328 Dresden (Germany); Popp, Manuel, E-mail: manuel.popp@praxisklinik-dresden.de [Dresden University Hospital, Department of Nuclear Medicine, Fetscherstr. 74, 01307 Dresden (Germany); Laniado, Michael, E-mail: michael.laniado@uniklinikum-dresden.de [Dresden University Hospital, Department of Radiology, Fetscherstr. 74, 01307 Dresden (Germany); Kotzerke, Jörg, E-mail: Joerg.Kotzerke@uniklinikum-dresden.de [Dresden University Hospital, Department of Nuclear Medicine, Fetscherstr. 74, 01307 Dresden (Germany); Hoff, Jörg van den, E-mail: j.van_den_hoff@hzdr.de [Helmholtz-Zentrum Dresden-Rossendorf, Institute of Radiopharmaceutical Cancer Research, Bautzner Landstr. 400, 01328 Dresden (Germany)

    2014-07-15

    Objective: To assess the diagnostic value of PET/MR (positron emission tomography/magnetic resonance imaging) with FDG (18F-fluorodeoxyglucose) for lymph node staging in head and neck cancer. Materials and methods: This prospective study was approved by the local ethics committee; all patients signed informed consent. Thirty-eight patients with squamous cell carcinoma of the head and neck region underwent a PET scan on a conventional scanner and a subsequent PET/MR on a whole-body hybrid system after a single intravenous injection of FDG. The accuracy of PET, MR and PET/MR for lymph node metastases were compared using receiver operating characteristic (ROC) analysis. Histology served as the reference standard. Results: Metastatic disease was confirmed in 16 (42.1%) of 38 patients and 38 (9.7%) of 391 dissected lymph node levels. There were no significant differences between PET/MR, MR and PET and MR (p > 0.05) regarding accuracy for cervical metastatic disease. Based on lymph node levels, sensitivity and specificity for metastatic involvement were 65.8% and 97.2% for MR, 86.8% and 97.0% for PET and 89.5% and 95.2% for PET/MR. Conclusions: In head and neck cancer, FDG PET/MR does not significantly improve accuracy for cervical lymph node metastases in comparison to MR or PET.

  6. PET-guided breast biopsy.

    Science.gov (United States)

    Kalinyak, Judith E; Schilling, Kathy; Berg, Wendie A; Narayanan, Deepa; Mayberry, Jennifer P; Rai, Rajesh; Dupree, Elizabeth B; Shusterman, Denise K; Gittleman, Mark A; Luo, Weidong; Matthews, Chris G

    2011-01-01

    Molecular imaging, using positron emission tomography (PET), has become an integral step in the evaluation of many patients with malignancy. However, its use in patients with breast cancer has been limited by the lower levels of (18) F-fluorodeoxyglucose (FDG) uptake in some breast malignancies compared to other cancers, the small size of many breast cancers, and the need for biopsy under PET guidance. High-resolution breast PET, or positron emission mammography (PEM), with biopsy guidance software, now addresses these issues. We report a prospective, multicenter study designed to test the efficacy and safety of PEM biopsy guidance software in women with FDG-avid breast lesions worrisome for malignancy. The intervention chosen was vacuum-assisted core biopsy. Nineteen subjects underwent a total of 24 PEM-guided biopsies. All lesions were successfully targeted and sampled as determined by post-biopsy image scan evaluation, specimen imaging, and pathologic concordance. Invasive cancer was identified in 13 of 24 lesions (54%), while four (17%) were high-risk lesions and three of these were upgraded to malignancy at excision. No serious adverse events occurred and all patients found the procedure to cause only minimal to mild discomfort. High-resolution PEM-guided breast biopsy is both safe and effective for the sampling of PET-depicted breast lesions. © 2011 Wiley Periodicals, Inc.

  7. Biodistribution and radiation dosimetry of 18F-CP-18, a potential apoptosis imaging agent, as determined from PET/CT scans in healthy volunteers.

    Science.gov (United States)

    Doss, Mohan; Kolb, Hartmuth C; Walsh, Joseph C; Mocharla, Vani; Fan, Hong; Chaudhary, Ashok; Zhu, Zhihong; Alpaugh, R Katherine; Lango, Miriam N; Yu, Jian Q

    2013-12-01

    (18)F-CP-18, or (18S,21S,24S,27S,30S)-27-(2-carboxyethyl)-21-(carboxymethyl)-30-((2S,3R,4R,5R,6S)-6-((2-(4-(3-F18-fluoropropyl)-1H-1,2,3-triazol-1-yl)acetamido)methyl)-3,4,5-trihydroxytetrahydro-2H-pyran-2-carboxamido)-24-isopropyl-18-methyl-17,20,23,26,29-pentaoxo-4,7,10,13-tetraoxa-16,19,22,25,28-pentaazadotriacontane-1,32-dioic acid, is being evaluated as a tissue apoptosis marker for PET imaging. The purpose of this study was to determine the biodistribution and estimate the normal-organ radiation-absorbed doses and effective dose from (18)F-CP-18. Successive whole-body PET/CT scans were obtained at approximately 7, 45, 90, 130, and 170 min after intravenous injection of (18)F-CP-18 in 7 healthy human volunteers. Blood samples and urine were collected between the PET/CT scans, and the biostability of (18)F-CP-18 was assessed using high-performance liquid chromatography. The PET scans were analyzed to determine the radiotracer uptake in different organs. OLINDA/EXM software was used to calculate human radiation doses based on the biodistribution of the tracer. (18)F-CP-18 was 54% intact in human blood at 135 min after injection. The tracer cleared rapidly from the blood pool with a half-life of approximately 30 min. Relatively high (18)F-CP-18 uptake was observed in the kidneys and bladder, with diffuse uptake in the liver and heart. The mean standardized uptake values (SUVs) in the bladder, kidneys, heart, and liver at around 50 min after injection were approximately 65, 6, 1.5, and 1.5, respectively. The calculated effective dose was 38 ± 4 μSv/MBq, with the urinary bladder wall having the highest absorbed dose at 536 ± 61 μGy/MBq using a 4.8-h bladder-voiding interval for the male phantom. For a 1-h voiding interval, these doses were reduced to 15 ± 2 μSv/MBq and 142 ± 15 μGy/MBq, respectively. For a typical injected activity of 555 MBq, the effective dose would be 21.1 ± 2.2 mSv for the 4.8-h interval, reduced to 8.3 ± 1.1 mSv for the 1-h interval

  8. Influence of FDG-PET on computed tomography-based radiotherapy planning for locally recurrent nasopharyngeal carcinoma.

    Science.gov (United States)

    Zheng, Xiao-Kang; Chen, Long-Hua; Wang, Quan-Shi; Wu, Hu-Bing; Wang, Hong-Mei; Chen, Yong-Qin; Yan, Wei-Pin; Li, Qi-Sheng; Xu, Yi-Kai

    2007-12-01

    Assuming F-18-fluoro-2-deoxy-d-glucose positron emission tomography (FDG-PET)/computed tomography (CT) to be more accurate in representing the true disease extent than CT alone, we prospectively designed this study to evaluate how the addition of FDG-PET influences CT-based radiotherapy planning for locally recurrent nasopharyngeal carcinoma. All patients underwent FDG-PET/CT simulation scans. For each patient, the gross tumor volume (GTV) was separately delineated with or without the addition of PET information and defined as GTV PET/CT and GTV CT, respectively. Corresponding planning target volumes (PTV) were generated for the GTV CT (PTV(CT)) and GTV PET/CT (PTV PET/CT). Three-dimensional conformal radiotherapy plans were separately created for PTV CT and PTV PET/CT. To assess the potential geographic miss of the PET/CT-based disease in CT-based treatment planning, the size and location of the GTV PET/CT, PTV(PET/CT), and PTV(CT) were analyzed, and the three-dimensional conformal radiotherapy plans created using the PTV CT were evaluated with the GTV PET/CT and PTV PET/CT information. A total of 43 patients were enrolled in this study. Distant metastasis was found in 4 patients with the addition of the PET information. The 39 patients without distant metastasis proceeded to three-dimensional conformal radiotherapy planning. Inadequate coverage of the GTV PET/CT and PTV PET/CT by the PTV CT occurred in 7 (18%) and 20 (51%) patients, respectively. This resulted in or=95% of the prescribed dose in 4 (10%) and 13 (33%) patients, respectively. The addition of FDG-PET information might influence CT-based radiotherapy planning for locally recurrent nasopharyngeal carcinoma by altering the definition of the target volume, with the potential to avoid a geographic miss of true disease.

  9. Iodine-124-labeled iodo-azomycin-galactoside imaging of tumor hypoxia in mice with serial microPET scanning

    Energy Technology Data Exchange (ETDEWEB)

    Zanzonico, Pat; O' Donoghue, Joseph; Cai, Shangde; Larson, Steven; Wen, Bixiu; Chen, Yuchun; Finn, Ronald; Ruan, Shutian; Humm, John; Ling, Clifton [Memorial Sloan Kettering Cancer Center, 1275 York Avenue, NY 10021, New York (United States); Chapman, J.Donald; Schneider, Richard [Fox Chase Cancer Center, Philadelphia, PA (United States); Gerweck, Leo [Massachusetts General Hospital, Boston, MA (United States)

    2004-01-01

    In the current study, serial microPET imaging was used to evaluate iodine-124-labeled iodo-azomycin-galactoside ({sup 124}I-IAZG) (4.2-day physical half-life) as a hypoxia imaging agent in 17 MCa breast tumors and six FSaII fibrosarcomas implanted in mice. For comparison, another promising hypoxic-cell PET radiotracer, fluorine-18-labeled fluoro-misonidazole ({sup 18}F-FMISO), was also imaged in the same tumor-bearing animals. Twelve animals were also imaged with {sup 18}F-labeled fluoro-deoxyglucose ({sup 18}F-FDG). In addition, histological examination was performed, and direct measurement of tumor oxygenation status carried out with the Oxylite probe system. Two size groups were used, relatively well-oxygenated tumors in the range of 80-180 mg were designated as small, and those >300 mg and highly hypoxic, as large. Based on the data from 11 MCa and six FSaII tumors, both {sup 124}I-IAZG and {sup 18}F-FMISO images showed high tracer uptake in the large tumors. In {sup 18}F-FMISO images at 1, 3-4, and 6-8 h post-injection (p.i.), there was considerable whole-body background activity. In contrast, {sup 124}I-IAZG imaging was optimal when performed at 24-48 h p.i., when the whole-body background had dissipated considerably. As a result, the {sup 124}I-IAZG images at 24-48 h p.i. had higher tumor to whole-body activity contrast than the {sup 18}F-FMISO images at 3-6 h p.i. Region-of-interest analysis was performed as a function of time p.i. and indicated a tumor uptake of 5-10% (of total-body activity) for FMISO at 3-6 h p.i., and of 17% for IAZG at 48 h p.i. This was corroborated by biodistribution data in that the tumor-to-normal tissue (T/N, normal tissues of blood, heart, lung, liver, spleen, kidney, intestine, and muscle) activity ratios of IAZG at 24 h p.i. was 1.5-2 times higher than those of FMISO at 3 h p.i., with the exception of stomach. Statistical analysis indicated that these differences in T/N ratios were significant. The small tumors were visualized

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

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Soo Jin; Lee, Wom Woo; Kim, Sang Eun [Dept. of Nuclear Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam (Korea, Republic of)

    2013-06-15

    Na1{sup 8F} bone positron emission tomography (bone PET) is a new imaging modality which is useful for the evaluation of bone diseases. Here, we compared the diagnostic accuracies between bone PET and bone scan for the detection of bone metastasis (BM). Sixteen cancer patients (M:F = 10:6, mean age = 60 ± 12 years) who underwent both bone PET and bone scan were analyzed. Bone PET was conducted 30 minutes after the injection of 370 MBq Na1{sup 8F}, and a bone scan was performed 3 hours after the injection of 1295 MBq 9{sup 9mT}c-hydroxymethylene diphosphonate. In the patient-based analysis (8 patients with BM and 8 without BM), the sensitivities of bone PET (100% 8/8) and bone scan (87.5% = 7/8) were not significantly different (p > 0.05), whereas the specificity of bone PET (87.5% = 7/8) was significantly greater than that of the bone scan (25% = 2/8) (p < 0.05). In the lesion-based analysis (43 lesions in 14 patients; 31 malignant and 12 benign), the sensitivity of bone PET (100% = 31/31) was significantly greater than that of bone scan (38.7% = 12/31) (p < 0.01), and the specificity of bone PET (75.0% = 9/12) was also significantly higher than that of bone scan (8.3% = 1/12) (p < 0.05). The receiver operating characteristic curve analysis showed that bone PET was significantly more accurate than the bone scan in the patient (p = 0.0306) and lesion (p = 0.0001) based analyses. Na1{sup 8F} bone PET is more accurate than bone scan for BM evaluation.

  11. Robustness of correlations between PCA of FDG-PET scans and biological variables in healthy and demented subjects.

    Science.gov (United States)

    Markiewicz, P J; Matthews, J C; Declerck, J; Herholz, K

    2011-05-15

    In neuroimaging it is helpful and useful to obtain robust and accurate estimates of relationships between the image derived data and separately derived covariates such as clinical and demographic measures. Due to the high dimensionality of brain images, complex image analysis is typically used to extract certain image features, which may or may not relate to the covariates. These correlations which explain variance within the image data are frequently of interest. Principal component analysis (PCA) is used to extract image features from a sample of 42 FDG PET brain images (19 normal controls (NCs), 23 Alzheimer's disease (AD) patients). For the first three most robust PCs, the correlation of the PC scores with: i) the Mini Mental Status Exam (MMSE) score and ii) age is examined. The key aspects of this work is the assessment of: i) the robustness and significance of the correlations using bootstrap resampling; ii) the influence of the PCA on the robustness of the correlations; iii) the impact of two intensity normalization methods (global and cerebellum). Results show that: i) Pearson's statistics can lead to overoptimistic results. ii) The robustness of the correlations deteriorate with the number of PCs. iii) The correlations are hugely influenced by the method of intensity normalization: the correlation of cognitive impairment with PC1 are stronger and more significant for global normalization; whereas the correlations with age were strongest and more robust with PC2 and cerebellar normalization. Copyright © 2010 Elsevier Inc. All rights reserved.

  12. Comparison of sequential planar {sup 177}Lu-DOTA-TATE dosimetry scans with {sup 68}Ga-DOTA-TATE PET/CT images in patients with metastasized neuroendocrine tumours undergoing peptide receptor radionuclide therapy

    Energy Technology Data Exchange (ETDEWEB)

    Sainz-Esteban, Aurora; Carril, Jose Manuel [Hospital Universitario Marques de Valdecilla, Department of Nuclear Medicine, Santander (Spain); Prasad, Vikas; Schuchardt, Christiane; Zachert, Carolin; Baum, Richard P. [Zentralklinik Bad Berka, Department of Nuclear Medicine and Centre for PET/CT, Bad Berka (Germany)

    2012-03-15

    The aim of the study was to compare sequential {sup 177}Lu-DOTA-TATE planar scans ({sup 177}Lu-DOTA-TATE) in patients with metastasized neuroendocrine tumours (NET) acquired during peptide receptor radionuclide therapy (PRRT) for dosimetry purposes with the pre-therapeutic {sup 68}Ga-DOTA-TATE positron emission tomography (PET)/CT ({sup 68}Ga-DOTA-TATE) maximum intensity projection (MIP) images obtained in the same patients concerning the sensitivity of the different methods. A total of 44 patients (59 {+-} 11 years old) with biopsy-proven NET underwent {sup 68}Ga-DOTA-TATE and {sup 177}Lu-DOTA-TATE imaging within 7.9 {+-} 7.5 days between the two examinations. {sup 177}Lu-DOTA-TATE planar images were acquired at 0.5, 2, 24, 48 and 72 h post-injection; lesions were given a score from 0 to 4 depending on the uptake of the radiopharmaceutical (0 being lowest and 4 highest). The number of tumour lesions which were identified on {sup 177}Lu-DOTA-TATE scans (in relation to the acquisition time after injection of the therapeutic dose as well as with regard to the body region) was compared to those detected on {sup 68}Ga-DOTA-TATE studies obtained before PRRT. A total of 318 lesions were detected; 280 (88%) lesions were concordant. Among the discordant lesions, 29 were {sup 68}Ga-DOTA-TATE positive and {sup 177}Lu-DOTA-TATE negative, whereas 9 were {sup 68}Ga-DOTA-TATE negative and {sup 177}Lu-DOTA-TATE positive. The sensitivity, positive predictive value and accuracy for {sup 177}Lu-DOTA-TATE as compared to {sup 68}Ga-DOTA-TATE were 91, 97 and 88%, respectively. Significantly more lesions were seen on the delayed (72 h) {sup 177}Lu-DOTA-TATE images (91%) as compared to the immediate (30 min) images (68%). The highest concordance was observed for bone metastases (97%) and the lowest for head/neck lesions (75%). Concordant lesions (n = 77; mean size 3.8 cm) were significantly larger than discordant lesions (n = 38; mean size 1.6 cm) (p < 0.05). No such significance was

  13. Nuclear Scans - Multiple Languages

    Science.gov (United States)

    ... Expand Section Bone Scan - 简体中文 (Chinese, Simplified (Mandarin dialect)) Bilingual PDF Health Information Translations PET (Positron Emission Tomography) Scan - 简体中文 (Chinese, Simplified ( ...

  14. Iodine-124-labeled iodo-azomycin-galactoside imaging of tumor hypoxia in mice with serial microPET scanning

    International Nuclear Information System (INIS)

    Zanzonico, Pat; O'Donoghue, Joseph; Cai, Shangde; Larson, Steven; Wen, Bixiu; Chen, Yuchun; Finn, Ronald; Ruan, Shutian; Humm, John; Ling, Clifton; Chapman, J.Donald; Schneider, Richard; Gerweck, Leo

    2004-01-01

    In the current study, serial microPET imaging was used to evaluate iodine-124-labeled iodo-azomycin-galactoside ( 124 I-IAZG) (4.2-day physical half-life) as a hypoxia imaging agent in 17 MCa breast tumors and six FSaII fibrosarcomas implanted in mice. For comparison, another promising hypoxic-cell PET radiotracer, fluorine-18-labeled fluoro-misonidazole ( 18 F-FMISO), was also imaged in the same tumor-bearing animals. Twelve animals were also imaged with 18 F-labeled fluoro-deoxyglucose ( 18 F-FDG). In addition, histological examination was performed, and direct measurement of tumor oxygenation status carried out with the Oxylite probe system. Two size groups were used, relatively well-oxygenated tumors in the range of 80-180 mg were designated as small, and those >300 mg and highly hypoxic, as large. Based on the data from 11 MCa and six FSaII tumors, both 124 I-IAZG and 18 F-FMISO images showed high tracer uptake in the large tumors. In 18 F-FMISO images at 1, 3-4, and 6-8 h post-injection (p.i.), there was considerable whole-body background activity. In contrast, 124 I-IAZG imaging was optimal when performed at 24-48 h p.i., when the whole-body background had dissipated considerably. As a result, the 124 I-IAZG images at 24-48 h p.i. had higher tumor to whole-body activity contrast than the 18 F-FMISO images at 3-6 h p.i. Region-of-interest analysis was performed as a function of time p.i. and indicated a tumor uptake of 5-10% (of total-body activity) for FMISO at 3-6 h p.i., and of 17% for IAZG at 48 h p.i. This was corroborated by biodistribution data in that the tumor-to-normal tissue (T/N, normal tissues of blood, heart, lung, liver, spleen, kidney, intestine, and muscle) activity ratios of IAZG at 24 h p.i. was 1.5-2 times higher than those of FMISO at 3 h p.i., with the exception of stomach. Statistical analysis indicated that these differences in T/N ratios were significant. The small tumors were visualized in the 18 F-FDG images, but not in the 124 I

  15. Separation of input function for rapid measurement of quantitative CMRO{sub 2} and CBF in a single PET scan with a dual tracer administration method

    Energy Technology Data Exchange (ETDEWEB)

    Kudomi, Nobuyuki; Watabe, Hiroshi; Hayashi, Takuya; Iida, Hidehiro [Department of Investigative Radiology, Advanced Medical-Engineering Center, National Cardiovascular Center-Research Institute, 5-7-1, Fujishirodai, Suita, Osaka 565-8565 (Japan)

    2007-04-07

    Cerebral metabolic rate of oxygen (CMRO{sub 2}), oxygen extraction fraction (OEF) and cerebral blood flow (CBF) images can be quantified using positron emission tomography (PET) by administrating {sup 15}O-labelled water (H{sup 15}{sub 2}O) and oxygen ({sup 15}O{sub 2}). Conventionally, those images are measured with separate scans for three tracers C{sup 15}O for CBV, H{sup 15}{sub 2}O for CBF and {sup 15}O{sub 2} for CMRO{sub 2}, and there are additional waiting times between the scans in order to minimize the influence of the radioactivity from the previous tracers, which results in a relatively long study period. We have proposed a dual tracer autoradiographic (DARG) approach (Kudomi et al 2005), which enabled us to measure CBF, OEF and CMRO{sub 2} rapidly by sequentially administrating H{sup 15}{sub 2}O and {sup 15}O{sub 2} within a short time. Because quantitative CBF and CMRO{sub 2} values are sensitive to arterial input function, it is necessary to obtain accurate input function and a drawback of this approach is to require separation of the measured arterial blood time-activity curve (TAC) into pure water and oxygen input functions under the existence of residual radioactivity from the first injected tracer. For this separation, frequent manual sampling was required. The present paper describes two calculation methods: namely a linear and a model-based method, to separate the measured arterial TAC into its water and oxygen components. In order to validate these methods, we first generated a blood TAC for the DARG approach by combining the water and oxygen input functions obtained in a series of PET studies on normal human subjects. The combined data were then separated into water and oxygen components by the present methods. CBF and CMRO{sub 2} were calculated using those separated input functions and tissue TAC. The quantitative accuracy in the CBF and CMRO{sub 2} values by the DARG approach did not exceed the acceptable range, i.e., errors in those

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

    International Nuclear Information System (INIS)

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

    2005-01-01

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

  17. Impact of 18F-FDG PET/CT on the management of adrenocortical carcinoma: analysis of 106 patients

    International Nuclear Information System (INIS)

    Takeuchi, Satoshi; Macapinlac, Homer A.; Chuang, Hubert H.; Balachandran, Aparna; Habra, Mouhammed Amir; Phan, Alexandria T.; Bassett, Roland L.

    2014-01-01

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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2014-11-15

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

  19. Utility of Amyloid and FDG-PET in Clinical Practice: Differences Between Secondary and Tertiary Care Memory Units.

    Science.gov (United States)

    Lage, Carmen; Suarez, Andrea Gonzalez; Pozueta, Ana; Riancho, Javier; Kazimierczak, Martha; Bravo, Maria; Jimenez Bonilla, Julio; de Arcocha Torres, Marıa; Quirce, Remedios; Banzo, Ignacio; Vazquez-Higuera, Jose Luis; Rabinovici, Gil D; Rodriguez-Rodriguez, Eloy; Sánchez-Juan, Pascual

    2018-04-27

    The clinical utility of amyloid positron emission tomography (PET) has not been fully established. Our aim was to evaluate the effect of amyloid imaging on clinical decision making in a secondary care unit and compare our results with a previous study in a tertiary center following the same methods. We reviewed retrospectively 151 cognitively impaired patients who underwent amyloid (Pittsburgh compound B [PiB]) PET and were evaluated clinically before and after the scan in a secondary care unit. One hundred and fifty concurrently underwent fluorodeoxyglucose (FDG)-PET. We assessed changes between the pre- and post-PET clinical diagnosis and Alzheimer's disease treatment plan. The association between PiB/FDG results and changes in management was evaluated using χ2 and multivariate logistic regression. Concordance between classification based on scan readings and baseline diagnosis was 66% for PiB and 47% for FDG. The primary diagnosis changed after PET in 17.2% of cases. When examined independently, discordant PiB and discordant FDG were both associated with diagnostic change (p PET due to a higher likelihood of diagnostic change. We found that changes in diagnosis after PET in our secondary center almost doubled those of our previous analysis of a tertiary unit (9% versus 17.2%). Our results offer some clues about the rational use of amyloid PET in a secondary care memory unit stressing its utility in mild cognitive impairment patients.

  20. Performance evaluation of a high resolution dedicated breast PET scanner

    Energy Technology Data Exchange (ETDEWEB)

    García Hernández, Trinitat, E-mail: mtrinitat@eresa.com; Vicedo González, Aurora; Brualla González, Luis; Granero Cabañero, Domingo [Department of Medical Physics, ERESA, Hospital General Universitario, Valencia 46014 (Spain); Ferrer Rebolleda, Jose; Sánchez Jurado, Raúl; Puig Cozar Santiago, Maria del [Department of Nuclear Medicine, ERESA, Hospital General Universitario, Valencia 46014 (Spain); Roselló Ferrando, Joan [Department of Medical Physics, ERESA, Hospital General Universitario, Valencia 46014 (Spain); Department of Physiology, University of Valencia, Valencia 46010 (Spain)

    2016-05-15

    Purpose: Early stage breast cancers may not be visible on a whole-body PET scan. To overcome whole-body PET limitations, several dedicated breast positron emission tomography (DbPET) systems have emerged nowadays aiming to improve spatial resolution. In this work the authors evaluate the performance of a high resolution dedicated breast PET scanner (Mammi-PET, Oncovision). Methods: Global status, uniformity, sensitivity, energy, and spatial resolution were measured. Spheres of different sizes (2.5, 4, 5, and 6 mm diameter) and various 18 fluorodeoxyglucose ({sup 18}F-FDG) activity concentrations were randomly inserted in a gelatine breast phantom developed at our institution. Several lesion-to-background ratios (LBR) were simulated, 5:1, 10:1, 20:1, 30:1, and 50:1. Images were reconstructed using different voxel sizes. The ability of experienced reporters to detect spheres was tested as a function of acquisition time, LBR, sphere size, and matrix reconstruction voxel size. For comparison, phantoms were scanned in the DbPET camera and in a whole body PET (WB-PET). Two patients who just underwent WB-PET/CT exams were imaged with the DbPET system and the images were compared. Results: The measured absolute peak sensitivity was 2.0%. The energy resolution was 24.0% ± 1%. The integral and differential uniformity were 10% and 6% in the total field of view (FOV) and 9% and 5% in the central FOV, respectively. The measured spatial resolution was 2.0, 1.9, and 1.7 mm in the radial, tangential, and axial directions. The system exhibited very good detectability for spheres ≥4 mm and LBR ≥10 with a sphere detection of 100% when acquisition time was set >3 min/bed. For LBR = 5 and acquisition time of 7 min the detectability was 100% for spheres of 6 mm and 75% for spheres of 5, 4, and 2.5 mm. Lesion WB-PET detectability was only comparable to the DbPET camera for lesion sizes ≥5 mm when acquisition time was >3 min and LBR > 10. Conclusions: The DbPET has a good

  1. Performance evaluation of a high resolution dedicated breast PET scanner

    International Nuclear Information System (INIS)

    García Hernández, Trinitat; Vicedo González, Aurora; Brualla González, Luis; Granero Cabañero, Domingo; Ferrer Rebolleda, Jose; Sánchez Jurado, Raúl; Puig Cozar Santiago, Maria del; Roselló Ferrando, Joan

    2016-01-01

    Purpose: Early stage breast cancers may not be visible on a whole-body PET scan. To overcome whole-body PET limitations, several dedicated breast positron emission tomography (DbPET) systems have emerged nowadays aiming to improve spatial resolution. In this work the authors evaluate the performance of a high resolution dedicated breast PET scanner (Mammi-PET, Oncovision). Methods: Global status, uniformity, sensitivity, energy, and spatial resolution were measured. Spheres of different sizes (2.5, 4, 5, and 6 mm diameter) and various 18 fluorodeoxyglucose ( 18 F-FDG) activity concentrations were randomly inserted in a gelatine breast phantom developed at our institution. Several lesion-to-background ratios (LBR) were simulated, 5:1, 10:1, 20:1, 30:1, and 50:1. Images were reconstructed using different voxel sizes. The ability of experienced reporters to detect spheres was tested as a function of acquisition time, LBR, sphere size, and matrix reconstruction voxel size. For comparison, phantoms were scanned in the DbPET camera and in a whole body PET (WB-PET). Two patients who just underwent WB-PET/CT exams were imaged with the DbPET system and the images were compared. Results: The measured absolute peak sensitivity was 2.0%. The energy resolution was 24.0% ± 1%. The integral and differential uniformity were 10% and 6% in the total field of view (FOV) and 9% and 5% in the central FOV, respectively. The measured spatial resolution was 2.0, 1.9, and 1.7 mm in the radial, tangential, and axial directions. The system exhibited very good detectability for spheres ≥4 mm and LBR ≥10 with a sphere detection of 100% when acquisition time was set >3 min/bed. For LBR = 5 and acquisition time of 7 min the detectability was 100% for spheres of 6 mm and 75% for spheres of 5, 4, and 2.5 mm. Lesion WB-PET detectability was only comparable to the DbPET camera for lesion sizes ≥5 mm when acquisition time was >3 min and LBR > 10. Conclusions: The DbPET has a good performance

  2. Attenuation correction of emission PET images with average CT: Interpolation from breath-hold CT

    Science.gov (United States)

    Huang, Tzung-Chi; Zhang, Geoffrey; Chen, Chih-Hao; Yang, Bang-Hung; Wu, Nien-Yun; Wang, Shyh-Jen; Wu, Tung-Hsin

    2011-05-01

    Misregistration resulting from the difference of temporal resolution in PET and CT scans occur frequently in PET/CT imaging, which causes distortion in tumor quantification in PET. Respiration cine average CT (CACT) for PET attenuation correction has been reported to improve the misalignment effectively by several papers. However, the radiation dose to the patient from a four-dimensional CT scan is relatively high. In this study, we propose a method to interpolate respiratory CT images over a respiratory cycle from inhalation and exhalation breath-hold CT images, and use the average CT from the generated CT set for PET attenuation correction. The radiation dose to the patient is reduced using this method. Six cancer patients of various lesion sites underwent routine free-breath helical CT (HCT), respiration CACT, interpolated average CT (IACT), and 18F-FDG PET. Deformable image registration was used to interpolate the middle phases of a respiratory cycle based on the end-inspiration and end-expiration breath-hold CT scans. The average CT image was calculated from the eight interpolated CT image sets of middle respiratory phases and the two original inspiration and expiration CT images. Then the PET images were reconstructed by these three methods for attenuation correction using HCT, CACT, and IACT. Misalignment of PET image using either CACT or IACT for attenuation correction in PET/CT was improved. The difference in standard uptake value (SUV) from tumor in PET images was most significant between the use of HCT and CACT, while the least significant between the use of CACT and IACT. Besides the similar improvement in tumor quantification compared to the use of CACT, using IACT for PET attenuation correction reduces the radiation dose to the patient.

  3. 68Ga-PSMA PET/CT in the evaluation of bone metastases in prostate cancer.

    Science.gov (United States)

    Sachpekidis, Christos; Bäumer, P; Kopka, K; Hadaschik, B A; Hohenfellner, M; Kopp-Schneider, A; Haberkorn, U; Dimitrakopoulou-Strauss, A

    2018-06-01

    The aims of this retrospective analysis were to compare 68 Ga-PSMA PET findings and low-dose CT findings (120 kV, 30 mA), and to obtain semiquantitative and quantitative 68 Ga-PSMA PET data in patients with prostate cancer (PC) bone metastases. In total, 152 PET/CT scans from 140 patients were evaluated. Of these patients, 30 had previously untreated primary PC, and 110 had biochemical relapse after treatment of primary PC. All patients underwent dynamic PET/CT scanning of the pelvis and lower abdomen as well as whole-body PET/CT with 68 Ga-PSMA-11. The PET/CT scans were analysed qualitatively (visually), semiquantitatively (SUV), and quantitatively based on a two-tissue compartment model and a noncompartmental approach leading to the extraction of the fractal dimension. Differences were considered significant for p values PET-positive and CT-positive, 65 were only 68 Ga-PSMA-positive, and 10 were only CT-positive. The Yang test showed that there were significantly more 68 Ga-PSMA PET-positive lesions than CT-positive lesions. Association analysis showed that PSA plasma levels were significantly correlated with several 68 Ga-PSMA-11-associated parameters in bone metastases, including the degree of tracer uptake (SUV average and SUV max ), its transport rate from plasma to the interstitial/intracellular compartment (K 1 ), its rate of binding to the PSMA receptor and its internalization (k 3 ), its influx rate (K i ), and its distribution heterogeneity. 68 Ga-PSMA PET/CT is a useful diagnostic tool in the detection of bone metastases in PC. 68 Ga-PSMA PET visualizes more bone metastases than low-dose CT. PSA plasma levels are significantly correlated with several 68 Ga-PSMA PET parameters.

  4. Automatic extraction of forward stroke volume using dynamic 11C-acetate PET/CT

    DEFF Research Database (Denmark)

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

    , potentially introducing bias if measured with a separate modality. The aim of this study was to develop and validate methods for automatically extracting FSV directly from the dynamic PET used for measuring oxidative metabolism. Methods: 16 subjects underwent a dynamic 27 min PET scan on a Siemens Biograph...... TruePoint 64 PET/CT scanner after bolus injection of 399±27 MBq of 11C-acetate. The LV-aortic time-activity curve (TAC) was extracted automatically from dynamic PET data using cluster analysis. The first-pass peak was derived by automatic extrapolation of the down-slope of the TAC. FSV...... was then calculated as the injected dose divided by the product of heart rate and the area under the curve of the first-pass peak. Gold standard FSV was measured in the left ventricular outflow tract by cardiovascular magnetic resonance using phase-contrast velocity mapping within two weeks of PET imaging. Results...

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

    International Nuclear Information System (INIS)

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

    1998-01-01

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

  6. Single scan parameterization of space-variant point spread functions in image space via a printed array: the impact for two PET/CT scanners

    Energy Technology Data Exchange (ETDEWEB)

    Kotasidis, F A; Matthews, J C; Angelis, G I; Noonan, P J; Jackson, A [Imaging, Genomics and Proteomics, Wolfson Molecular Imaging Centre, MAHSC, University of Manchester, Manchester (United Kingdom); Price, P [Academic Department of Radiation Oncology, University of Manchester, Manchester (United Kingdom); Lionheart, W R [School of Mathematics, Alan Turing Building, University of Manchester, Manchester (United Kingdom); Reader, A J, E-mail: fotis.kotasidis@mmic.man.ac.uk [Brain Imaging Centre, Montreal Neurological Institute, McGill University, Montreal, QC (Canada)

    2011-05-21

    Incorporation of a resolution model during statistical image reconstruction often produces images of improved resolution and signal-to-noise ratio. A novel and practical methodology to rapidly and accurately determine the overall emission and detection blurring component of the system matrix using a printed point source array within a custom-made Perspex phantom is presented. The array was scanned at different positions and orientations within the field of view (FOV) to examine the feasibility of extrapolating the measured point source blurring to other locations in the FOV and the robustness of measurements from a single point source array scan. We measured the spatially-variant image-based blurring on two PET/CT scanners, the B-Hi-Rez and the TruePoint TrueV. These measured spatially-variant kernels and the spatially-invariant kernel at the FOV centre were then incorporated within an ordinary Poisson ordered subset expectation maximization (OP-OSEM) algorithm and compared to the manufacturer's implementation using projection space resolution modelling (RM). Comparisons were based on a point source array, the NEMA IEC image quality phantom, the Cologne resolution phantom and two clinical studies (carbon-11 labelled anti-sense oligonucleotide [{sup 11}C]-ASO and fluorine-18 labelled fluoro-l-thymidine [{sup 18}F]-FLT). Robust and accurate measurements of spatially-variant image blurring were successfully obtained from a single scan. Spatially-variant resolution modelling resulted in notable resolution improvements away from the centre of the FOV. Comparison between spatially-variant image-space methods and the projection-space approach (the first such report, using a range of studies) demonstrated very similar performance with our image-based implementation producing slightly better contrast recovery (CR) for the same level of image roughness (IR). These results demonstrate that image-based resolution modelling within reconstruction is a valid alternative to

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

    International Nuclear Information System (INIS)

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

    2013-01-01

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

  8. Senior Pets

    Science.gov (United States)

    ... Care Animal Welfare Veterinary Careers Public Health Senior Pets Veterinarians Get the Senior Pets client information brochure . ... healthier life for your pet. When does a pet become “old”? It varies, but cats and small ...

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

    Directory of Open Access Journals (Sweden)

    Yu-Wen Chen

    2007-12-01

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

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

    DEFF Research Database (Denmark)

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

    2013-01-01

    The study aimed at comparing PET/MR to PET/CT for imaging the carotid arteries in patients with known increased risk of atherosclerosis. Six HIV-positive men underwent sequential PET/MR and PET/CT of the carotid arteries after injection of 400 MBq of 18F-FDG. PET/MR was performed a median of 131 ...

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

    International Nuclear Information System (INIS)

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

    2014-01-01

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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2014-03-15

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

  13. Quantitative accuracy of denoising techniques applied to dynamic 82Rb myocardial blood flow PET/CT scans

    DEFF Research Database (Denmark)

    Harms, Hans; Tolbod, Lars Poulsen; Bouchelouche, Kirsten

    be performed successfully for all scans. Quantitative performance was suboptimal when 5 or less factors were used for the Hotelling method, both in 2D and 3D. For 6 or more factors and for HYPR-LR, excellent quantitative accuracy was obtained when compared to non-denoised data (r2 = 0.996, slope = 1.013 for 2D...... Hotelling with 6 factors; r2 = 0.994, slope = 0.998 for 3D Hotelling with 6 factors; r2 = 0.995, slope = 0.996 for HYPR-LR). Conclusions: Both HYPR-LR and Hotelling denoising methods can be applied to 82Rb data with excellent quantitative accuracy. This enables an improvement in image quality or potentially....... This increases radiation dose to the patient, reduces Sr/Rb generator lifetimes and increases risk of scanner saturation. The aim of this study was to evaluate quantitative performance of several image denoising techniques which could ultimately be used to reduce administered activity. Methods: Fifty patients...

  14. Clinical value of whole-body FDG-PET for recurrent gastric cancer. A multicenter study

    International Nuclear Information System (INIS)

    Nakamoto, Yuji; Togashi, Kaori; Kaneta, Tomohiro

    2009-01-01

    The purpose of this multicenter study was to evaluate the clinical usefulness of positron emission tomography (PET) using 18 F-fluorodeoxyglucose (FDG) for suspected recurrent gastric cancer. We performed a retrospective review of 92 consecutive patients who underwent PET [either integrated PET/computed tomography (CT) or manual fusion of dedicated PET and CT] scans for post-treatment surveillance of gastric cancer between June 2006 and December 2007. Of these patients, 46 patients were suspected of recurrence by other imaging modalities (Group A), 19 patients were suspected of recurrence by tumor markers without definite findings (Group B) and the remaining 27 patients underwent a PET scan without evidence of recurrence (Group C). The diagnostic performance and prevalence of the clinical impact of FDG-PET were analyzed. Recurrence of gastric cancer was confirmed in 31 patients (67%) in Group A, in 11 patients (58%) in Group B and in 2 patients (7%) in Group C. In addition, colon cancer (n=3), lung cancer (n=1) and pulmonary carcinoid (n=1) were identified in five patients (5%). In patient-basis, the sensitivity, specificity and diagnostic accuracy of PET for recurrence were 81%, 87% and 83%, respectively, in Group A, 73%, 88% and 79%, respectively, in Group B and 50%, 88% and 85%, respectively, in Group C. Therapeutic management was influenced by PET results in 22 patients (48%) in Group A, in 8 patients (42%) in Group B and in 2 patients (7%) in Group C, including cases in which PET was helpful for detecting second primary cancer. PET with FDG yielded useful information in patients with suspected recurrent gastric cancer, especially when recurrence was suspected in the clinical setting. (author)

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2007-01-15

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

  16. PET/CT for staging and follow-up of pediatric nasopharyngeal carcinoma

    Energy Technology Data Exchange (ETDEWEB)

    Cheuk, Daniel K.L. [St Jude Children' s Research Hospital, Department of Oncology, Memphis, TN (United States); The University of Hong Kong, Department of Paediatrics and Adolescent Medicine, Pokfulam (China); Sabin, Noah D.; Hossain, Moinul; Krasin, Matthew J.; Shulkin, Barry L. [St Jude Children' s Research Hospital, Department of Radiological Sciences, Memphis, TN (United States); Wozniak, Amy [St Jude Children' s Research Hospital, Department of Biostatistics, Memphis, TN (United States); Naik, Mihir [St Jude Children' s Research Hospital, Department of Radiological Sciences, Memphis, TN (United States); University of Texas Health Science Center, Department of Radiation Oncology, San Antonio, TX (United States); Rodriguez-Galindo, Carlos [St Jude Children' s Research Hospital, Department of Oncology, Memphis, TN (United States); Hematology/Oncology, Dana-Farber Cancer Institute, Boston, MA (United States)

    2012-07-15

    While FDG PET/CT for the evaluation of nasopharyngeal carcinoma (NPC) in adult patients has documented advantages and disadvantages compared with conventional imaging, to our knowledge, no studies of FDG PET/CT for the evaluation of NPC in pediatric patients have been performed. In this investigation, we studied the utility of FDG PET/CT in children with NPC. The study group comprised 18 children with biopsy-proven NPC who underwent FDG PET/CT and MRI (total 38 pairs of images). All baseline and follow-up FDG PET/CT and MRI studies were independently reviewed for restaging of disease. The concordance between FDG PET/CT and MRI in T, N, and overall staging was 29%, 64%, and 43%, respectively. Compared with MRI, FDG PET/CT yielded lower T and overall staging and showed less cervical and retropharyngeal lymphadenopathy. The concordance between follow-up FDG PET/CT and MRI was 79% overall and 100% 9 months after therapy. In patients who achieved complete remission, FDG PET/CT showed disease clearance 3-6 months earlier than MRI. There were no false-positive or false-negative FDG PET/CT scans during follow-up. FDG PET/CT may underestimate tumor extent and regional lymphadenopathy compared with MRI at the time of diagnosis, but it helps to detect metastases and clarify ambiguous findings. FDG PET/CT is sensitive and specific for follow-up and enables earlier determination of disease remission. FDG PET/CT is a valuable imaging modality for the evaluation and monitoring of NPC in pediatric patients. (orig.)

  17. PET/CT for staging and follow-up of pediatric nasopharyngeal carcinoma

    International Nuclear Information System (INIS)

    Cheuk, Daniel K.L.; Sabin, Noah D.; Hossain, Moinul; Krasin, Matthew J.; Shulkin, Barry L.; Wozniak, Amy; Naik, Mihir; Rodriguez-Galindo, Carlos

    2012-01-01

    While FDG PET/CT for the evaluation of nasopharyngeal carcinoma (NPC) in adult patients has documented advantages and disadvantages compared with conventional imaging, to our knowledge, no studies of FDG PET/CT for the evaluation of NPC in pediatric patients have been performed. In this investigation, we studied the utility of FDG PET/CT in children with NPC. The study group comprised 18 children with biopsy-proven NPC who underwent FDG PET/CT and MRI (total 38 pairs of images). All baseline and follow-up FDG PET/CT and MRI studies were independently reviewed for restaging of disease. The concordance between FDG PET/CT and MRI in T, N, and overall staging was 29%, 64%, and 43%, respectively. Compared with MRI, FDG PET/CT yielded lower T and overall staging and showed less cervical and retropharyngeal lymphadenopathy. The concordance between follow-up FDG PET/CT and MRI was 79% overall and 100% 9 months after therapy. In patients who achieved complete remission, FDG PET/CT showed disease clearance 3-6 months earlier than MRI. There were no false-positive or false-negative FDG PET/CT scans during follow-up. FDG PET/CT may underestimate tumor extent and regional lymphadenopathy compared with MRI at the time of diagnosis, but it helps to detect metastases and clarify ambiguous findings. FDG PET/CT is sensitive and specific for follow-up and enables earlier determination of disease remission. FDG PET/CT is a valuable imaging modality for the evaluation and monitoring of NPC in pediatric patients. (orig.)

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

    International Nuclear Information System (INIS)

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

    2012-01-01

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

  19. Automatic lesion tracking for a PET/CT based computer aided cancer therapy monitoring system

    Science.gov (United States)

    Opfer, Roland; Brenner, Winfried; Carlsen, Ingwer; Renisch, Steffen; Sabczynski, Jörg; Wiemker, Rafael

    2008-03-01

    Response assessment of cancer therapy is a crucial component towards a more effective and patient individualized cancer therapy. Integrated PET/CT systems provide the opportunity to combine morphologic with functional information. However, dealing simultaneously with several PET/CT scans poses a serious workflow problem. It can be a difficult and tedious task to extract response criteria based upon an integrated analysis of PET and CT images and to track these criteria over time. In order to improve the workflow for serial analysis of PET/CT scans we introduce in this paper a fast lesion tracking algorithm. We combine a global multi-resolution rigid registration algorithm with a local block matching and a local region growing algorithm. Whenever the user clicks on a lesion in the base-line PET scan the course of standardized uptake values (SUV) is automatically identified and shown to the user as a graph plot. We have validated our method by a data collection from 7 patients. Each patient underwent two or three PET/CT scans during the course of a cancer therapy. An experienced nuclear medicine physician manually measured the courses of the maximum SUVs for altogether 18 lesions. As a result we obtained that the automatic detection of the corresponding lesions resulted in SUV measurements which are nearly identical to the manually measured SUVs. Between 38 measured maximum SUVs derived from manual and automatic detected lesions we observed a correlation of 0.9994 and a average error of 0.4 SUV units.

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

    Science.gov (United States)

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

    2013-05-01

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

  1. Evaluation of 68Ga-DOTATOC PET/MRI for whole-body staging of neuroendocrine tumours in comparison with 68Ga-DOTATOC PET/CT

    International Nuclear Information System (INIS)

    Sawicki, Lino M.; Deuschl, Cornelius; Beiderwellen, Karsten; Forsting, Michael; Umutlu, Lale; Ruhlmann, Verena; Poeppel, Thorsten D.; Bockisch, Andreas; Herrmann, Ken; Heusch, Philipp; Antoch, Gerald; Lahner, Harald; Fuehrer, Dagmar

    2017-01-01

    To compare the diagnostic performance of 68 Ga-DOTATOC PET/MRI and 68 Ga-DOTATOC PET/CT in the whole-body staging of patients with neuroendocrine tumours (NET). Thirty patients with histopathologically confirmed NET underwent PET/CT and PET/MRI in a single-injection protocol. PET/CT and PET/MRI scans were prospectively evaluated with regard to lesion count, localization, nature (NET/non-NET), and conspicuity (four-point scale). Histopathology and follow-up imaging served as the reference standards. The proportions of NET and non-NET lesions rated correctly were compared using McNemar's chi-squared test. The Wilcoxon test was used to assess differences in SUVmax and lesion conspicuity. The correlation between the SUVmax for the same lesions from each modality was analysed using Pearson's correlation coefficient (r). According to the reference standard, there were 197 lesions (142 NET, 55 non-NET). Lesion-based analysis showed a higher proportion of correctly rated NET lesions on PET/MRI than on PET/CT (90.8% vs. 86.7%, p = 0.031), whereas on PET/CT there was a higher proportion of correctly rated non-NET lesions (94.5% vs. 83.6%, p = 0.031). SUVmax was strongly correlated (r = 0.86; p < 0.001) and did not differ significantly (p = 0.35) between the modalities. Overall conspicuity and NET lesion conspicuity were higher on PET/MRI (both p < 0.01). Ga-DOTATOC PET/MRI yielded a higher proportion of correctly rated NET lesions and should be regarded as a valuable alternative to 68 Ga-DOTATOC PET/CT in whole-body staging of NET patients. (orig.)

  2. Prospective evaluation of 18F-FACBC PET/CT and PET/MRI versus multiparametric MRI in intermediate- to high-risk prostate cancer patients (FLUCIPRO trial).

    Science.gov (United States)

    Jambor, Ivan; Kuisma, Anna; Kähkönen, Esa; Kemppainen, Jukka; Merisaari, Harri; Eskola, Olli; Teuho, Jarmo; Perez, Ileana Montoya; Pesola, Marko; Aronen, Hannu J; Boström, Peter J; Taimen, Pekka; Minn, Heikki

    2018-03-01

    The purpose of this study was to evaluate 18 F-FACBC PET/CT, PET/MRI, and multiparametric MRI (mpMRI) in detection of primary prostate cancer (PCa). Twenty-six men with histologically confirmed PCa underwent PET/CT immediately after injection of 369 ± 10 MBq 18 F-FACBC (fluciclovine) followed by PET/MRI started 55 ± 7 min from injection. Maximum standardized uptake values (SUV max ) were measured for both hybrid PET acquisitions. A separate mpMRI was acquired within a week of the PET scans. Logan plots were used to calculate volume of distribution (V T ). The presence of PCa was estimated in 12 regions with radical prostatectomy findings as ground truth. For each imaging modality, area under the curve (AUC) for detection of PCa was determined to predict diagnostic performance. The clinical trial registration number is NCT02002455. In the visual analysis, 164/312 (53%) regions contained PCa, and 41 tumor foci were identified. PET/CT demonstrated the highest sensitivity at 87% while its specificity was low at 56%. The AUC of both PET/MRI and mpMRI significantly (p PET/CT while no differences were detected between PET/MRI and mpMRI. SUV max and V T of Gleason score (GS) >3 + 4 tumors were significantly (p PET/CT and PET/MRI demonstrated true-positive findings in only 1/7 patients with metastatic lymph nodes. Quantitative 18 F-FACBC imaging significantly correlated with GS but failed to outperform MRI in lesion detection. 18 F-FACBC may assist in targeted biopsies in the setting of hybrid imaging with MRI.

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

    Science.gov (United States)

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

    2016-02-01

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

  4. PET pharmacokinetic analysis to estimate boron concentration in tumor and brain as a guide to plan BNCT for malignant cerebral glioma

    Energy Technology Data Exchange (ETDEWEB)

    Nariai, Tadashi [Department of Neurosurgery, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo (Japan)], E-mail: nariai.nsrg@tmd.ac.jp; Ishiwata, Kiichi [Positron Medical Center, Tokyo Metropolitan Institute of Gerontology, 1-1, Nakacho, Itabashi-ku, Tokyo (Japan); Kimura, Yuichi [Molecular Imaging Center, National Institute of Radiological Sciences, 4-9-1 Anagawa, Inage-ku, Chiba (Japan); Inaji, Motoki; Momose, Toshiya [Department of Neurosurgery, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo (Japan); Yamamoto, Tetsuya; Matsumura, Akira [Department of Neurosurgery, University of Tsukuba, Tennodai, Tsukuba, Igaraki (Japan); Ishii, Kenji [Positron Medical Center, Tokyo Metropolitan Institute of Gerontology, 1-1, Nakacho, Itabashi-ku, Tokyo (Japan); Ohno, Kikuo [Department of Neurosurgery, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo (Japan)

    2009-07-15

    Introduction: To plan the optimal BNCT for patients with malignant cerebral glioma, estimation of the ratio of boron concentration in tumor tissue against that in the surrounding normal brain (T/N ratio of boron) is important. We report a positron emission tomography (PET) imaging method to estimate T/N ratio of tissue boron concentration based on pharmacokinetic analysis of amino acid probes. Methods: Twelve patients with cerebral malignant glioma underwent 60 min dynamic PET scanning of brain after bolus injection of {sup 18}F-borono-phenyl-alanine (FBPA) with timed arterial blood sampling. Using kinetic parameter obtained by this scan, T/N ratio of boron concentration elicited by one-hour constant infusion of BPA, as performed in BNCT, was simulated on Runge-Kutta algorithm. {sup 11}C-methionine (MET) PET scan, which is commonly used in worldwide PET center as brain tumor imaging tool, was also performed on the same day to compare the image characteristics of FBPA and that of MET. Result: PET glioma images obtained with FBPA and MET are almost identical in all patients by visual inspection. Estimated T/N ratio of tissue boron concentration after one-hour constant infusion of BPA, T/N ratio of FBPA on static condition, and T/N ratio of MET on static condition showed significant linear correlation between each other. Conclusion: T/N ratio of boron concentration that is obtained by constant infusion of BPA during BNCT can be estimated by FBPA PET scan. This ratio can also be estimated by MET-PET imaging. As MET-PET study is available in many clinical PET center, selection of candidates for BNCT may be possible by MET-PET images. Accurate planning of BNCT may be performed by static images of FBPA PET. Use of PET imaging with amino acid probes may contribute very much to establish an appropriate application of BNCT for patients with malignant glioma.

  5. PET pharmacokinetic analysis to estimate boron concentration in tumor and brain as a guide to plan BNCT for malignant cerebral glioma

    International Nuclear Information System (INIS)

    Nariai, Tadashi; Ishiwata, Kiichi; Kimura, Yuichi; Inaji, Motoki; Momose, Toshiya; Yamamoto, Tetsuya; Matsumura, Akira; Ishii, Kenji; Ohno, Kikuo

    2009-01-01

    Introduction: To plan the optimal BNCT for patients with malignant cerebral glioma, estimation of the ratio of boron concentration in tumor tissue against that in the surrounding normal brain (T/N ratio of boron) is important. We report a positron emission tomography (PET) imaging method to estimate T/N ratio of tissue boron concentration based on pharmacokinetic analysis of amino acid probes. Methods: Twelve patients with cerebral malignant glioma underwent 60 min dynamic PET scanning of brain after bolus injection of 18 F-borono-phenyl-alanine (FBPA) with timed arterial blood sampling. Using kinetic parameter obtained by this scan, T/N ratio of boron concentration elicited by one-hour constant infusion of BPA, as performed in BNCT, was simulated on Runge-Kutta algorithm. 11 C-methionine (MET) PET scan, which is commonly used in worldwide PET center as brain tumor imaging tool, was also performed on the same day to compare the image characteristics of FBPA and that of MET. Result: PET glioma images obtained with FBPA and MET are almost identical in all patients by visual inspection. Estimated T/N ratio of tissue boron concentration after one-hour constant infusion of BPA, T/N ratio of FBPA on static condition, and T/N ratio of MET on static condition showed significant linear correlation between each other. Conclusion: T/N ratio of boron concentration that is obtained by constant infusion of BPA during BNCT can be estimated by FBPA PET scan. This ratio can also be estimated by MET-PET imaging. As MET-PET study is available in many clinical PET center, selection of candidates for BNCT may be possible by MET-PET images. Accurate planning of BNCT may be performed by static images of FBPA PET. Use of PET imaging with amino acid probes may contribute very much to establish an appropriate application of BNCT for patients with malignant glioma.

  6. The Role of 18F-FDG PET/CT in Evaluating Elevated Levels of Tumor Markers in Breast Cancer

    Directory of Open Access Journals (Sweden)

    İnan Göktaş

    2018-02-01

    Full Text Available Objective: Our aim was to assess the diagnostic performance of integrated positron emission tomography/computed tomography (PET/CT in the follow-up of breast cancer patients, who underwent a PET/CT scan due to a suspicion of recurrence based on elevated levels of serum tumor markers. Methods: Seventy-seven consecutive patients were included in this study. PET/CT scan results were compared with the final diagnoses that were obtained from histopathological sampling or a minimum 6 months of radiological follow-up. The sensitivity, specificity, positive predictive value (PPV, negative predictive value (NPV and the diagnostic accuracy of PET/CT for detecting recurrence were calculated. Results: All 77 patients had increased serum cancer antigen 15-3 levels while 37 had increased serum carcinoembryonic antigen levels. According to PET/CT scan results, 59 of 77 patients (PET/CT positive had local recurrence and/or distant metastasis while there was no pathological finding in 18 patients (PET/CT negative. In a follow-up of minimum 6 months, tumor recurrence was confirmed in 58 of “PET/CT positive” patients while no tumor recurrence was detected in 16 of “PET/CT negative” patients. According to these results the sensitivity, specificity, PPV, NPV and the diagnostic accuracy of PET/CT for detecting recurrence on a per-person basis were calculated as 98%, 88%, 96%, 94% and 96%, respectively. Conclusion: In case of elevated levels of serum tumor markers, PET/CT has a high diagnostic accuracy in detecting tumor recurrence in patients with breast cancer, and it is an effective modality that can be used in addition to conventional imaging techniques.

  7. PET scan for breast cancer

    Science.gov (United States)

    ... radioactive substance (called a tracer) to look for breast cancer. This tracer can help identify areas of cancer ... only after a woman has been diagnosed with breast cancer. It is done to see if the cancer ...

  8. Whole-body biodistribution and the influence of body activity on brain kinetic analysis of the11C-PiB PET scan.

    Science.gov (United States)

    Akamatsu, Go; Nishio, Tomoyuki; Adachi, Kazuhiko; Ikari, Yasuhiko; Senda, Michio

    2017-12-01

    Dynamic 11 C-PiB PET imaging with kinetic analysis has been performed for accurate quantification of amyloid binding in patients with Alzheimer's disease (AD). In this study, we measured the whole-body biodistribution of 11 C-PiB in nine subjects. We then evaluated the effect of body activity on quantitative accuracy of brain 11 C-PiB three-dimensional (3D) dynamic PET. Based on clinical biodistribution data, we conducted phantom experiments to estimate the effect of body activity on quantification of the brain 3D dynamic 11 C-PiB PET data and the error introduced by body activity using six different PET camera models. One of the PET cameras was used to acquire 11 C-PiB brain 3D dynamic PET data on a patient with AD. We calculated the distribution volume ratio (DVR) in two kinetic methods using both the original human time-activity-curve (TAC) data and the TAC corrected for the error caused by body activity. In the early phase, both healthy subjects and patients with AD showed a biodistribution of 11 C-PiB that reflected regional blood flow. In the simulated early phase of the phantom experiments, activity outside the field of view led to a maximum 6.0% overestimation of brain activity in the vertex region. Conversely, the effect of body activity on the DVR estimate was small (≤1.2%), probably because the tested kinetic methods did not rely heavily on early phase data. These results indicate that the effect of body activity on brain 11 C-PiB PET quantification is generally small and that it depends on the method of kinetic analysis, the region of interest, and the PET camera model used.

  9. The role of F-18 fluorodeoxyglucose (FDG) positron emission tomography (PET) in the evaluation of residual germ cell tumours

    International Nuclear Information System (INIS)

    Ballok, Z.E.; Scott, A.M.; Hannah, A.; Berlangieri, S.; Tochon-Danguy, H.; Chan, J.G.; Hicks, R.; Burns, I.; McKendrich, J.; Tauro, A.

    1998-01-01

    Full text: The role of FDG-PET is not well established in the assessment of patients with germ cell tumours. The aim of this study was to assess the accuracy of FDG-PET in detecting residual disease in patients with germ cell tumours, and its potential role in patient management. A total of 34 FDG-PET scans in 29 patients (23 patients (IF:22M) with nonseminomatous germ cell tumours (NSGCT), and 6 male patients with advanced seminoma) performed over a 4 yr period were evaluated. Results of FDG-PET studies were compared to pathology or follow-up. For NSGCT patients, pathological evidence of residual high grade tumour was seen in 9 patients on subsequent surgical specimens. FDG-PET studies were true positive in all of these patients. In 8 NSGCT patients pathology revealed fibrosis or teratoma at subsequent surgery: all had negative FDG-PET studies. There were no false positive, nor false negative FDG-PET studies. Resection was not performed in the remaining 6 patients, and on follow-up 2 patients had a progressive clinical course after positive FDG-PET scans, and 2 patients were in clinical remission 3 and 29 months after a negative FDG-PET study, respectively. Two patients were not evaluable. Of the 6 seminoma patients, 5 underwent further chemotherapy /radiotherapy after having abnormal FDG-PET studies due to clinical evidence of disease. The 6th pt with a negative FDG-PET study had stable retroperitoneal lymph node enlargement after 3 years follow-up. In our series FDG-PET was able to predict the presence of high grade malignancy within residual masses in patients with NSGCT and seminoma with a high accuracy. These initial results encourage further evaluation

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2012-08-15

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

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

    International Nuclear Information System (INIS)

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

    2012-01-01

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

  12. Comparison of CT and 18F-FDG PET for Detecting Peritoneal Metastasis on the Preoperative Evaluation for Gastric Carcinoma

    Energy Technology Data Exchange (ETDEWEB)

    Lim, Joon Seok; Kim, Myeong Jin; Yun, Mi jin [Yonsei University College of Medicine, Seoul (Korea, Republic of)] (and others)

    2006-12-15

    The aim of our study was to compare the accuracy of CT and {sup 18}F-FDG PET for detecting peritoneal metastasis in patients with gastric carcinoma. One-hundred-twelve patients who underwent a histologic confirmative exam or treatment (laparotomy, n = 107; diagnostic laparoscopy, n = 4; peritoneal washing cytology, n = 1) were retrospectively enrolled. All the patients underwent CT and {sup 18}F-FDG PET scanning for their preoperative evaluation. The sensitivities, specificities and accuracies of CT and {sup 18}FFDG PET imaging for the detection of peritoneal metastasis were calculated and then compared using Fisher's exact probability test (p < 0.05), on the basis of the original preoperative reports. In addition, two board-certified radiologists and two board-certified nuclear medicine physicians independently reviewed the CT and PET scans, respectively. A receiver-operating characteristic curve analysis was performed to compare the diagnostic performance of CT and {sup 18}F-FDG PET imaging for detecting peritoneal metastasis. Based on the original preoperative reports, CT and {sup 18}F-FDG PET showed sensitivities of 76.5% and 35.3% (p = 0.037), specificities of 91.6% and 98.9% (p = 0.035), respectively, and equal accuracies of 89.3% (p = 1.0). The receptor operating characteristics curve analysis showed a significantly higher diagnostic performance for CT (Az 0.878) than for PET (Az = 0.686) (p 0.004). The interobserver agreement for detecting peritoneal metastasis was good ({kappa} value = 0.684) for CT and moderate (({kappa} value = 0.460) for PET. For the detection of peritoneal metastasis, CT was more sensitive and showed a higher diagnostic performance than PET, although CT had a relatively lower specificity than did PET.

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

    Energy Technology Data Exchange (ETDEWEB)

    Yen, Tzu-Chen; Chang, Yu-Chen; Chan, Sheng-Chieh; Lin, Kun-Ju [Chang Gung Memorial University Hospital, Linkou Medical Center, Department of Nuclear Medicine (Taiwan); Chang, Joseph Tung-Chieh [Chang Gung Memorial University Hospital, Linkou Medical Center, Department of Radiation Oncology (Taiwan); Hsu, Ching-Han [National Tsing Hua University, Department of Nuclear Science (Taiwan); Lin, Wuu-Jyh; Fu, Ying-Kai [Institute of Nuclear Energy Research, Taoyuan (Taiwan); Ng, Shu-Hang [Chang Gung Memorial University Hospital, Linkou Medical Center, Department of Diagnostic Radiology, Taoyuan (Taiwan)

    2005-04-01

    This prospective study aimed to investigate the efficacy of dual-phase positron emission tomography (PET) in evaluating the loco-regional status of nasopharyngeal carcinoma (NPC). Eighty-four patients with newly diagnosed NPC and a fasting serum glucose level of <200 mg/dl were enrolled. [{sup 18}F]fluoro-2-deoxy-D-glucose ({sup 18}F-FDG) PET studies (at 40 min and 3 h after injection of 370 MBq {sup 18}F-FDG) and head and neck magnetic resonance imaging (MRI) were performed within 1 week. Diagnostic criteria for NPC comprised the histopathological findings, the joint judgments of the research team and the post-treatment outcome. Each lesion's maximum standardised uptake value (SUV) and retention index were obtained. SUV data were evaluated using a paired test. Receiver operating characteristic curves and calculation of the area under the curve (AUC) determined the discriminative power. {sup 18}F-FDG PET was significantly superior to MRI in identifying lower neck NPC nodal metastasis (AUC: 1 vs 0. 972, P=0.046) and overall loco-regional metastases (AUC: 0.985 vs 0.958, P=0.036). However, {sup 18}F-FDG PET was similar to MRI in detecting primary tumour, as well as retropharyngeal, upper neck and supraclavicular nodal metastases. There was no significant difference between early phase (40 min) and delayed phase (3 h) {sup 18}F-FDG PET in the detection of primary tumours (accuracy: 100% vs 100%) or loco-regional nodal metastasis (AUC: 0.984 vs 0.985, P=0.834). {sup 18}F-FDG PET is superior to MRI in identifying lower neck nodal metastasis of NPC. Additional 3-h {sup 18}F-FDG PET contributes no further information in the detection of primary tumours or loco-regional metastatic nodes in untreated NPC patients. (orig.)

  14. Impact of Ge-68/Ga-68-based versus CT-based attenuation correction on PET.

    NARCIS (Netherlands)

    Dalen, J.A. van; Visser, E.P.; Vogel, W.V.; Corstens, F.H.M.; Oyen, W.J.G.

    2007-01-01

    Transmission (Tx) scans are used in PET for attenuation correction (AC). For standalone PET this is typically done using Ge-68/Ga-68 sources, for PET-CT using CT. Therefore, standalone PET suffers from emission contamination during Tx scans, PET-CT does not. Here, we studied the effects of AC across

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

    DEFF Research Database (Denmark)

    Nielsen, M. S.; Carl, J.

    2017-01-01

    Respiratory-induced motions are prone to degrade the positron emission tomography (PET) signal with the consequent loss of image information and unreliable segmentations. This phantom study aims to assess the discrepancies relative to stationary PET segmentations, of widely used semiautomatic PET...... segmented using three SUV threshold methods (Max40%, SUV40% and 2.5SUV) and a gradient based method (GradientSeg). Segmentations in static 3D-PET scans (PETsta) specified the reference conditions for the individual segmentation methods, target lesions and tracer concentrations. The motion included PET...... images followed a 4D-PET (PET4D) and a 3D-PET (PETmot) scan protocol. Moreover, motion-corrected PET images (PETdeb) were derived from the PETmot images. Segmentations in PET4D, PETmot and PETdeb were compared to the PETsta segmentations according to volume changes (Delta Vol) and an error estimate (low...

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

    Science.gov (United States)

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

    2009-03-01

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

  17. F.D.G.-PET scanning in managing patients with lymphoma; La place de la TEP au FDG dans l'evaluation des lymphomes

    Energy Technology Data Exchange (ETDEWEB)

    Bodet-Milin, C.; Kraeber-Bodere, F. [CHU de Nantes, Service de Medecine Nucleaire, Hotel-Dieu, 44 - Nantes (France); Salaun, P.Y. [CHU de Brest, Service de Medecine Nucleaire, 29 - Brest (France); Crespin, C.; Vuillez, J.P. [CHU de Grenoble, Service de Medecine Nucleaire, 38 - Grenoble (France); Kraeber-Bodere, F. [Centre Rene-Gauducheau, Service de Medecine Nucleaire, 44 - Saint-Herblain (France); CRCNA, Inserm UMR 892, 44 - Nantes (France)

    2009-08-15

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

  18. Quantification of cardiopulmonary blood volume turnover using dynamic PET

    DEFF Research Database (Denmark)

    Harms, Hans; Tolbod, Lars Poulsen; Kero, Tanja

    index, the central circulatory turnover (CCT) which represents the fractional exchange of blood per stroke within the cardiopulmonary blood pool and can be measured from any dynamic PET scan. Methods: Data from 111 clinical patients were analysed retrospectively. Patients underwent a 6-min 15O......Background: Dynamic 15O-water PET is used to quantify myocardial blood flow. For clinical use however, additional information regarding left ventricular performance is often required but is not obtained from standard tracer kinetic modelling. The aim of this study was to explore the use of a novel......-water scan during rest and adenosine-induced stress. Patients were categorized into 4 groups based on stress myocardial blood flow (MBF, in mL/g/min): all segments >2.3 (group 1, n=53), one vessel

  19. Relations between pathological markers and radioiodine can and {sup 18}F-FDG PET/CT findings in papillary thyroid cancer patients with recurrent cervical nodal metastases

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Jeong Won [Dept. of Nuclear Medicine, Catholic Kwandong University International St. Mary' s Hospital, Seoul (Korea, Republic of); Min, Hye Sook [Dept. of athology, Seoul National University Hospital, Seoul (Korea, Republic of); Lee, Sang Mi [Dept. of Nuclear Medicine, Soonchunhyang University Cheonan Hospital, Cheonan (Korea, Republic of); Kwon, Hyun Woo; Chung, June Key [Dept. of Nuclear Medicine,Seoul National University College of Medicine, Seoul (Korea, Republic of)

    2015-06-15

    The aim of this study was to investigate relationships between the immunohistochemical results and radioiodine scan and {sup 18}F-FDG PET findings in papillary thyroid cancer (PTC) patients with recurrent cervical nodal metastases. A total of 46 PTC patients who had undergone a radioiodine scan and/or {sup 18}F-FDG PET/CT and a subsequent operation on recurrent cervical lymph nodes were enrolled. Twenty-seven patients underwent {sup 18}F-FDG PET/CT, 8 underwent radioiodine scans, and 11 underwent both scans. In all surgical specimens, the immunoexpressions of thyroglobulin (Tg), sodium-iodide symporter (NIS), glucose transporter 1 (Glut-1), and somatostatin receptor 1 and 2A (SSTR1 and SSTR2A) were assessed, and associations between these expressions and radioiodine scan and {sup 18}F-FDG PET findings were evaluated. Of the 38 patients who underwent {sup 18}F-FDG PET/CT, all patients with weak Tg expression had positive {sup 18}F-FDG uptake, while only 45 % of the patients with moderate or strong Tg expression showed positive uptake (p = 0.01). The proportion of patients with positive {sup 18}F-FDG uptake increased as the degree of Glut-1 expression with luminal accentuation increased. Of the 19 patients who underwent a radioiodine scan, the proportion with positive radioiodine uptake was greater among patients with strong NIS and SSTR2A expression than among patients expressing these markers at weak levels (p = 0.04 for all). All three patients with weak Tg expression were negative for radioiodine uptake. The {sup 18}F-FDG uptakes of recurrent cervical nodes are related to strong Glut-1 expression with luminal accentuation and weak Tg expression, whereas radioiodine uptake is related to the strong expressions of NIS and SSTR2A.

  20. Malignant peritoneal esothelioma masqueradesas peritoneal metastasis on {sup 18}F-FDG PET/CT scans: A rare diagnosis that should not be missed

    Energy Technology Data Exchange (ETDEWEB)

    Claimon, Apichaya; Bang, Ji In; Cheon, Gi Jeong; Lee, Dong Soo [Dept. of Nuclear Medicine, Seoul National University Hospital, Seoul (Korea, Republic of); Kim, Eui Shin Edmund [Molecular Medicine and Biopharmaceutical Sciences, WCU Graduate School of Convergence Science and Technology, Seoul National University College of Medicine, Seoul (Korea, Republic of)

    2015-12-15

    Malignant peritoneal mesothelioma (MPM) is a rare but fatal tumor. The clinical presentations and imaging findings are nonspecific and resemble various diseases, including peritoneal metastasis. Imaging findings of MPH on {sup 18}F-{sup 18}F-fluorodeoxyglucose ({sup 18}F-FDG) positron emission tomography (PET)/computed tomography (CT) are diverse and not well described. We report the two cases of biopsy-proven MPH using {sup 18}F-FDG PET/CT. In our cases, interesting disease patterns—including MPH arising from visceral peritoneal lining of kidney that suffer from polycystic disease and from the parietal peritoneum beneath the appendectomy scar—were presented. One case showed classical metastases localized within the abdominal cavity; while the other case exhibited the rare pattern of extensive multi-organ metastases. By knowing the possible variations and diagnostic pitfalls of {sup 18}F-FDG PET/CT findings in MPM, more accurate interpretation of such mysterious cancer is attainable.

  1. Comparison of six methods of segmentation of tumor volume on the 18F-F.D.G. PET scan with reference histological volume in non small cell bronchopulmonary cancers

    International Nuclear Information System (INIS)

    Venel, Y.; Garhi, H.; Baulieu, J.L.; Prunier-Aesch, C.; Muret, A. de; Barillot, I.

    2008-01-01

    The 18 F-F.D.G. PET has demonstrated its importance in oncology, for initial extension and efficacy of anti tumoral therapeutics. Several studies have attempted to prove its utility to define tumoral volumes for conformational radiotherapy in non small cell lung cancers. Some authors have suggested the use of threshold of tumor intensity uptake with 40 or 50% of maximal intensity. Black et al. have determined contouring with linear regression formula of mean semi-quantitative index of tumor uptake (standard uptake value): SUV threshold = 0.307 Sub average + 0.588. Nestle et al. have taken into account the background noise intensity and mean intensity of the tumor: I threshold = β I average +I noise with β 0.15. Our study was done in collaboration with Inserm U618 team and has compared volumes defined on PET scan defined according to different methods based on intensity or S.U.V. to the tumour volume determined on CT scan by radio physicist. We have compared those volumes with histological volume that we considered for reference. Four patients have been included. They had 18 F-F.D.G. PET scan followed by complete tumoral removal surgery. Specific histological procedure allowed to define complete size of the tumor in re expanded lung. Comparatively to pathology, the volumes obtained using I max 40 and I max 50 are all underestimated. The volumes defined by Black's et al. method are under evaluated for the two largest tumours (15.8% to 22%) and overestimated for the two smallest ones (17.9 to 82.9%). Nestle's et al. method, using β = 0.15, correctly estimates two tumor volumes over 2 cm, but overestimates the two small tumors (79.6 to 124%). Finally, the corrected Nestle's et al. formula (using β = 0.264) overestimates three tumours. Volumes defined on CT scan by radio physicist are correct for one lesion, underestimated for one and overestimated for two other ones (44 and 179.5%). Nestle's et al. method seems to be the most accurate for tumours over 2 cm of

  2. Evaluation of a Fast Protocol for Staging Lymphoma Patients with Integrated PET/MRI.

    Directory of Open Access Journals (Sweden)

    Johannes Grueneisen

    Full Text Available The aim of this study was to assess the applicability of a fast MR-protocol for whole-body staging of lymphoma patients using an integrated PET/MR system.A total of 48 consecutive lymphoma patients underwent 52 clinically indicated PET/CT and subsequent PET/MRI examinations with the use of 18F-FDG. For PET/MR imaging, a fast whole-body MR-protocol was implemented. A radiologist and a nuclear medicine physician interpreted MRI and PET/MRI datasets in consensus and were instructed to identify manifestations of lymphoma on a site-specific analysis. The accuracy for the identification of active lymphoma disease was calculated and the tumor stage for each examination was determined. Furthermore, radiation doses derived from administered tracer activities and CT protocol parameters were estimated and the mean scan duration of PET/CT and PET/MR imaging was determined. Statistical analysis was performed to compare the diagnostic performance of PET/MRI and MRI alone. The results of PET/CT imaging, all available histopathological samples as well as results of prior examinations and follow-up imaging were used for the determination of the reference standard.Active lymphoma disease was present in 28/52 examinations. PET/MRI revealed higher values of diagnostic accuracy for the identification of active lymphoma disease in those 52 examinations in comparison to MRI, however, results of the two ratings did not differ significantly. On a site specific analysis, PET/MRI showed a significantly higher accuracy for the identification of nodal manifestation of lymphoma (p<0.05 if compared to MRI, whereas ratings for extranodal regions did not reveal a significant difference. In addition, PET/MRI enabled correct identification of lymphoma stage in a higher percentage of patients than MRI (94% vs. 83%. Furthermore, SUVs derived from PET/MRI were significantly higher than in PET/CT, however, there was a strong positive correlation between SUVmax and SUVmean of the two

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

    Science.gov (United States)

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

    2014-08-01

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

  4. Disease progression in AIDS on PET fluorodeoxyglucose, CT and MR brain images

    International Nuclear Information System (INIS)

    Verma, R.C.; Bennett, L.; Gan, M.; Kloumehr, F.; Mathisen, G.; Jones, F.D.; Wasterlain, C.; Mandelkern, M.; Ropchan, J.; Blahd, W.; Yaghmal, I.

    1990-01-01

    This paper correlates changes in the brain demonstrated on F-18 fluorodeoxyglucose (FDG) positron emission tomographic (PET) scans and CT or MR images with disease severity in patients with acquired immunodeficiency syndrome (AIDS). Data from 30 patients who tested positive for human immunodeficiency virus (HIV) who were at various stages of AIDS, and who had undergone FDG PET, CT, and/or MR imaging were reviewed retrospectively. The average CD4 lymphocyte counts, an indicator of disease severity in AIDS, in 25 symptomatic (group I) and five healthy seropositive (group II) subjects were 300 and 694 cells/mm 3 , respectively. Cortical atrophy was present on CT and/or MR imaging in 92% in group I and only 20% in group II. Of the 17 patients in group I who underwent PET scans 11 demonstrated an elevated basal ganglia to frontal cortex (BG/FC) ratio of FDG uptake; only one of the four in group II had this finding

  5. Value of surveillance {sup 18}F FDG PET/CT in colorectal cancer:comparison with conventional imaging studies

    Energy Technology Data Exchange (ETDEWEB)

    Choi, Eun Kyoung; Yoo, Ie Ryung; Park, Hye Lim; Choi, Hyun Su; Han, Eun Ji; Kim, Sung Hoon; Chung, Soo Kyo; O, Joo Hyun [The Catholic Univ. of Korea, Seoul (Korea, Republic of)

    2012-09-15

    To assess the value of PET/CT for detecting local or distant recurrence in patients who undergo surgery for colorectal cancer (CRC)and to compare the accuracy of PET/CT to that of conventional imaging studies (CIS). Tumor surveillance PET/CT scans done between March 2005 and December 2009 of disease free patients after surgery with or without adjuvant chemotherapy for CRC were retrospectively studied. CIS (serial enhanced CT from lung base to pelvis and plain chest radiograph)were performed within 1 month of PET/CT. We excluded patients with distant metastasis on initial staging, a known recurrent tumor, and a lack of follow up imaging. The final diagnosis was based on at least 6 months of follow up with colonoscopy, biopsy, and serial imaging studies in combination with carcinoembryonic antigen levels. A total of 262 PET/CT scans of 245 patients were included. Local and distant recurrences were detected in 27 cases (10.3%). On case based analysis, the overall sensitivity, specificity, and accuracy were 100, 97.0, and 97.3% for PET/CT and 85.1, 97.0, and 95.8% for CIS, respectively. On lesion based analysis, PET/CT detected more lesions compared to CIS in local recurrence and lung metastasis. PET/CT and CIS detected the same number of lesions in abdominal lymph nodes, hepatic metastasis, and peritoneal carcinomatosis. PET/CT detected two more metachronous tumors than did CIS in the lung and thyroid gland. PET/CT detected more recurrences in patients who underwent surgery for CRC than did CIS and had the additional advantage of evaluating the entire body during a single scan.

  6. Meta-analysis study of lymph node staging by 18 F-FDG PET/CT scan in non-small cell lung cancer: Comparison of TB and non-TB endemic regions

    Energy Technology Data Exchange (ETDEWEB)

    Liao, Chih-Ying, E-mail: jine871@yahoo.com.tw [Department of Radiation Therapy and Oncology, Taichung Hospital, Department of Health, Executive Yuan, Taiwan (China); Institute of Integrated Medicine, China Medical University, Taichung, Taiwan (China); Chen, Jin-Hua, E-mail: chenjh12@gmail.com [Biostatistics Center and Graduate Institute of Biostatistics, China Medical University, Taichung, Taiwan (China); Liang, Ji-An, E-mail: hope.jal@msa.hinet.net [Institute of Clinical Medicine Science and School of Medicine, College of Medicine, China Medical University, Taichung, Taiwan (China); Department of Radiation Oncology, China Medical University Hospital, Taichung, Taiwan (China); Yeh, Jun-Jun, E-mail: anvin.funlan@msa.hinet.net [Institute of Clinical Medicine Science and School of Medicine, College of Medicine, China Medical University, Taichung, Taiwan (China); Department of Research, PingTung Christian Hospital and Meiho University, Pingtung, Taiwan (China); Kao, Chia-Hung, E-mail: d10040@mail.cmuh.org.tw [Institute of Clinical Medicine Science and School of Medicine, College of Medicine, China Medical University, Taichung, Taiwan (China); Department of Nuclear Medicine and PET Center, China Medical University Hospital, Taichung, Taiwan (China)

    2012-11-15

    Lymph node staging in non-small cell lung cancer (NSCLC) is challenging and important for deciding treatment policy. The role of PET/CT scans in lymph node staging of NSCLC remains controversial when comparing TB and non-TB endemic regions. This study systematically reviews the literature regarding the diagnostic performance of PET/CT in lymph node staging of patients with NSCLC, and determines its pooled sensitivity and specificity. Methods: The databases of PubMed, Medline, and Cochrane library were searched for relevant studies. Two reviewers independently assessed the methodological quality of each study. A meta-analysis of the reported sensitivity and specificity of each study was performed. Results: Seven of 86 studies were included. These studies had moderate to good methodological quality. Pooled sensitivity, specificity, positive likelihood ratio, and negative likelihood ratio for patient-based analyses (five studies) were 66%, 92.7%, 5.86%, and 0.41%, respectively, and those for lesion-based analyses (six studies) were 59.4%, 96.5%, 9.37%, and 0.31%, respectively. Subanalysis of endemic regions of tuberculosis (TB) showed that these regions had lower sensitivity and similar specificity to non-TB endemic regions. Conclusion: PET/CT showed high specificity in the lymph node staging of NSCLC and lower sensitivity in TB endemic regions.

  7. Sphenoid wing meningioma behavior on 11C-PiB and 18F-FDG PET.

    Science.gov (United States)

    Chaves, Hernan; Bergamo, Yanina; Paz, Santiago; Sanchez, Flavio; Vazquez, Silvia

    2015-01-01

    Two patients with mild cognitive impairment underwent C-PiB and F-FDG brain PET. Both patients had previously gone through a contrast-enhanced MRI scan that revealed extra-axial tumors next to the sphenoid wing, suggestive of meningiomas. C-PiB PET images showed a highly increased uptake by the extra-axial masses. These 2 cases represent 1.2% of our C-PiB population (n = 163). No meningioma was found with negative C-PiB uptake. The F-FDG concentration was not increased within the lesions. C-PiB could be used as a meningioma marker.

  8. Pilot Study for the Prediction of Response to Radiotherapy Using [18F]Fluorothymidine PET in Nasopharyngeal Cancer: Comparison with [18F]FDG PET

    International Nuclear Information System (INIS)

    Baek, So Ra; Chae, Sun Young; Kim, Hye Ok; Lee, Sang Wook; Oh, Seung Jun; Im, Ki Chun; Moon, Dae Hyuk; Kim, Jae Seung; Ryu, Jin Sook

    2009-01-01

    This study was performed to know whether [ 18 F]Fluorothymidine (FLT) positron emission tomography (PET) can be used to monitor early response to radiotherapy in comparison with [ 18 F]Fluorodeoxyglucose (FDG) PET, and to establish the optimal imaging time for prediction of therapy response. Two patients with nasopharyngeal cancer underwent serial FLT PET and FDG PET before and during radiotherapy. Three on-treatment FLT and FDG PET scans were performed on 1 week, 2 weeks and 3 weeks (at each time of 10 Gy, 20 Gy and 30 Gy delivered). The peak standardized uptake values (SUV peak ) of primary tumors were measured on FLT and FDG PET. Then, percent changes of SUV peak after therapy were calculated. In two patients, baseline values of SUV peak on FDT PET were higher than those on FLT PET (FLT vs FDG; 3.7 vs 5.0, and 5.7 vs 15.0). In patient 1, FLT SUV peak showed 78%, 78% and 84% of decrease on 1 week, 2 and 3 weeks after treatment, whereas FDG SUV peak showed 18%, 52% and 66% of decrease, respectively. In patient 2, FLT SUV peak showed 75%, 75% and 68% of decrease, whereas FDG SUV peak showed 51%, 49% and 58% of decrease, respectively. Both patients reached to complete remission after radiotherapy. After radiotherapy, the decrease of FLT tumor uptake preceded the decrease of FDG tumor uptake in patients with nasopharyngeal cancer, and 1 week after therapy may be appropriate time for the assessment of early response. FLT PET might be more useful than FDG PET for monitoring early response to radiotherapy

  9. Simultaneous scanning of two mice in a small-animal PET scanner: a simulation-based assessment of the signal degradation.

    Science.gov (United States)

    Reilhac, Anthonin; Boisson, Frédéric; Wimberley, Catriona; Parmar, Arvind; Zahra, David; Hamze, Hasar; Davis, Emma; Arthur, Andrew; Bouillot, Caroline; Charil, Arnaud; Grégoire, Marie-Claude

    2016-02-07

    In PET imaging, research groups have recently proposed different experimental set ups allowing multiple animals to be simultaneously imaged in a scanner in order to reduce the costs and increase the throughput. In those studies, the technical feasibility was demonstrated and the signal degradation caused by additional mice in the FOV characterized, however, the impact of the signal degradation on the outcome of a PET study has not yet been studied. Here we thoroughly investigated, using Monte Carlo simulated [18F]FDG and [11C]Raclopride PET studies, different experimental designs for whole-body and brain acquisitions of two mice and assessed the actual impact on the detection of biological variations as compared to a single-mouse setting. First, we extended the validation of the PET-SORTEO Monte Carlo simulation platform for the simultaneous simulation of two animals. Then, we designed [18F]FDG and [11C]Raclopride input mouse models for the simulation of realistic whole-body and brain PET studies. Simulated studies allowed us to accurately estimate the differences in detection between single- and dual-mode acquisition settings that are purely the result of having two animals in the FOV. Validation results showed that PET-SORTEO accurately reproduced the spatial resolution and noise degradations that were observed with actual dual phantom experiments. The simulated [18F]FDG whole-body study showed that the resolution loss due to the off-center positioning of the mice was the biggest contributing factor in signal degradation at the pixel level and a minimal inter-animal distance as well as the use of reconstruction methods with resolution modeling should be preferred. Dual mode acquisition did not have a major impact on ROI-based analysis except in situations where uptake values in organs from the same subject were compared. The simulated [11C]Raclopride study however showed that dual-mice imaging strongly reduced the sensitivity to variations when mice were

  10. 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.

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

    Science.gov (United States)

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

    2015-08-01

    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. © 2015 The Royal Australian and New Zealand College of Radiologists.

  12. 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.)

  13. Equal sensitivity of early and late scans after injection of FDG for the detection of Alzheimer pattern. An analysis of 3D PET data from J-ADNI, a multi-center study

    International Nuclear Information System (INIS)

    Takahashi, Ryuichi; Ishii, Kazunari; Senda, Michio

    2013-01-01

    The objective of this study was to determine the optimal accumulation time for three-dimensional positron emission tomography (3D-PET) with 18 F-2-fluoro-2-deoxy-D-glucose ( 18 F-FDG) to detect the brain uptake pattern typical of Alzheimer's disease (AD). Patients with mild AD or amnestic mild cognitive impairment (MCI) and normal control subjects were recruited in the Japanese Alzheimer's disease neuroimaging initiative and examined with a PET scan during the 30-60 min after FDG injection. Three independent blinded experts interpreted the 30- to 60-min sum images, and images of patients with AD and MCI presenting AD patterns and normal subjects presenting normal patterns were used in the analysis. Early-scan (ES) and late-scan (LS) images were obtained from the data acquired at 30-35 min and 55-60 min after the injection, respectively. Separate target regions of interest (ROI) for ES and LS were defined as areas of significant reductions in the posterior cingulate and parietotemporal lobe in both hemispheres from the results of an initial cohort with 21 patients (AD 16, MCI 5) and 19 controls. A subsequent sample of 36 (AD 9, MCI 27) patients and 38 controls were used to compare the diagnostic capability of ES and LS using Z scores within the target ROI in individual statistical parametric mapping analysis. Compared to LS, ES showed lower activity in the frontal lobes and higher activity in the venous sinus than LS; however, the diagnostic capability of ES and LS did not significantly differ (sensitivity 0.97 and 0.97, specificity 0.82 and 0.84, area under the receiver-operating characteristic curve 0.96 and 0.97, respectively). For a qualitative diagnosis of the AD pattern in 3D FDG-PET, results of ES were equivalent to those of LS. ES may be an option to shorten the entire PET procedure time, particularly in diagnosing early stages of AD. (author)

  14. [68Ga]DOTATATE PET/MRI and [18F]FDG PET/CT are complementary and superior to diffusion-weighted MR imaging for radioactive-iodine-refractory differentiated thyroid cancer

    International Nuclear Information System (INIS)

    Vrachimis, Alexis; Stegger, Lars; Wenning, Christian; Noto, Benjamin; Konnert, Julia Renate; Riemann, Burkhard; Weckesser, Matthias; Burg, Matthias Christian; Allkemper, Thomas; Heindel, Walter; Schaefers, Michael

    2016-01-01

    The purpose of this study was to determine whether [ 68 Ga]DOTATATE PET/MRI with diffusion-weighted imaging (DWI) can replace or complement [ 18 F]FDG PET/CT in patients with radioactive-iodine (RAI)-refractory differentiated thyroid cancer (DTC). The study population comprised 12 patients with elevated thyroglobulin and a negative RAI scan after thyroidectomy and RAI remnant ablation who underwent both [ 18 F]FDG PET/CT and [ 68 Ga]DOTATATE PET/MRI within 8 weeks of each other. The presence of recurrent cancer was evaluated on a per-patient, per-organ and per-lesion basis. Histology, and prior and follow-up examinations served as the standard of reference. Recurrent or metastatic tumour was confirmed in 11 of the 12 patients. [ 68 Ga]DOTATATE PET(/MRI) correctly identified the tumour burden in all 11 patients, whereas in one patient local relapse was missed by [ 18 F]FDG PET/CT. In the lesion-based analysis, overall lesion detection rates were 79/85 (93 %), 69/85 (81 %) and 27/82 (33 %) for [ 18 F]FDG PET/CT, [ 68 Ga]DOTATATE PET/MRI and DWI, respectively. [ 18 F]FDG PET(/CT) was superior to [ 68 Ga]DOTATATE PET(/MRI) in the overall evaluation and in the detection of pulmonary metastases. In the detection of extrapulmonary metastases, [ 68 Ga]DOTATATE PET(/MRI) showed a higher sensitivity than [ 18 F]FDG PET(/CT), at the cost of lower specificity. DWI achieved only poor sensitivity and was significantly inferior to [ 18 F]FDG PET in the lesion-based evaluation in the detection of both extrapulmonary and pulmonary metastases. [ 18 F]FDG PET/CT was more sensitive than [ 68 Ga]DOTATATE PET/MRI in the evaluation of RAI-refractory DTC, mostly because of its excellent ability to detect lung metastases. In the evaluation of extrapulmonary lesions, [ 68 Ga]DOTATATE PET(/MRI) was more sensitive and [ 18 F]FDG PET(/CT) more specific. Furthermore, DWI did not provide additional information and cannot replace [ 18 F]FDG PET for postoperative monitoring of patients with

  15. Evaluation of {sup 68}Ga-DOTATOC PET/MRI for whole-body staging of neuroendocrine tumours in comparison with {sup 68}Ga-DOTATOC PET/CT

    Energy Technology Data Exchange (ETDEWEB)

    Sawicki, Lino M. [University Dusseldorf, Department of Diagnostic and Interventional Radiology, Medical Faculty, Dusseldorf (Germany); University Duisburg-Essen, Department of Nuclear Medicine, Medical Faculty, Essen (Germany); Deuschl, Cornelius; Beiderwellen, Karsten; Forsting, Michael; Umutlu, Lale [University Duisburg-Essen, Department of Diagnostic and Interventional Radiology and Neuroradiology, Medical Faculty, Essen (Germany); Ruhlmann, Verena; Poeppel, Thorsten D.; Bockisch, Andreas; Herrmann, Ken [University Duisburg-Essen, Department of Nuclear Medicine, Medical Faculty, Essen (Germany); Heusch, Philipp; Antoch, Gerald [University Dusseldorf, Department of Diagnostic and Interventional Radiology, Medical Faculty, Dusseldorf (Germany); Lahner, Harald; Fuehrer, Dagmar [University Duisburg-Essen, Department of Endocrinology and Metabolism, Endocrine Tumour Center at WTZ and ENETS Center of Excellence, Medical Faculty, Essen (Germany); Endocrine Tumour Center at WTZ and ENETS Center of Excellence, Essen (Germany)

    2017-10-15

    To compare the diagnostic performance of {sup 68}Ga-DOTATOC PET/MRI and {sup 68}Ga-DOTATOC PET/CT in the whole-body staging of patients with neuroendocrine tumours (NET). Thirty patients with histopathologically confirmed NET underwent PET/CT and PET/MRI in a single-injection protocol. PET/CT and PET/MRI scans were prospectively evaluated with regard to lesion count, localization, nature (NET/non-NET), and conspicuity (four-point scale). Histopathology and follow-up imaging served as the reference standards. The proportions of NET and non-NET lesions rated correctly were compared using McNemar's chi-squared test. The Wilcoxon test was used to assess differences in SUVmax and lesion conspicuity. The correlation between the SUVmax for the same lesions from each modality was analysed using Pearson's correlation coefficient (r). According to the reference standard, there were 197 lesions (142 NET, 55 non-NET). Lesion-based analysis showed a higher proportion of correctly rated NET lesions on PET/MRI than on PET/CT (90.8% vs. 86.7%, p = 0.031), whereas on PET/CT there was a higher proportion of correctly rated non-NET lesions (94.5% vs. 83.6%, p = 0.031). SUVmax was strongly correlated (r = 0.86; p < 0.001) and did not differ significantly (p = 0.35) between the modalities. Overall conspicuity and NET lesion conspicuity were higher on PET/MRI (both p < 0.01). Ga-DOTATOC PET/MRI yielded a higher proportion of correctly rated NET lesions and should be regarded as a valuable alternative to {sup 68}Ga-DOTATOC PET/CT in whole-body staging of NET patients. (orig.)

  16. Speeding up PET/MR for cancer staging of children and young adults

    Energy Technology Data Exchange (ETDEWEB)

    Aghighi, Maryam; Pisani, Laura Jean; Sun, Ziyan; Klenk, Christopher; Madnawat, Himani; Owen, Daniel; Quon, Andrew; Moseley, Michael; Daldrup-Link, Heike E. [Stanford University, Department of Radiology, Molecular Imaging Program at Stanford, Stanford, CA (United States); Fineman, Sandra Luna [Stanford University, Department of Pediatrics, Lucile Packard Children' s Hospital, Stanford, CA (United States); Advani, Ranjana [Stanford University, Department of Medicine, Stanford Hospital, Stanford, CA (United States); Von Eyben, Rie [Stanford University, Department of Radiation and Oncology, Stanford, CA (United States)

    2016-12-15

    Combining {sup 18}F-FDG PET with whole-body MR for paediatric cancer staging is practically feasible if imaging protocols can be streamlined. We compared {sup 18}F-FDG PET/STIR with accelerated {sup 18}F-FDG PET/FSPGR for whole-body tumour imaging in children and young adults. Thirty-three children and young adults (17.5 ± 5.5 years, range 10-30) with malignant lymphoma or sarcoma underwent a {sup 18}F-FDG PET staging examination, followed by ferumoxytol-enhanced STIR and FSPGR whole-body MR. {sup 18}F-FDG PET scans were fused with MR data and the number and location of tumours on each integrated examination were determined. Histopathology and follow-up imaging served as standard of reference. The agreement of each MR sequence with the reference and whole-body imaging times were compared using Cohen's kappa coefficient and Student's t-test, respectively. Comparing {sup 18}F-FDG PET/FSPGR to {sup 18}F-FDG PET/STIR, sensitivities were 99.3 % for both, specificities were statistically equivalent, 99.8 versus 99.9 %, and the agreement with the reference based on Cohen's kappa coefficient was also statistically equivalent, 0.989 versus 0.992. However, the total scan-time for accelerated FSPGR of 19.8 ± 5.3 minutes was significantly shorter compared to 29.0 ± 7.6 minutes for STIR (p = 0.001). F-FDG PET/FSPGR demonstrated equivalent sensitivities and specificities for cancer staging compared to {sup 18}F-FDG PET/STIR, but could be acquired with shorter acquisition time. (orig.)

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

    Science.gov (United States)

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

    2018-04-13

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

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

    Science.gov (United States)

    Frederiksen, K S; Hasselbalch, S G; Hejl, A-M; Law, I; Højgaard, L; Waldemar, G

    2012-01-01

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

  19. Respiratory gating in cardiac PET

    DEFF Research Database (Denmark)

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

    2017-01-01

    BACKGROUND: Respiratory motion due to breathing during cardiac positron emission tomography (PET) results in spatial blurring and erroneous tracer quantification. Respiratory gating might represent a solution by dividing the PET coincidence dataset into smaller respiratory phase subsets. The aim...... stress (82)RB-PET. Respiratory rates and depths were measured by a respiratory gating system in addition to registering actual respiratory rates. Patients undergoing adenosine stress showed a decrease in measured respiratory rate from initial to later scan phase measurements [12.4 (±5.7) vs 5.6 (±4.......7) min(-1), P PET...

  20. PET and PET/CT - clinical value in lung cancer; PET und PET/CT - Stellenwert beim Lungenkarzinom

    Energy Technology Data Exchange (ETDEWEB)

    Steinert, H.C. [Klinik und Poliklinik fuer Nukearmedizin, Dept. Medizinische Radiologie, Univ. Zuerich (Switzerland)

    2004-12-01

    Preoperative staging of lung cancer is essential for prognosis and management. The aim of this overview is to present the synergistic effects of FDG-PET and CT. For planning surgery and planning radiation treatment the precise definition of the tumor extend is essential. Integrated PET/CT scanning enables the exact localization of tumor infiltration into surrounding tissue and of small metastases. In this overview the applications of PET and PET/CT in non-small-cell lung cancer, small-cell lung cancer and malignant pleural mesothelioma are presented. (orig.)

  1. Natural history of atherosclerotic disease progression as assessed by (18)F-FDG PET/CT.

    Science.gov (United States)

    Hetterich, Holger; Rominger, Axel; Walter, Lisa; Habs, Maximilian; Volpers, Sarah; Hacker, Marcus; Reiser, Maximilian F; Bartenstein, Peter; Saam, Tobias

    2016-01-01

    The aim of this study was to assess the impact of cardiovascular risk factors and plaque inflammation on the progression of atherosclerosis as assessed by positron emission tomography/computed tomography (PET/CT) imaging with (18)F-radiolabled fluorodeoxyglucose ((18)F-FDG). This study was designed as a retrospective cohort study. Patients who received a (18)F-FDG PET/CT scan and follow-up scan 9-24 months later without systemic inflammation or steroid medication were eligible for the study. (18)F-FDG PET/CT included a full diagnostic contrast enhanced CT scan. Cardiovascular risk factors and medication were documented. Calcified plaque volume, lumen area and (18)F-FDG uptake, quantified by the target-to-background ratio (TBR), were measured in the carotid arteries, aorta and iliac arteries. Influence of cardiovascular risk factors and vessel wall inflammation on atherosclerotic disease progression was analyzed. Ninety-four patients underwent baseline and follow-up whole body (18)F-FDG PET/CT (mean follow-up time 14.5 ± 3.5 months). Annualized calcified plaque volume increased by 15.4 % (p history of atherosclerotic disease burden in multiple vascular beds and emphasize the value of morphological and physiologic information provided by (18)F-FDG PET/CT imaging.

  2. Effect of different pneumoperitoneum pressure on stress state in patients underwent gynecological laparoscopy

    Directory of Open Access Journals (Sweden)

    Ai-Yun Shen

    2016-10-01

    Full Text Available Objective: To observe the effect of different CO2 pneumoperitoneum pressure on the stress state in patients underwent gynecological laparoscopy. Methods: A total of 90 patients who were admitted in our hospital from February, 2015 to October, 2015 for gynecological laparoscopy were included in the study and divided into groups A, B, and C according to different CO2 pneumoperitoneum pressure. The changes of HR, BP, and PetCO2 during the operation process in the three groups were recorded. The changes of stress indicators before operation (T0, 30 min during operation (T1, and 12 h after operation (T2 were compared. Results: The difference of HR, BP, and PetCO2 levels before operation among the three groups was not statistically significant (P>0.05. HR, BP, and PetCO2 levels 30 min after pneumoperitoneum were significantly elevated when compared with before operation (P0.05. PetCO2 level 30 min after pneumoperitoneum in group B was significantly higher than that in group A (P0.05. Conclusions: Low pneumoperitoneum pressure has a small effect on the stress state in patients underwent gynecological laparoscopy, will not affect the surgical operation, and can obtain a preferable muscular relaxation and vision field; therefore, it can be selected in preference.

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

    International Nuclear Information System (INIS)

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

    2015-01-01

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

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

    Science.gov (United States)

    ... News Physician Resources Professions Site Index A-Z Positron Emission Tomography - Computed Tomography (PET/CT) Positron emission tomography (PET) ... Emission Tomography – Computed Tomography (PET/CT)? What is Positron Emission Tomography – Computed Tomography (PET/CT) Scanning? Positron emission tomography, ...

  5. Radiotherapy volume delineation using 18F-FDG-PET/CT modifies gross node volume in patients with oesophageal cancer.

    Science.gov (United States)

    Jimenez-Jimenez, E; Mateos, P; Aymar, N; Roncero, R; Ortiz, I; Gimenez, M; Pardo, J; Salinas, J; Sabater, S

    2018-05-02

    Evidence supporting the use of 18F-FDG-PET/CT in the segmentation process of oesophageal cancer for radiotherapy planning is limited. Our aim was to compare the volumes and tumour lengths defined by fused PET/CT vs. CT simulation. Twenty-nine patients were analyzed. All patients underwent a single PET/CT simulation scan. Two separate GTVs were defined: one based on CT data alone and another based on fused PET/CT data. Volume sizes for both data sets were compared and the spatial overlap was assessed by the Dice similarity coefficient (DSC). The gross tumour volume (GTVtumour) and maximum tumour diameter were greater by PET/CT, and length of primary tumour was greater by CT, but differences were not statistically significant. However, the gross node volume (GTVnode) was significantly greater by PET/CT. The DSC analysis showed excellent agreement for GTVtumour, 0.72, but was very low for GTVnode, 0.25. Our study shows that the volume definition by PET/CT and CT data differs. CT simulation, without taking into account PET/CT information, might leave cancer-involved nodes out of the radiotherapy-delineated volumes.

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2017-08-15

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

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

    International Nuclear Information System (INIS)

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

    2017-01-01

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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2017-03-15

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

  9. The utility of PET/CT in staging and assessment of treatment response of naso pharyngeal cancer

    International Nuclear Information System (INIS)

    Law, Alastair; Peters, L.J.; Dutu, Gaelle; Rischin, Danny; Lau, Eddie; Drummond, Elizabeth; Corry, June

    2011-01-01

    Full text: The aim of this study was to evaluate the impact of positron emission tomography/computerised tomography (PET/CT) as an adjunct to conventional imaging (CI) in the management of nasopharyngeal cancer (NPC) both for initial staging and assessment of post-treatment response. Methods: All NPC cases referred to the Peter MacCallum Centre for Metabolic Imaging between January 2002 and December 2007 were identified, In patients undergoing initial staging, any differences between the pre PET/CT management plan based on CI and that following performance of the PET/CT scan were noted. Clinical impact was scored using the Centre's published criteria: 'high' if PET /CT changed the primary treatment modality or intent, 'medium' if treatment modality was unchanged but the radiotherapy technique or dose was altered, and 'low' if there was no change in treatment modality or intent. Patients undergoing PET/CT following definitive treatment were scored according to whether or not they achieved a complete metabolic response. Results: Forty-eight patients underwent a staging PET/CT. The clinical impact was high in 8%, medium in 25% and low in 66% of patients. Twenty-one patients were scanned for post-treatment response. PET/CT was less frequently equivocal than MRI (3 vs 8/21). A complete metabolic response on PET /CT was associated with a 93% negative predictive value for subsequent recurrence. Conclusion: PET /CT is a valuable staging tool for the detection of occult metastatic disease and defining the extent of neck nodal disease, Pos treatment, a complete metabolic response on PET /CT has a very high negative predictive value with fewer equivocal results than MRI.

  10. PET in lung cancer staging

    Energy Technology Data Exchange (ETDEWEB)

    Coleman, R. E. [Duke University Medical Center, Dept. of Radiology, Durham, NC (United States)

    2001-09-01

    The primary clinical application of FDG-PET is in the evaluation of patients with lung cancer and includes diagnosis, staging and restaging of non-small cell lung cancer. PET has a very high accuracy (sensitivity=97%, specificity=78%) for characterizing nodules that are indeterminate by chest radiograph and computed tomography. The major utility of PET in the evaluation of patients with lung cancer is the staging of the entire body. PET is more accurate than the conventional imaging modalities of CT and bone scans in the detection of metastatic disease. PET is accurate in the staging of the mediastinum, adrenal glands, and the skeletal system. PET is not as accurate in the detection of brain metastases because of their small size and the normal cortical accumulation.

  11. Cerebral histamine H1 receptor binding potential measured with PET under a test dose of olopatadine, an antihistamine, is reduced after repeated administration of olopatadine.

    Science.gov (United States)

    Senda, Michio; Kubo, Nobuo; Adachi, Kazuhiko; Ikari, Yasuhiko; Matsumoto, Keiichi; Shimizu, Keiji; Tominaga, Hideyuki

    2009-06-01

    Some antihistamine drugs that are used for rhinitis and pollinosis have a sedative effect as they enter the brain and block the H(1) receptor, potentially causing serious accidents. Receptor occupancy has been measured with PET under single-dose administration in humans to classify antihistamines as more sedating or as less sedating (or nonsedating). In this study, the effect of repeated administration of olopatadine, an antihistamine, on the cerebral H(1) receptor was measured with PET. A total of 17 young men with rhinitis underwent dynamic brain PET with (11)C-doxepin at baseline, under an initial single dose of 5 mg of olopatadine (acute scan), and under another 5-mg dose after repeated administration of olopatadine at 10 mg/d for 4 wk (chronic scan). The H(1) receptor binding potential was estimated using Logan graphical analysis with cerebellum as reference region input. The acute scan showed a slight decrease in H(1) receptor binding potential across the cerebral cortex (by 15% in the frontal cortex), but the chronic scan showed a marked decrease (by 45% from the acute scan in the frontal cortex). Behavioral data before and after the PET scans did not reveal any sedative effect. The results may be interpreted as either intracerebral accumulation of olopatadine or H(1) receptor downregulation due to repeated administration. The study shows feasibility and potential value for PET in evaluating the pharmacologic effect of a drug not only after a single dose but also after repeated administration.

  12. VII. Boettstein Colloquium: PET-Radiopharmaceuticals at PSI: achievement and future prospects

    Energy Technology Data Exchange (ETDEWEB)

    Schubiger, P.A.; Beer, H.F.; Blaeuenstein, P.; Leenders, K.E.

    1993-12-31

    The three sessions of the 1993 Boettstein colloquium dealt with the following topics: - PET-radiopharmaceuticals, - PET-scanning: significance of tracer uptake, - clinical options using PET. 22 papers were presented. figs., refs.

  13. Sequential Change of Hypometabolic Metastasis from Non-small-cell Lung Cancer on Brain FDG-PET/CT

    Energy Technology Data Exchange (ETDEWEB)

    Park, Soon Ah; Yang, Sei Hoon; Yang, Chung Yong; Choi, Keum Ha [Wonkwang Medical Science, Wonkwang University College of Medicine, Iksan (Korea, Republic of)

    2009-10-15

    A 60-year-old woman, who had non-small-cell lung cancer (NSCLC) in left lower lobe underwent brain F-18 fluorodeoxyglucose positron emission tomography/computed tomography (FDG-PET/CT) for evaluation of cerebral metastasis. On follow-up FDG-PET/CT, only hypometaolic lesion was detected and progressed in right frontal lobe at 6 months and 10 months, later. Hypermetabolic metastasis was not detected even at last scan time of FDG-PET/CT. Brain MRI showed brain metastasis in right frontal lobe. As might be expected, the physician should take cerebral metastasis into consideration even though there is only hypometabolic change on subsequent FDG-PET/CT in patients with NSCLC.

  14. Comparison of PET/CT and whole-mount histopathology sections of the human prostate: a new strategy for voxel-wise evaluation.

    Science.gov (United States)

    Schiller, F; Fechter, T; Zamboglou, C; Chirindel, A; Salman, N; Jilg, C A; Drendel, V; Werner, M; Meyer, P T; Grosu, A-L; Mix, M

    2017-08-17

    Implementation of PET/CT in diagnosis of primary prostate cancer (PCa) requires a profound knowledge about the tracer, preferably from a quantitative evaluation. Direct visual comparison of PET/CT slices to whole prostate sections is hampered by considerable uncertainties from imperfect coregistration and fundamentally different image modalities. In the current study, we present a novel method for advanced voxel-wise comparison of histopathology from excised prostates to pre-surgical PET. Resected prostates from eight patients who underwent PSMA-PET/CT were scanned (ex vivo CT) and thoroughly pathologically prepared. In vivo and ex vivo CT including histopathology were coregistered with three different methods (manual, semi-/automatic). Spatial overlap after CT-based registration was evaluated with dice similarity (DSC). Furthermore, we constructed 3D cancer distribution models from histopathologic information in various slices. Subsequent smoothing reflected the intrinsically limited spatial resolution of PSMA-PET. The resulting histoPET models were used for quantitative analysis of spatial histopathology-PET pattern agreement focusing on p values and coefficients of determination (R 2 ). We examined additional rigid mutual information (MI) coregistration directly based on PSMA-PET and histoPET. Mean DSC for the three different methods (ManReg, ScalFactReg, and DefReg) were 0.79 ± 0.06, 0.82 ± 0.04, and 0.90 ± 0.02, respectively, while quantification of PET-histopathology pattern agreement after CT-based registration revealed R 2 45.7, 43.2, and 41.3% on average with p histopathological preparation allowed sophisticated quantitative analyses showing highly significant correlations between histopathology and (PSMA-)PET. We recommend manual CT-based coregistration followed by a PET-based MI algorithm to overcome limitations of purely CT-based coregistrations for meaningful voxel-wise comparisons between PET and histopathology.

  15. Pet Health

    Science.gov (United States)

    Pets can add fun, companionship and a feeling of safety to your life. Before getting a pet, think carefully about which animal is best for ... is each family member looking for in a pet? Who will take care of it? Does anyone ...

  16. Radiology for PET/CT reporting

    Energy Technology Data Exchange (ETDEWEB)

    Nanni, Cristina; Fanti, Stefano; Zanoni, Lucia [Univ. Hospital Sant Orsola-Malpighi, Bologna (Italy). Dept. of Nuclear Medicine

    2014-07-01

    Offers rapid access to slice by slice CT descriptions of anatomical structures from PET/CT studies. Presents images and descriptions of CT findings that may be detected while reviewing PET/CT scans. Includes principal MRI findings in diseases susceptible to PET/CT evaluation. Reading PET/CT scans is sometimes challenging. Not infrequently, abnormal findings on CT images are functionally silent and therefore difficult for nuclear medicine practitioners to interpret. Furthermore, in general only a low-dose CT scan is produced as part of the combined PET/CT study, and the resulting CT images may prove suboptimal for image interpretation. This atlas is designed to enable nuclear medicine practitioners who routinely read PET/CT scans to recognize the most common CT abnormalities. Slice-by-slice descriptions are provided of anatomical structures as visualized on CT scans obtained in PET/CT studies. The CT findings that may be detected while reviewing PET/CT scans of various body regions and conditions are then illustrated and fully described. The concluding section of the book is devoted to the principal MRI findings in diseases which cannot be evaluated using PETs/CTs.

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2015-08-15

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

  18. 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.)

  19. Integrating respiratory-gated PET-based target volume delineation in liver SBRT planning, a pilot study

    International Nuclear Information System (INIS)

    Riou, Olivier; Thariat, Juliette; Serrano, Benjamin; Azria, David; Paulmier, Benoit; Villeneuve, Remy; Fenoglietto, Pascal; Artenie, Antonella; Ortholan, Cécile; Faraggi, Marc

    2014-01-01

    To assess the feasibility and benefit of integrating four-dimensional (4D) Positron Emission Tomography (PET) – computed tomography (CT) for liver stereotactic body radiation therapy (SBRT) planning. 8 patients with 14 metastases were accrued in the study. They all underwent a non-gated PET and a 4D PET centered on the liver. The same CT scan was used for attenuation correction, registration, and considered the planning CT for SBRT planning. Six PET phases were reconstructed for each 4D PET. By applying an individualized threshold to the 4D PET, a Biological Internal Target Volume (BITV) was generated for each lesion. A gated Planning Target Volume (PTVg) was created by adding 3 mm to account for set-up margins. This volume was compared to a manual Planning Target Volume (PTV) delineated with the help of a semi-automatic Biological Target Volume (BTV) obtained from the non-gated exam. A 5 mm radial and a 10 mm craniocaudal margins were applied to account for tumor motion and set-up margins to create the PTV. One undiagnosed liver metastasis was discovered thanks to the 4D PET. The semi-automatic BTV were significantly smaller than the BITV (p = 0.0031). However, after applying adapted margins, 4D PET allowed a statistically significant decrease in the PTVg as compared to the PTV (p = 0.0052). In comparison to non-gated PET, 4D PET may better define the respiratory movements of liver targets and improve SBRT planning for liver metastases. Furthermore, non respiratory-gated PET exams can both misdiagnose liver metastases and underestimate the real internal target volumes

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

    International Nuclear Information System (INIS)

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

    2009-01-01

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

  1. 13N-ammonia myocardial perfusion imaging with a PET/CT scanner: impact on clinical decision making and cost-effectiveness

    International Nuclear Information System (INIS)

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

    2008-01-01

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

  2. 18F-FDG accumulation in the oral cavity is associated with periodontal disease and apical periodontitis. An initial demonstration on PET/CT

    International Nuclear Information System (INIS)

    Shimamoto, Hiroaki; Kakimoto, Naoya; Murakami, Shumei; Furukawa, Souhei; Tatsumi, Mitsuaki; Shimosegawa, Eku; Hatazawa, Jun; Hamada, Seiki

    2008-01-01

    The objective of this study was to prospectively investigate the relationship between high accumulation of 2-deoxy-2-[ 18 F] fluoro-D-glucose (FDG) in the oral cavity and dental infections on positron emission tomography/computed tomography (PET/CT). FDG-PET/CT scans of 103 patients who underwent a health screening were evaluated. The dental examination was performed prior to each PET/CT scan, and dental infections were assessed. Dental infections were classified into six blocks. The severity of dental caries was classified into five grades, and periodontal disease and apical periodontitis were classified into three grades. Two radiologists classified the PET images in the same manner as the dental examination. They evaluated the intensity of FDG uptake by a four-point visual PET image score for each block. The comparison of the dental examination, as a gold standard, and the visual PET image score was performed on a patient or block basis. On a patient-based analysis, 21 of 103 patients (20.4%) showed PET positive findings in the oral cavity; 18 of the 21 patients (85.7%) had dental infections. On a block-based analysis, 25 of 605 blocks (4.1%) showed PET positive findings in the oral cavity; 22 of the 25 blocks (88.0%) had dental infections. On a detailed block-based analysis, a significant difference was observed between the presence of periodontal disease, or apical periodontitis and the positivity of the visual PET image findings (P<0.01). Their severity correlated with the visual PET image score (P<0.05). Periodontal disease or apical periodontitis, but not dental caries, caused FDG accumulation in the oral cavity. This finding should be taken into account when a head and neck FDG-PET study is interpreted. (author)

  3. Impact of staging with 18F-FDG-PET on outcome of patients with stage III non-small cell lung cancer: PET identifies potential survivors

    International Nuclear Information System (INIS)

    Eschmann, S.M.; Reimold, M.; Bares, R.; Friedel, G.; Paulsen, F.; Hehr, T.; Scheiderbauer, J.; Budach, W.; Kotzerke, J.

    2007-01-01

    The aim of this study was to analyse the impact of FDG-PET staging on treatment results of neo-adjuvant radiochemotherapy in patients with advanced non-small cell lung cancer (NSCLC). We compared prospectively the outcome of two patient groups with stage III NSCLC undergoing the same neo-adjuvant radio-chemotherapy (NARCT). In one group, FDG-PET was part of the pretherapeutic staging, whereas in the other group, no PET scans were performed. One hundred and eighty-eight patients with advanced stage III NSCLC were selected for a phase II trial of NARCT. The first 115 patients underwent conventional workup (CWU) and FDG-PET before inclusion (group I); the remaining 73 patients underwent CWU only (group II). All patients were followed up according to a standardised protocol for at least 11 months (up to 64 months). Overall survival and disease-free survival were used as parameters of therapeutic success and analysed statistically. After staging, 157/188 patients were included in the clinical trial. Thirty-one were excluded owing to the results of FDG-PET, in most cases because of the detection of previously unknown distant metastases. Overall survival and metastasis-free survival were significantly longer in patients of group I stratified by FDG-PET than in group II (p=0.006 and 0.02 respectively). Another significant factor for survival was complete tumour resection (p=0.02). Gender, histological tumour type, tumour grade and UICC stage had no significant influence. Pretherapeutic staging by FDG-PET significantly influences the results of NARCT and subsequent surgery by identifying patients not eligible for curative treatment. (orig.)

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2014-12-15

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

  5. Deep Inspiration Breath Hold [(18)F]FDG PET-CT on 4-rings scanners in evaluating lung lesions: evidences from a phantom and a clinical study.

    Science.gov (United States)

    Caobelli, Federico; Puta, Erinda; Kaiser, Stefano Ren; Massetti, Valentina; Andreoli, Michela; Mostarda, Angelica; Soffientini, Alberto; Pizzocaro, Claudio; Guerra, Ugo Paolo

    2014-01-01

    To investigate the clinical feasibility of a Deep Inspiration Breath Hold (DIBH) (18)F-FDG PET-CT acquisition in apnea and compare the results obtained between these acts of acquisition in apnea and in Free Breathing in the evaluation of lung lesions. A pre-clinical phantom study was performed to evaluate the shortest simulated DIBH time according to the minimum detectable lesion that can be detected by our ultrasound scanner. This study was conducted by changing acquisition time and sphere-to-background activity ratio values and by using radioactivity densities similar to those generally found in clinical examinations. In the clinical study, 25 patients with pulmonary lesions underwent a standard whole body (18)F-FDG PET-CT scan in free breathing followed by a 20s single thorax acquisition PET/CT in DIBH acquisition. The phantom study indicated that a 20-s acquisition time provides an accurate evaluation of smallest sphere shaped lesions. In the clinical study, PET-CT scans obtained in DIBH studies showed a significant reduction of misalignment between the PET and CT scan images and an increase of SUVmax compared to free breathing acquisitions. A correlation between the %BH-index and lesion displacement between PET and CT images in FB acquisition was demonstrated, significantly higher for lesions with a displacement>8mm. The single 20s acquisition of DIBH PET-CT is a feasible technique for lung lesion detection in the clinical setting. It only requires a minor increase in examination time without special patient training. 20s DIBH scan provided a more precise measurement of SUVmax, especially for lesions in the lower lung lobes which usually show greater displacement between PET and CT scan images in FB acquisition. Copyright © 2013 Elsevier España, S.L. and SEMNIM. All rights reserved.

  6. The value of FDG-PET/CT in the post-treatment evaluation of endometrial carcinoma: a comparison of PET/CT findings with conventional imaging and CA 125 as a tumour marker.

    Science.gov (United States)

    Ozcan Kara, P; Kara, T; Kaya, B; Kara Gedik, G; Sari, O

    2012-09-01

    This retrospective study was designed to assess the value of positron emission tomography/computed tomography imaging (PET/CT) in the post-treatment evaluation of the patients with endometrial carcinoma and to compare PET/CT scan with conventional imaging (CI) including computed tomography (CT), ultrasonography (US) and magnetic resonance imaging (MRI) and CA 125 with both 20U/ml and 35U/ml cut-off values. A total of 31 patients who were treated for histopathologically proven endometrial adenocarcinoma, underwent PET/CT examination for restaging and suspected recurrence. Thirty five PET/CT studies were performed in 31 patients. Lesion status was determined on the basis of clinical follow-up including radiological imaging (follow-up CT scan) at least 6 months and response to therapy. Of the 35 PET/CT studies, 13 (37%) studies were positive, whereas 22 (63%) of them were negative. On study-based analysis the overall sensitivity, specificity, accuracy for PET/CT imaging were 100%, 96% and 97%, respectively. The corresponding information for CI were 46%, 87% and 74%, for CA 125 (cut off=20U/ml) measurement were 45%, 88% and 74%, and for CA 125 (cut off=35U/ml) measurement were 27%, 100% and 78%, respectively. On lesion-based analysis, PET/CT revealed only one false positive case. In none of 21 patients with negative 22 PET/CT studies, no subsequent clinical or radiological recurrences were observed with a follow-up of at least 6 months. FDG-PET/CT is found more useful modality than CI and CA 125 in the evaluation of post-treatment endometrial carcinoma patients, for suspected recurrence. Copyright © 2011 Elsevier España, S.L. and SEMNIM. All rights reserved.

  7. 18F-FDG PET/CT in detection of gynecomastia in patients with hepatocellular carcinoma.

    Science.gov (United States)

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

    2013-01-01

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

  8. Biodistribution and estimation of radiation-absorbed doses in humans for 13N-ammonia PET.

    Science.gov (United States)

    Yi, Chang; Yu, Donglan; Shi, Xinchong; He, Qiao; Zhang, Xuezhen; Zhang, Xiangsong

    2015-11-01

    To evaluate the biodistribution of radiation-absorbed doses of (13)N-ammonia in healthy people. Five healthy human subjects underwent whole-body PET and CT scans after injection of 555-740 MBq of (13)N-ammonia. Five serial dynamic emission scans in each healthy volunteer were acquired. Regions of interest were drawn on the CT image and transferred to the corresponding transverse PET slice. Estimates of the radiation-absorbed doses were calculated using the medical internal radiation dosimetry method. The highest concentrations of (13)N-ammonia were found in the heart and liver, followed by pancreas, brain, spleen and stomach. The highest absorbed organ doses were to the heart wall (7.14E-03 ± 3.63E-03 mGy/MBq) and kidneys (6.02E-03 ± 3.53E-03 mGy/MBq). The effective dose (ED) was 6.58E-03 ± 1.23E-03 mSv/MBq. With these new estimates for (13)N-ammonia dosimetry, the results for Chinese people were not appreciably different from those of the previous study performed with old devices. As one of the most important myocardial perfusion PET tracers, the whole-body (13)N-ammonia PET appears to be safe for humans, yielding a relatively modest radiation burden that would allow multiple PET studies on the same subject per year.

  9. Effect of motion-induced PET-CT misalignment on cardiac function and myocardial blood flow measured using dynamic 15O-water PET

    DEFF Research Database (Denmark)

    Lubberink, Mark; Ebrahimi, M; Harms, Hans

    Aim: Motion-induced PET-CT misalignment artifacts are common in myocardial blood flow (MBF) measurements with 82Rb and 13N-ammonia. For 15O-water, MBF is based on the clearance rate rather than uptake of the tracer. The clearance rate is determined by the shape of the time-activity curve, not its......-CT misalignment on MBF, transmural MBF (MBFt), perfusable tissue fraction (PTF), cardiac output (CO), stroke volume (SV) and left-ventricular ejection fraction (LVEF) based on dynamic 15O-water scans. Methods: 10 patients underwent 6 min PET scans after injection of 400 MBq 15O-water at rest and during adenosine...

  10. Prognostic value of metabolic tumour volume and total lesion glycolysis in 18F-FDG PET/CT scans in locally advanced breast cancer staging.

    Science.gov (United States)

    Jiménez-Ballvé, A; García García-Esquinas, M; Salsidua-Arroyo, O; Serrano-Palacio, A; García-Sáenz, J A; Ortega Candil, A; Fuentes Ferrer, M E; Rodríguez Rey, C; Román-Santamaría, J M; Moreno, F; Carreras-Delgado, J L

    To determine whether metabolic tumour volume (MTV) and total lesion glycolysis (TLG) are able to predict recurrence risk in locally advanced breast cancer (LABC) patients. Retrospective study of LABC patients who undertook neoadjuvant, local and adjuvant treatment and follow up. A 18 F-FDG PET/CT study for initial staging was performed analysing in this study different metabolic parameters (MTV, TLG, SUVmax and SUVmed) both in the primary tumour (T) as well as in axillary nodes (N) and whole-body (WB). Forty females were included between January 2010-2011; follow up until January 2015 was completed. The average follow-up was 46 months. Twenty percent presented recurrence: local disease (n=2) and distant metastasis (n=6); 3 patients died (38% of the patients which recurred and 7.5% from the total). SUVmax, MTV and TLG, in T, N and WB, were higher in those patients with recurrence. The MTV and TLG parameters in the tumour (T) were related to the recurrence rate (P=.020 and P=.028, respectively); whereas SUVmax in the lymph nodes (N) was significantly related (P=.008) to the recurrence rate. The best cut-off points to predict recurrence where: MTV T ≥19.3cm 3 , TLG T≥74.4g and SUVmax N≥13.8, being 10-12 times more likely to recidivate when these thresholds where exceeded. Tumour grade was the only clinical-pathological variable which was related to recurrence probability (p=.035). In this study of LABC patients the metabolic parameters which have a better relationship with recurrence rate are: MTV and TLG in the primary tumour, SUVmax in the regional lymph node disease and whole-body PET data. Copyright © 2016 Elsevier España, S.L.U. y SEMNIM. All rights reserved.

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

    Science.gov (United States)

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

    2012-08-01

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

  12. PET-CT–Guided Surveillance of Head and Neck Cancers

    Science.gov (United States)

    Patients with advanced squamous cell carcinoma of the head and neck who underwent PET-CT–guided surveillance had fewer operations but similar overall survival rates to those of patients who underwent planned neck dissection.

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2013-07-15

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

  14. PET imaging of inflammation

    International Nuclear Information System (INIS)

    Buscombe, J. R.

    2014-01-01

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

  15. The Effect of Defective PET Detectors in Clinical Simultaneous [18F]FDG Time-of-Flight PET/MR Imaging.

    Science.gov (United States)

    Ter Voert, Edwin E G W; Delso, Gaspar; de Galiza Barbosa, Felipe; Huellner, Martin; Veit-Haibach, Patrick

    2017-08-01

    The purpose of this study was to evaluate the effect of defective positron emission tomography (PET) detectors on clinical PET image quality in simultaneous PET/magnetic resonance imaging (MRI) for both time-of-flight (TOF) and non-TOF reconstructed images. A total of six patients with various malignant tumors were included and underwent a 2-deoxy-2-[ 18 F]fluoro-D-glucose PET scan in a fully functional simultaneous TOF PET/MRI. TOF and non-TOF PET images were reconstructed before and after simulating defective detector units. All images were clinically assessed and scored. In addition, a quantitative assessment was performed. Differences were ascertained and compared using the Wilcoxon matched pairs signed-rank test. Without TOF, the image artifacts introduced by one defective detector unit already started to degrade the overall image quality. It reduced the confidence and could lead to a change in diagnosis. Simulating three or five defective detector units resulted in more artifacts and further reduced overall image quality and confidence. By including TOF information, the effects were mitigated: Images reconstructed with one defective detector unit had similar scores as the ones without defective units. The average absolute percentage error for one, three, and five defective detector units were respectively 8, 20, and 37 % for the non-TOF cases and only 5, 11, and 19 % for the TOF cases. Our study indicates that PET image artifacts due to (simulated) defective detectors are significantly mitigated with the integration of TOF information in simultaneous PET/MR. One defective detector unit introduces, on average, a 5 % absolute percentage error. However, in TOF imaging, even in cases with one or three defective units for head and neck imaging and one defective unit for chest and abdominal imaging, overall image quality, artifact scoring, and reader confidence are not significantly degraded.

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2017-02-15

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

  17. Evaluation of 18-F-fluoro-2-deoxyglucose (FDG positron emission tomography/computed tomography (PET/CT as a staging and monitoring tool for dogs with stage-2 splenic hemangiosarcoma - A pilot study.

    Directory of Open Access Journals (Sweden)

    Antonella Borgatti

    Full Text Available Positron Emission Tomography-Computed Tomography (PET-CT is routinely used for staging and monitoring of human cancer patients and is becoming increasingly available in veterinary medicine. In this study, 18-fluorodeoxyglucose (18FDG-PET-CT was used in dogs with naturally occurring splenic hemangiosarcoma (HSA to assess its utility as a staging and monitoring modality as compared to standard radiography and ultrasonography. Nine dogs with stage-2 HSA underwent 18FDG-PET-CT following splenectomy and prior to commencement of chemotherapy. Routine staging (thoracic radiography and abdominal ultrasonography was performed prior to 18FDG-PET-CT in all dogs. When abnormalities not identified on routine tests were noted on 18FDG-PET-CT, owners were given the option to repeat a PET-CT following treatment with eBAT. A PET-CT scan was repeated on Day 21 in three dogs. Abnormalities not observed on conventional staging tools, and most consistent with malignant disease based on location, appearance, and outcome, were detected in two dogs and included a right atrial mass and a hepatic nodule, respectively. These lesions were larger and had higher metabolic activity on the second scans. 18FDG-PET-CT has potential to provide important prognostic information and influence treatment recommendations for dogs with stage-2 HSA. Additional studies will be needed to precisely define the value of this imaging tool for staging and therapy monitoring in dogs with this and other cancers.

  18. Evaluation of 18-F-fluoro-2-deoxyglucose (FDG) positron emission tomography/computed tomography (PET/CT) as a staging and monitoring tool for dogs with stage-2 splenic hemangiosarcoma - A pilot study.

    Science.gov (United States)

    Borgatti, Antonella; Winter, Amber L; Stuebner, Kathleen; Scott, Ruth; Ober, Christopher P; Anderson, Kari L; Feeney, Daniel A; Vallera, Daniel A; Koopmeiners, Joseph S; Modiano, Jaime F; Froelich, Jerry

    2017-01-01

    Positron Emission Tomography-Computed Tomography (PET-CT) is routinely used for staging and monitoring of human cancer patients and is becoming increasingly available in veterinary medicine. In this study, 18-fluorodeoxyglucose (18FDG)-PET-CT was used in dogs with naturally occurring splenic hemangiosarcoma (HSA) to assess its utility as a staging and monitoring modality as compared to standard radiography and ultrasonography. Nine dogs with stage-2 HSA underwent 18FDG-PET-CT following splenectomy and prior to commencement of chemotherapy. Routine staging (thoracic radiography and abdominal ultrasonography) was performed prior to 18FDG-PET-CT in all dogs. When abnormalities not identified on routine tests were noted on 18FDG-PET-CT, owners were given the option to repeat a PET-CT following treatment with eBAT. A PET-CT scan was repeated on Day 21 in three dogs. Abnormalities not observed on conventional staging tools, and most consistent with malignant disease based on location, appearance, and outcome, were detected in two dogs and included a right atrial mass and a hepatic nodule, respectively. These lesions were larger and had higher metabolic activity on the second scans. 18FDG-PET-CT has potential to provide important prognostic information and influence treatment recommendations for dogs with stage-2 HSA. Additional studies will be needed to precisely define the value of this imaging tool for staging and therapy monitoring in dogs with this and other cancers.

  19. Intestinal Glycolysis Visualized by FDG PET/CT Correlates With Glucose Decrement After Gastrectomy.

    Science.gov (United States)

    Ku, Cheol Ryong; Lee, Narae; Hong, Jae Won; Kwon, In Gyu; Hyung, Woo Jin; Noh, Sung Hoon; Lee, Eun Jig; Yun, Mijin; Cho, Arthur

    2017-02-01

    Gastrectomy method is known to influence glucose homeostasis. 18 F-fluoro-2-fluorodeoxyglucose (FDG) positron emission tomography (PET)/computed tomography (CT) images acquired after gastrectomy often reveals newly developed physiological small bowel uptake. We correlated newly developed small bowel FDG uptake and glucose homeostasis in postgastrectomy gastric cancer patients. We retrospectively analyzed 239 patients without diabetes who underwent staging and follow-up FDG PET/CT scanning before and after gastrectomy for gastric cancer. Postoperative small bowel glycolysis was quantified by recording intestinal total lesion glycolysis (TLG). TLG was assessed with regard to surgical method (Billroth I, Billroth II [BII], Roux-en-Y [RY]), fasting glucose decrement (≥10 mg/dL), and other clinical factors. Patients' weight, fasting glucose, cholesterol, TLG, and body fat levels significantly decreased after surgery. The glucose decrement was significantly associated with fasting glucose, surgical methods, total cholesterol, TLG, and total body fat on univariate analysis. Multivariate analysis showed that BII surgery (odds ratio 6.51) and TLG (odds ratio 3.17) were significantly correlated with glucose decrement. High small bowel glycolysis (TLG >42.0 g) correlated with glucose decrement in RY patients. Newly developed small bowel glycolysis on postgastrectomy FDG PET/CT scanning is correlated with a glucose decrement. These findings suggest a potential role of FDG PET/CT scanning in the evaluation of small bowel glycolysis and glucose control. © 2017 by the American Diabetes Association.

  20. Clinical use of 11C-methionine and 18F-FDG-PET for germinoma in central nervous system

    International Nuclear Information System (INIS)

    Okochi, Yoshiyuki; Nihashi, Takashi; Fujii, Masazumi

    2014-01-01

    The purpose of this study was to examine the 11 C-methionine (MET) and 18 F-fluorodeoxyglucose (FDG) positron emission tomography (PET) findings of central nervous system (CNS) germinoma and the diagnostic utility of these findings. We retrospectively evaluated the cases of 10 patients who were diagnosed with CNS germinoma according to their histopathological or clinical findings. All the patients underwent pretreatment MET and/or FDG-PET scans, and the resultant images were assessed qualitatively and quantitatively. In the qualitative assessments, we used 3- and 5-grade visual scoring systems for the MET- and FDG-PET images, respectively. In the quantitative assessments, the maximal standardized uptake value (SUV max ) and the ratio of the SUV max of the tumor (T) divided by the mean SUV for the normal white or gray matter [T/N (WM), T/N (GM)], was calculated. The mean and SD values of SUV max, T/N (WM), and T/N(GM) were 1.9 ± 1.4, 2.5 ± 1.3, and 1.7 ± 0.9 on MET-PET and 5.8 ± 2.2, 1.6 ± 0.5, and 0.8 ± 0.2 on FDG-PET, respectively. On MET-PET, only one lesion was not detected. On the other hand, on FDG-PET all of the lesions exhibited uptake values that were intermediate between those of the normal white matter and gray matter. In terms of its tumor-contouring ability, MET is a good tracer for diagnosing CNS germinomas; therefore, MET-PET is considered to be useful for planning biopsies or surgery. Although FDG-PET is capable of detecting CNS germinomas, it produced insufficient image contrast in the present study. Further studies are needed before FDG-PET can be used in clinical examinations of CNS germinoma. (author)

  1. Three-phase 18F-fluorocholine PET/CT in the evaluation of prostate cancer recurrence

    International Nuclear Information System (INIS)

    Steiner, C.; Zaidi, H.; Wissmeyer, M.; Berrebi, O.; Ratib, O.; Miralbell, R.; Buchegger, F.; University Hospital of Lausanne

    2009-01-01

    Contribution of 3-phase 18 F-fluorocholine PET/CT in suspected prostate cancer recurrence at early rise of PSA. Retrospective analysis was performed in 47 patients after initial treatment with radiotherapy (n = 30) or surgery (n 17). Following CT, 10 minutes list-mode PET acquisition was done over the prostate bed after injection of 300 MBq of 18 F-fluorocholine. Three timeframes of 3 minutes each were reconstructed for analysis. All patients underwent subsequent whole body PET/CT. Delayed pelvic PET/CT was obtained in 36 patients. PET/CT was interpreted visually by two observers and SUV max determined for suspicious lesions. Biopsies were obtained from 13 patients. Biopsies confirmed the presence of cancer in 11 of 13 patients with positive PET for a total of 15 local recurrences in which average SUV max increased during 14 minutes post injection and marginally decreased in delayed scanning. Conversely inguinal lymph nodes with mild to moderate metabolic activity on PET showed a clearly different pattern with decreasing SUV max on dynamic images. Three-phase PET/CT contributed to the diagnostic assessment of 10 of 47 patients with biological evidence of recurrence of cancer. It notably allowed the discrimination of confounding blood pool or urinary activity from suspicious hyperactivities. PET/CT was positive in all patients with PSA ≥ 2 ng/ml (n 34) and in 4/13 patients presenting PSA values 18 F-fluorocholine 3-phase PET/CT showed a progressively increasing SUV max in biopsy confirmed cancer lesions up to 14 minutes post injection while decreasing in inguinal lymph nodes interpreted as benign. Furthermore, it was very useful in differentiating local recurrences from confounding blood pool and urinary activity. (orig.)

  2. [(11)C]PiB PET in Gerstmann-Sträussler-Scheinker disease.

    Science.gov (United States)

    Deters, Kacie D; Risacher, Shannon L; Yoder, Karmen K; Oblak, Adrian L; Unverzagt, Frederick W; Murrell, Jill R; Epperson, Francine; Tallman, Eileen F; Quaid, Kimberly A; Farlow, Martin R; Saykin, Andrew J; Ghetti, Bernardino

    2016-01-01

    Gerstmann-Sträussler-Scheinker Disease (GSS) is a familial neurodegenerative disorder characterized clinically by ataxia, parkinsonism, and dementia, and neuropathologically by deposition of diffuse and amyloid plaques composed of prion protein (PrP). The purpose of this study was to evaluate if [(11)C]Pittsburgh Compound B (PiB) positron emission tomography (PET) is capable of detecting PrP-amyloid in PRNP gene carriers. Six individuals at risk for GSS and eight controls underwent [(11)C]PiB PET scans using standard methods. Approximately one year after the initial scan, each of the three asymptomatic carriers (two with PRNP P102L mutation, one with PRNP F198S mutation) underwent a second [(11)C]PiB PET scan. Three P102L carriers, one F198S carrier, and one non-carrier of the F198S mutation were cognitively normal, while one F198S carrier was cognitively impaired during the course of this study. No [(11)C]PiB uptake was observed in any subject at baseline or at follow-up. Neuropathologic study of the symptomatic individual revealed PrP-immunopositive plaques and tau-immunopositive neurofibrillary tangles in cerebral cortex, subcortical nuclei, and brainstem. PrP deposits were also numerous in the cerebellar cortex. This is the first study to investigate the ability of [(11)C]PiB PET to bind to PrP-amyloid in GSS F198S subjects. This finding suggests that [(11)C]PiB PET is not suitable for in vivo assessment of PrP-amyloid plaques in patients with GSS.

  3. [11C]PiB PET in Gerstmann-Sträussler-Scheinker disease

    Science.gov (United States)

    Deters, Kacie D; Risacher, Shannon L; Yoder, Karmen K; Oblak, Adrian L; Unverzagt, Frederick W; Murrell, Jill R; Epperson, Francine; Tallman, Eileen F; Quaid, Kimberly A; Farlow, Martin R; Saykin, Andrew J; Ghetti, Bernardino

    2016-01-01

    Gerstmann-Sträussler-Scheinker Disease (GSS) is a familial neurodegenerative disorder characterized clinically by ataxia, parkinsonism, and dementia, and neuropathologically by deposition of diffuse and amyloid plaques composed of prion protein (PrP). The purpose of this study was to evaluate if [11C]Pittsburgh Compound B (PiB) positron emission tomography (PET) is capable of detecting PrP-amyloid in PRNP gene carriers. Six individuals at risk for GSS and eight controls underwent [11C]PiB PET scans using standard methods. Approximately one year after the initial scan, each of the three asymptomatic carriers (two with PRNP P102L mutation, one with PRNP F198S mutation) underwent a second [11C]PiB PET scan. Three P102L carriers, one F198S carrier, and one non-carrier of the F198S mutation were cognitively normal, while one F198S carrier was cognitively impaired during the course of this study. No [11C]PiB uptake was observed in any subject at baseline or at follow-up. Neuropathologic study of the symptomatic individual revealed PrP-immunopositive plaques and tau-immunopositive neurofibrillary tangles in cerebral cortex, subcortical nuclei, and brainstem. PrP deposits were also numerous in the cerebellar cortex. This is the first study to investigate the ability of [11C]PiB PET to bind to PrP-amyloid in GSS F198S subjects. This finding suggests that [11C]PiB PET is not suitable for in vivo assessment of PrP-amyloid plaques in patients with GSS. PMID:27069768

  4. {sup 18}F-FDG PET/CT for initial staging in breast cancer patients. Is there a relevant impact on treatment planning compared to conventional staging modalities?

    Energy Technology Data Exchange (ETDEWEB)

    Krammer, J.; Schnitzer, A.; Kaiser, C.G.; Buesing, K.A.; Schoenberg, S.O.; Wasser, K. [University of Heidelberg, Institute of Clinical Radiology and Nuclear Medicine, University Medical Centre Mannheim, Medical Faculty Mannheim, Mannheim (Germany); Sperk, E. [University of Heidelberg, Department of Radiation Oncology, University Medical Centre Mannheim, Medical Faculty Mannheim, Mannheim (Germany); Brade, J. [University of Heidelberg, Institute of Medical Statistics, Biomathematics and Data Processing, Medical Faculty Mannheim, Mannheim (Germany); Wasgindt, S.; Suetterlin, M. [University of Heidelberg, Department of Gynaecology and Obstetrics, University Medical Centre Mannheim, Medical Faculty Mannheim, Mannheim (Germany); Sutton, E.J. [Memorial Sloan-Kettering Cancer Center, Evelyn H. Lauder Breast Center, Department of Radiology, New York, NY (United States)

    2015-08-15

    To evaluate the impact of whole-body {sup 18}F-FDG PET/CT on initial staging of breast cancer in comparison to conventional staging modalities. This study included 102 breast cancer patients, 101 patients were eligible for evaluation. Preoperative whole-body staging with PET/CT was performed in patients with clinical stage ≥ T2 tumours or positive local lymph nodes (n = 91). Postoperative PET/CT was performed in patients without these criteria but positive sentinel lymph node biopsy (n = 10). All patients underwent PET/CT and a conventional staging algorithm, which included bone scan, chest X-ray and abdominal ultrasound. PET/CT findings were compared to conventional staging and the impact on therapeutic management was evaluated. PET/CT led to an upgrade of the N or M stage in overall 19 patients (19 %) and newly identified manifestation of breast cancer in two patients (2 %). PET/CT findings caused a change in treatment of 11 patients (11 %). This is within the range of recent studies, all applying conventional inclusion criteria based on the initial T and N status. PET/CT has a relevant impact on initial staging and treatment of breast cancer when compared to conventional modalities. Further studies should assess inclusion criteria beyond the conventional T and N status, e.g. tumour grading and receptor status. (orig.)

  5. Use of an in-field-of-view shield to improve count rate performance of the single crystal layer high-resolution research tomograph PET scanner for small animal brain scans

    International Nuclear Information System (INIS)

    Boellaard, R; Jong, H W A M de; Molthoff, C F M; Buijs, F; Lenox, M; Nutt, R; Lammertsma, A A

    2003-01-01

    The count rate performance of the single LSO crystal layer high-resolution research tomograph (HRRT-S) PET scanner is limited by the processing speed of its electronics. Therefore, the feasibility of using an in-field-of-view (in-FOV) shield to improve the noise equivalent count rates (NECR) for small animal brain studies was investigated. The in-FOV shield consists of a lead tube of 12 cm length, 6 cm inner diameter and 9 mm wall thickness. It is large enough to shield the activity in the body of a rat or mouse. First, the effect of this shield on NECR was studied. Secondly, a number of experiments were performed to assess the effects of the shield on the accuracy of transmission scan data and, next, on reconstructed activity distribution in the brain. For activities below 150 MBq NECR improved only by 5-10%. For higher activities NECR maxima of 1.2E4 cps at 200 MBq and 2.2E4 cps at 370 MBq were found without and with shield, respectively. Listmode data taken without shield, however, were corrupted for activities above 75 MBq due to data overrun problems (time tag losses) of the electronics. When the shield was used data overrun was avoided up to activities of 150 MBq. For the unshielded part of the phantom, transmission scan data were the same with and without shield. The estimated scatter contribution was approximately 8.5% without and 5.5% with shield. Reconstructed emission data showed a difference up to 5% in the unshielded part of the phantom at 5 mm or more from the edge of the shielding. Of this 5% about 3% results from the difference in the uncorrected scatter contribution. In conclusion, an in-FOV shield can be used successfully in an HRRT PET scanner to improve NECR and accuracy of small animal brain studies. The latter is especially important when high activities are required for tracers with low brain uptake or when multiple animals are scanned simultaneously. (note)

  6. Fluorine-18-fluorodeoxyglucose PET/CT for the evaluation of suspected recurrent uterine leiomyosarcomas

    International Nuclear Information System (INIS)

    Kao, Yung Hsiang; Saad, U.; Tan, Andrew E.H.; Magsombol, Butch M.; Padhy, Ajit Kumar

    2011-01-01

    Background Uterine leiomyosarcomas are rare and aggressive malignancies of the uterine corpus with high recurrence rates and poor prognoses. The current recommendation for detection of recurrent uterine leiomyosarcoma involves periodic physical examination and conventional imaging such as CT or MRI. The role of fluorine-18-fluorodeoxyglucose positron emission tomography with integrated computed tomography (FDG-PET/CT) in the detection of recurrent uterine leiomyosarcomas is not yet established. Purpose To evaluate the use of FDG-PET/CT as a single integrated modality for the evaluation of suspected recurrent uterine leiomyosarcomas. Material and Methods A retrospective study was performed on patients who underwent FDG-PET/CT scans for suspected recurrent uterine leiomyosarcoma. Only patients with follow-up data were included in the study. FDG-PET/CT was evaluated as a single integrated imaging modality. A positive lesion on FDG-PET/CT was defined as a focal abnormality detected on either the PET or CT components, or both. Results Sixteen consecutive patients over 5 years underwent FDG-PET/CT for suspected recurrent uterine leiomyosarcoma. Five patients were excluded due to incomplete follow-up data. The remaining 11 patients were aged 36-58 years (mean age 48). FDG-PET/CT had a sensitivity of 100% (95% CI 63-100) and specificity of 100% (95% CI 20-100) for the detection of recurrent uterine leiomyosarcomas. Sites of metastases include lungs, peritoneum, liver, pancreas and breast, of which lungs and peritoneum were the most common. Two (18%) patients had discordant findings: FDG-PET negative metastatic nodules in the breast and lung detected on the CT component. The maximum standardized uptake value (SUVmax) of metastatic lesions ranged from 2.0 to 16.0 (mean 7.6). Conclusion FDG-PET/CT as a single integrated modality may be a useful for the evaluation of suspected recurrent uterine leiomyosarcomas. FDG-PET negative discordant nodules detected on the CT component

  7. Target volume definition for 18F-FDG PET-positive lymph nodes in radiotherapy of patients with non-small cell lung cancer.

    Science.gov (United States)

    Nestle, Ursula; Schaefer-Schuler, Andrea; Kremp, Stephanie; Groeschel, Andreas; Hellwig, Dirk; Rübe, Christian; Kirsch, Carl-Martin

    2007-04-01

    FDG PET is increasingly used in radiotherapy planning. Recently, we demonstrated substantial differences in target volumes when applying different methods of FDG-based contouring in primary lung tumours (Nestle et al., J Nucl Med 2005;46:1342-8). This paper focusses on FDG-positive mediastinal lymph nodes (LN(PET)). In our institution, 51 NSCLC patients who were candidates for radiotherapy prospectively underwent staging FDG PET followed by a thoracic PET scan in the treatment position and a planning CT. Eleven of them had 32 distinguishable non-confluent mediastinal or hilar nodal FDG accumulations (LN(PET)). For these, sets of gross tumour volumes (GTVs) were generated at both acquisition times by four different PET-based contouring methods (visual: GTV(vis); 40% SUVmax: GTV40; SUV=2.5: GTV2.5; target/background (T/B) algorithm: GTV(bg)). All differences concerning GTV sizes were within the range of the resolution of the PET system. The detectability and technical delineability of the GTVs were significantly better in the late scans (e.g. p = 0.02 for diagnostic application of SUVmax = 2.5; p = 0.0001 for technical delineability by GTV2.5; p = 0.003 by GTV40), favouring the GTV(bg) method owing to satisfactory overall applicability and independence of GTVs from acquisition time. Compared with CT, the majority of PET-based GTVs were larger, probably owing to resolution effects, with a possible influence of lesion movements. For nodal GTVs, different methods of contouring did not lead to clinically relevant differences in volumes. However, there were significant differences in technical delineability, especially after early acquisition. Overall, our data favour a late acquisition of FDG PET scans for radiotherapy planning, and the use of a T/B algorithm for GTV contouring.

  8. Target volume definition for 18F-FDG PET-positive lymph nodes in radiotherapy of patients with non-small cell lung cancer

    International Nuclear Information System (INIS)

    Nestle, Ursula; Schaefer-Schuler, Andrea; Hellwig, Dirk; Kirsch, Carl-Martin; Kremp, Stephanie; Ruebe, Christian; Groeschel, Andreas

    2007-01-01

    FDG PET is increasingly used in radiotherapy planning. Recently, we demonstrated substantial differences in target volumes when applying different methods of FDG-based contouring in primary lung tumours (Nestle et al., J Nucl Med 2005;46:1342-8). This paper focusses on FDG-positive mediastinal lymph nodes (LN PET ). In our institution, 51 NSCLC patients who were candidates for radiotherapy prospectively underwent staging FDG PET followed by a thoracic PET scan in the treatment position and a planning CT. Eleven of them had 32 distinguishable non-confluent mediastinal or hilar nodal FDG accumulations (LN PET ). For these, sets of gross tumour volumes (GTVs) were generated at both acquisition times by four different PET-based contouring methods (visual: GTV vis ; 40% SUV max : GTV 40 ; SUV=2.5: GTV 2.5 ; target/background (T/B) algorithm: GTV bg ). All differences concerning GTV sizes were within the range of the resolution of the PET system. The detectability and technical delineability of the GTVs were significantly better in the late scans (e.g. p 0.02 for diagnostic application of SUV max = 2.5; p = 0.0001 for technical delineability by GTV 2.5 ; p = 0.003 by GTV 40 ), favouring the GTV bg method owing to satisfactory overall applicability and independence of GTVs from acquisition time. Compared with CT, the majority of PET-based GTVs were larger, probably owing to resolution effects, with a possible influence of lesion movements. For nodal GTVs, different methods of contouring did not lead to clinically relevant differences in volumes. However, there were significant differences in technical delineability, especially after early acquisition. Overall, our data favour a late acquisition of FDG PET scans for radiotherapy planning, and the use of a T/B algorithm for GTV contouring. (orig.)

  9. PET imaging in pediatric oncology

    International Nuclear Information System (INIS)

    Shulkin, B.L.

    2004-01-01

    High-quality PET imaging of pediatric patients is challenging and requires attention to issues commonly encountered in the practice of pediatric nuclear medicine, but uncommon to the imaging of adult patients. These include intravenous access, fasting, sedation, consent, and clearance of activity from the urinary tract. This paper discusses some technical differences involved in pediatric PET to enhance the quality of scans and assure the safety and comfort of pediatric patients. (orig.)

  10. Single 20-second acquisition of deep-inspiration breath-hold PET/CT: clinical feasibility for lung cancer.

    Science.gov (United States)

    Torizuka, Tatsuo; Tanizaki, Yasuo; Kanno, Toshihiko; Futatsubashi, Masami; Yoshikawa, Etsuji; Okada, Hiroyuki; Ouchi, Yasuomi

    2009-10-01

    This study was designed to compare tumor (18)F-FDG uptake between a single 20-s acquisition of deep-inspiration breath-hold PET/CT and free-breathing PET/CT for lung cancer. Before the clinical study, a phantom study was performed to determine the optimum breath-hold time for the PET scan. We studied 47 patients with lung cancer who underwent free-breathing PET/CT with the standard clinical protocol, followed by deep-inspiration breath-hold PET/CT of the thorax. In breath-hold PET/CT, the patients were asked to hold their breath in deep inspiration for 10 s during the CT scan and for 20 s during the PET scan. Maximum tumor (18)F-FDG standardized uptake value (SUVmax) was measured in free-breathing PET and breath-hold PET, and the percentage difference between these 2 values was calculated. Breath-hold PET showed a significant increase in SUVmax, as compared with free-breathing PET (8.26 +/- 4.59 vs. 11.25 +/- 7.24, P < 0.0001). The mean difference in SUVmax was 39.5% +/- 43.4%, and the range was 2.9%-248.3%. The difference in SUVmax was significant when compared between tumors in the upper lung (n = 22) and tumors in the lower lung (n = 25) (24.4% +/- 17.7% vs. 52.9% +/- 54.3%, P = 0.0077). The mean tumor size of the group with a high SUVmax difference (n = 13) was significantly smaller than that of the group with a low SUVmax difference (n = 34) (2.45 +/- 0.87 cm vs. 3.21 +/- 1.22 cm, P = 0.043), using a cutoff of 39.5%. The single 20-s acquisition of breath-hold PET/CT enabled more precise measurement of SUVmax, especially in the lower lung field and for small tumors, which may be affected by respiratory motion. This technique is feasible in the clinical setting and requires only a minor increase in examination time.

  11. FDG-PET/CT for differentiating between aseptic and septic delayed union in the lower extremity.

    Science.gov (United States)

    van Vliet, Kirsten E; de Jong, Vincent M; Termaat, M Frank; Schepers, Tim; van Eck-Smit, Berthe L F; Goslings, J Carel; Schep, Niels W L

    2018-02-01

    18 F-fluorodeoxyglucose ( 18 F-FDG) positron emission tomography (PET)/computed tomography (CT) has proven to have a high diagnostic accuracy for the detection of bone infections. In patients with delayed union it may be clinically important to differentiate between aseptic and septic delayed union. The aim of this study was to evaluate the efficacy and to assess the optimal diagnostic accuracy of FDG-PET/CT in differentiating between aseptic and septic delayed union in the lower extremity. This is a retrospective study of consecutive patients who underwent FDG-PET/CT scanning for suspicion of septic delayed union of the lower extremity. Diagnosis of aseptic delayed union or septic delayed union was made based on surgical deep cultures following PET/CT scanning and information on clinical follow-up. FDG-uptake values were measured at the fractured site by use of the maximum standardized uptake value (SUV max ). Sensitivity, specificity and diagnostic accuracy of FDG-PET/CT were calculated at various SUV max cut-off points. A total of 30 patients were included; 13 patients with aseptic delayed unions and 17 patients with septic delayed unions. Mean SUV max in aseptic delayed union patients was 3.23 (SD ± 1.21). Mean SUV max in septic delayed union patients was 4.77 (SD ± 1.87). A cut-off SUV max set at 4.0 showed sensitivity, specificity and diagnostic accuracy of FDG-PET/CT were 65, 77 and 70% to differentiate between aseptic and septic delayed union, respectively. Using a semi-quantitative measure (SUV max ) for interpretation of FDG-PET/CT imaging seems to be a promising tool for the discrimination between aseptic and septic delayed union.

  12. The value of FDG-PET in the diagnosis of thromboangiitis obliterans--a case series.

    Science.gov (United States)

    Hackl, Gerald; Milosavljevic, Robert; Belaj, Klara; Gary, Thomas; Rief, Peter; Hafner, Franz; Lipp, Rainer W; Brodmann, Marianne

    2015-04-01

    Thromboangiitis obliterans (TAO) is an inflammatory vascular disease affecting dominantly the vessels of the extremities and is etiologically strongly associated with tobacco consumption. Different imaging techniques are generally used to exclude potential differential diagnoses. We investigated the value of (18) F-flourodeoxyglucose positron emission tomography ([(18) F]FDG-PET) in the diagnosis of TAO. All consecutive patients with diagnosed TAO between Nov 2001 and Nov 2003 at our institution who underwent [(18) F]FDG-PET in the diagnostic workup were analyzed retrospectively. Whole-body scans were conducted after a fasting period of at least 6 h and blood glucose levels lower than 180 mg/dl. The primary endpoint was defined as significantly increased vascular FDG uptake. Tracer uptake was visually determined and, in accordance with strength, divided into grades 0 to 3. In total, ten patients were statistically evaluated. The median patient age at the date of the first [(18) F]FDG-PET was 41.5 years. Repetitive FDG-PET imaging was performed in seven out of ten patients (70 %). The endpoint was objectified in one of the initial examinations (10 %) and in another one out of seven follow-up scans (14.3 %). One positive [(18) F]FDG-PET was observed in the pelvic vessels and the other in the infrapopliteal arteries. Therefore, increased tracer uptake could be observed in two examinations on two different patients (both with grade 3 tracer uptake) out of 17 conducted [(18) F]FDG-PETs in total. The [(18) F]FDG-PET was not a suitable investigative procedure for the diagnosis of TAO in the present patient cohort.

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

    International Nuclear Information System (INIS)

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

    2010-01-01

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

  14. A method for accurate spatial registration of PET images and histopathology slices.

    Science.gov (United States)

    Puri, Tanuj; Chalkidou, Anastasia; Henley-Smith, Rhonda; Roy, Arunabha; Barber, Paul R; Guerrero-Urbano, Teresa; Oakley, Richard; Simo, Ricard; Jeannon, Jean-Pierre; McGurk, Mark; Odell, Edward W; O'Doherty, Michael J; Marsden, Paul K

    2015-12-01

    Accurate alignment between histopathology slices and positron emission tomography (PET) images is important for radiopharmaceutical validation studies. Limited data is available on the registration accuracy that can be achieved between PET and histopathology slices acquired under routine pathology conditions where slices may be non-parallel, non-contiguously cut and of standard block size. The purpose of this study was to demonstrate a method for aligning PET images and histopathology slices acquired from patients with laryngeal cancer and to assess the registration accuracy obtained under these conditions. Six subjects with laryngeal cancer underwent a (64)Cu-copper-II-diacetyl-bis(N4-methylthiosemicarbazone) ((64)Cu-ATSM) PET computed tomography (CT) scan prior to total laryngectomy. Sea urchin spines were inserted into the pathology specimen to act as fiducial markers. The specimen was fixed in formalin, as per standard histopathology operating procedures, and was then CT scanned and cut into millimetre-thick tissue slices. A subset of the tissue slices that included both tumour and fiducial markers was taken and embedded in paraffin blocks. Subsequently, microtome sectioning and haematoxylin and eosin staining were performed to produce 5-μm-thick tissue sections for microscopic digitisation. A series of rigid registration procedures was performed between the different imaging modalities (PET; in vivo CT-i.e. the CT component of the PET-CT; ex vivo CT; histology slices) with the ex vivo CT serving as the reference image. In vivo and ex vivo CTs were registered using landmark-based registration. Histopathology and ex vivo CT images were aligned using the sea urchin spines with additional anatomical landmarks where available. Registration errors were estimated using a leave-one-out strategy for in vivo to ex vivo CT and were estimated from the RMS landmark accuracy for histopathology to ex vivo CT. The mean ± SD accuracy for registration of the in vivo to ex

  15. The impact of the PET/CT in comparison with the same day contrast enhanced CT in breast cancer management

    International Nuclear Information System (INIS)

    Piperkova, E.; Raphael, B.; Altinyay, M.; Castellon, I.; Libes, R.; Abdel-Dayem, H.

    2006-01-01

    Full text: The aim of this study is to evaluate the impact of 18F-fluorodeoxyglucose FDG positron emission tomography with fused computerized tomography (PET/CT) in comparison with the same day contrast enhanced CT (CE-CT) in the breast cancer (BC) management. 68 studies in 48 BC patients, 8 for initial and 60 for restaging disease, after surgery, radiation/chemotherapy, for radiation therapy planning or evaluating treatment response were included. All patients underwent whole body PET/CT for diagnostic purposes followed by CE-CT diagnostic scans of selected body regions. PET/CT was performed approximately 90 minutes following 10-15 mCi of 18F-FDG on a GE Discovery PET/CT system. CT part acquired with low dose X-ray for localization and attenuation correction. The CE-CT was performed according to departmental protocol. Out of a total of 235 lesions in 68 PET/CT and CE-CT studies, 189 were concordant between PET/CT and CE-CT. However, there were 46 discordant lesions, which were verified by either follow-up or biopsy. PET/CT correctly identified 25 (True Positive-TP). CE-CT identified 2 TP lesions missed by PET/CT (False negative): one liver metastasis with necrosis, which is a known non-avid FDG, the other was a missed abdominal metastatic node, which did not change staging or treatment. PET/CT incorrectly identified 2 lesions (False Positive) while CE-CT incorrectly identified 17 FP. For evaluating treatment response in 40 follow up studies PET/CT reported complete response in 15, partial response in 11, stable disease in 2, progression in 5, and free of disease following surgery - in 7. The CE-CT described progression of the disease in 1 PET/CT true negative study and no progression in 2 TP PET/CT studies. In this study, PET/CT played more important role than CECT scans alone and provided an impact on the management of BC patients

  16. 11C-choline vs. 18F-FDG PET/CT in assessing bone involvement in patients with multiple myeloma

    Directory of Open Access Journals (Sweden)

    Ambrosini Valentina

    2007-06-01

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

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

    DEFF Research Database (Denmark)

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

    2003-01-01

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

  18. Evaluation of pulmonary lesions with {sup 18}FDG CoDo PET: comparison with CT, MRI and clinical findings

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Su Zy; Park, Chan Hee; Han, Myung Ho; Hwang, Sung Chul; Lee, Chul Joo; Pai, Moon Sun [College of Medicine, Ajou Univ., Suwon (Korea, Republic of)

    1998-07-01

    Dual-head gamma camera coincidence (PET) is one of the recent approaches to overcome the problems of the dedicated PET scans such as high cost and limited availability. The purpose of this study was to evaluate the accuracy of {sup 18}FDG coincidence detection (CoDe) PET in differentiating benign from malignant lesions and staging malignancy. Thirty-one patients with pulmonary lesions underwent {sup 18}FDG CoDe PET. Patients were prepared for the study by overnight fasting. The images were acquired at about 1 hr postinjection of 3-10 mCi {sup 18}FDG intravenously using dual head gamma camera (Elscint, Varicam) equipped with 5/8 inch thick NaI crystal. The images were analyzed visually. Pathologic proof of diagnosis was obtained by aspiration biopsy in 24 patients and by operation in 7 patients. Among 25 patients with pathologically proven malignant lesions ( 11 adenocarcinoma, 3 non-small cell lung cancer, 5 squamous cell cancer, 4 small cell lung cancer, 1 invasive thymoma and 1 adenosquamous cell cancer), {sup 18}FDG CoDe PET could not detect only 1 lesion which was adenocarcinoma of less than 1 cm in size. In seven patients underwent lobectomy, 6 CoDe PET studies agreed with pathologic results. Whereas only 3 of 7 patients CT findings agreed with pathologic findings. However, 6 patients with benign lesions also showed positive FDG uptake. The false positive pathologies were due to tuberculosis, pneumonia, and granulomatous changes due to silicosis. {sup 18}FDG CoDe PET was sensitive in the evaluation of lung lesions but was not specific for malignancy. {sup 18}FDG CoDe PET was more sensitive than CT in nodal staging in limited number of patients studied thus far.

  19. Follow-up segmentation of lung tumors in PET and CT data

    Science.gov (United States)

    Opfer, Roland; Kabus, Sven; Schneider, Torben; Carlsen, Ingwer C.; Renisch, Steffen; Sabczynski, Jörg

    2009-02-01

    Early response assessment of cancer therapy is a crucial component towards a more effective and patient individualized cancer therapy. Integrated PET/CT systems provide the opportunity to combine morphologic with functional information. We have developed algorithms which allow the user to track both tumor volume and standardized uptake value (SUV) measurements during the therapy from series of CT and PET images, respectively. To prepare for tumor volume estimation we have developed a new technique for a fast, flexible, and intuitive 3D definition of meshes. This initial surface is then automatically adapted by means of a model-based segmentation algorithm and propagated to each follow-up scan. If necessary, manual corrections can be added by the user. To determine SUV measurements a prioritized region growing algorithm is employed. For an improved workflow all algorithms are embedded in a PET/CT therapy monitoring software suite giving the clinician a unified and immediate access to all data sets. Whenever the user clicks on a tumor in a base-line scan, the courses of segmented tumor volumes and SUV measurements are automatically identified and displayed to the user as a graph plot. According to each course, the therapy progress can be classified as complete or partial response or as progressive or stable disease. We have tested our methods with series of PET/CT data from 9 lung cancer patients acquired at Princess Margaret Hospital in Toronto. Each patient underwent three PET/CT scans during a radiation therapy. Our results indicate that a combination of mean metabolic activity in the tumor with the PET-based tumor volume can lead to an earlier response detection than a purely volume based (CT diameter) or purely functional based (e.g. SUV max or SUV mean) response measures. The new software seems applicable for easy, faster, and reproducible quantification to routinely monitor tumor therapy.

  20. Comparisons of 13NH3, 18FDG PET and MRS in the presurgical evaluation of intractable epilepsy

    International Nuclear Information System (INIS)

    Cai Li; Gao Shuo; Li Dacheng; Li Zugui

    2004-01-01

    Purpose: Surgery offers a high chance of seizure-free outcome in patients with intractable epilepsy. Other than EEG, several functional and morphologic imaging Methods are used to define the spatial seizure origin. Blood flow perfusion and metabolic abnormalities in those patients are well described respectively. Proton MR spectroscopy (MRS) is still in the early stages in the evaluation of epilepsy. Comparisons with 13NH3 perfusion, 18FDG metabolic PET imaging and MRS in the same patients have rarely been documented. The present study was undertaken to compare the merits of 13NH3 PET, 18FDG PET, magnetic resonance imaging (MRI) and MRS for the lateralization of seizure foci. Methods: Preoperative long-term-EEG, Video-EEG, 13NH3 perfusion PET, 18FDG metabolic PET, MRI, MRS and neuropsychological assessment were performed in 15 patients with intractable epilepsy within 2 weeks(mean age=24.8 years, range 4 to 44 years; mean epilepsy duration=11 years, range 2 to 36 years), who received electrocorticography (ECoG). Antiepileptic drug (AED) was stopped taking at least 2 days before PET scanning. 13NH3 and FDG PET was performed in one day and analyzed with a region of interest template. An absolute asymmetry index, |AI|, greater than 0.15 was considered abnormal. 13 subjects were underwent MRS obtained from the hippocampus bilaterally, who had a presumptive temporal seizure focus based on seizure semiology, video-EEG and MRI. Metabolite ratio of NAA/Cho+Cr was calculated from the relative peak height measurements. An NAA/Cho+Cr ratio of 0.72 or less was regarded as abnormal. All the examination Results were compared with EcoG to evaluate their values of seizure foci lateraliaztion. Results: 1. The results were divided into ictal (n=4) and interictal (n= 11) groups. In the ictal group, the sensitivity of 13NH3 PET and 18FDG PET were both 100%(4/4), and 13NH3 PET showed bilateral hippocampus hyperfusion foci in one case. In the interictal group, 13NH3 PET correctly

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2016-04-15

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

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

    International Nuclear Information System (INIS)

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

    2016-01-01

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

  3. Diagnostic value of contrast-enhanced CT combined with 18-FDG PET in patients selected for cytoreductive surgery and hyperthermic intraperitoneal chemotherapy (HIPEC).

    Science.gov (United States)

    Sommariva, Antonio; Evangelista, Laura; Pintacuda, Giovanna; Cervino, Anna Rita; Ramondo, Gaetano; Rossi, Carlo Riccardo

    2018-05-01

    Aim of the study is to assess the reliability and correlation with surgical peritoneal cancer index (PCI) of combined PET/CT and ceCT scans (PET/ceCT) performed in a session in patients with peritoneal carcinomatosis candidates for cytoreductive surgery (CS) and hyperthermic intraperitoneal chemotherapy (HIPEC). We retrospectively analyzed data collected from 27 patients with different types of peritoneal carcinomatosis candidates to CS + HIPEC who underwent FDG PET/ceCT in a single session. Two nuclear medicine physicians and two radiologists independently and blindly evaluated PET/CT and ceCT imaging, respectively. In the case of discordance, the consensus was reached by a discussion between the specialists. Moreover, the combined images were evaluated by all the specialists in consensus. The PCIs obtained from surgical look, PET/CT, ceCT, and PET/ceCT were compared with each other. The coefficients of correlation (r) were calculated. The study was conducted after approval of local ethics committee. Surgical PCI was available in 21 patients. The coefficient of correlation between PCI of PET/CT and surgery was 0.528, while it resulted higher between PET/ceCT and surgery (r = 0.878), very similar to ceCT and surgery (r = 0.876). The r coefficient between surgical PCI and PET/CT was higher in patients with a non-mucinous cancer (n = 12) than the counterpart (0.601 vs. 0.303) and the addition of ceCT significantly increases the correlation (r = 0.863), which is anyway similar to ceCT alone (r = 0.856). PET/ceCT as single examination is more accurate than PET/CT but not than ceCT alone for the definition of PCI in a selected group of patients candidates to CS + HIPEC.

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

    Science.gov (United States)

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

    2018-05-01

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

  5. 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

  6. 2-[F-18] fluoro-2-deoxy-D-glucose (FDG) positron emission tomography (PET) in uncommon malignancies

    International Nuclear Information System (INIS)

    Nair, N.; Basu, S.

    2004-01-01

    management strategy. In all these cases, unsuspected distant metastases were revealed by PET scan. 3 cases of anaplastic carcinoma of thyroid were evaluated. PET showed multiple unsuspected metastatic foci in the neck and mediastinal nodes. In one of them, the neck nodes were evaluated to be operable and underwent surgery. 2 cases of very rare neuroendocrine carcinoma were studied. One of them had a primary in the breast and presented with local recurrence. Patient was referred for consideration of 131-I MIBG therapy, which did not show any appreciable concentration in the diagnostic scan. PET revealed multiple metastatic foci in both lungs and mediastinum in addition to the local recurrence. In another case, the primary was in the sphenoid, which showed persistence post radiotherapy by MRI. However, PET showed no residual disease. In 4 cases of Gastrointestinal stromal tumour (GIST)/LMS, PET findings were concordant with the finding of other imaging modalities in 2 cases. There was change in decision-making process in the 2 cases, of which PET upstaged the disease in one case. In the remaining one, a case of advanced GIST who was Imatinib mesylate treatment; PET was done to evaluate the known hepatic metastases, where it demonstrated absence of disease in the cavitating lesions seen in morphologic imaging. In 2 cases of Angiosarcoma and 1 case of liposarcoma and 3 cases of synovial sarcoma, PET revealed multiple unsuspected metastatic foci in the body and upstaged the disease. In one case of synovial sarcoma, PET revealed an unsuspected metastasis to the male breast. 4 cases of Germ cell tumour and 5 cases of Carcinoma of Buccal mucosa, Oropharynx and tonsil were evaluated; the staging and management strategy were changed by PET in all of them. In conclusion, PET made a significant contribution in the decision making process in a wide variety of malignancies and studies with larger sample size are warranted to prove its efficacy in these tumours

  7. Interim PET After Two ABVD Cycles in Early-Stage Hodgkin Lymphoma: Outcomes Following the Continuation of Chemotherapy Plus Radiotherapy

    Energy Technology Data Exchange (ETDEWEB)

    Simontacchi, Gabriele [Radiotherapy Unit, Azienda Ospedaliera Universitaria Careggi, University of Florence, Florence (Italy); Filippi, Andrea Riccardo, E-mail: andreariccardo.filippi@unito.it [Department of Oncology, University of Torino, Torino (Italy); Ciammella, Patrizia [Radiation Oncology Unit, Department of Advanced Technology, Arcispedale Santa Maria Nuova, Istituto di Ricovero e Cura a Carattere Scientifico, Reggio Emilia (Italy); Buglione, Michela [Radiation Oncology Department, University and Spedali Civili, Brescia (Italy); Saieva, Calogero [Molecular and Nutritional Epidemiology Unit, Cancer Research and Prevention Institute, Florence (Italy); Magrini, Stefano Maria [Radiation Oncology Department, University and Spedali Civili, Brescia (Italy); Livi, Lorenzo [Radiotherapy Unit, Azienda Ospedaliera Universitaria Careggi, University of Florence, Florence (Italy); Iotti, Cinzia [Radiation Oncology Unit, Department of Advanced Technology, Arcispedale Santa Maria Nuova, Istituto di Ricovero e Cura a Carattere Scientifico, Reggio Emilia (Italy); Botto, Barbara [Hematology Unit, Città della Salute e della Scienza Hospital, Torino (Italy); Vaggelli, Luca [Nuclear Medicine Department, Azienda Ospedaliera Universitaria Careggi, University of Florence, Florence (Italy); Re, Alessandro [Hematology Unit, University and Spedali Civili, Brescia (Italy); Merli, Francesco [Hematology Unit, Arcispedale Santa Maria Nuova, Istituto di Ricovero e Cura a Carattere Scientifico, Reggio Emilia (Italy); Ricardi, Umberto [Department of Oncology, University of Torino, Torino (Italy)

    2015-08-01

    Purpose: This multicenter retrospective study was designed to evaluate the prognostic role of interim fluorodeoxyglucose-labeled positron emission tomography (i-FDG-PET) in a cohort of patients affected with early-stage Hodgkin lymphoma (HL) treated initially with adriamycin, bleomycin, vinblastine, dacarbazine (ABVD) chemotherapy followed by radiation therapy, and to assess the role of chemotherapy continuation plus radiation therapy for i-FDG-PET-positive patients. Methods and Materials: Data from 257 patients were retrieved from 4 hematology and radiation oncology departments. Inclusion criteria were stage I to IIAB HL, “intention-to-treat” AVBD plus radiation therapy, and FDG-PET at diagnosis and after the first 2 ABVD cycles. All i-FDG-PET scans underwent blinded local review by using the Deauville 5-point scoring system; patients were stratified as negative or positive using 2 Deauville score cutoff values, ≥3 or ≥4. Results: Median follow-up time was 56 months (range: 9-163 months); 5-year overall survival (OS) and disease-specific survival (DSS) for the whole cohort were 97.5% and 98.3%, respectively. Five-year progression-free survival (PFS) was 95.6%. After i-FDG-PET revision, 43 of 257 patients (16.7%) had a positive i-FDG-PET (Deauville scores: 3-5). Five-year PFS rates for i-FDG-PET-negative and i-FDG-PET-positive patients were 98.1% and 83.7%, respectively, if using a Deauville score cutoff of 3, and 97.7% and 78.6%, respectively, if using a cutoff of 4 (P=.0001). Five-year OS for i-FDG-PET-negative and i-FDG-PET-positive patients was 98.5% and 93.0%, respectively, if using a cutoff of 3, and 98.6% and 89.3%, respectively, if using a cutoff of 4 (P=.029 and P=.002). At univariate regression analysis, i-FDG-PET positivity was associated with worse OS and PFS. At multivariate analysis, performed only for PFS, i-FDG-PET positivity confirmed its negative impact (P=.002). Conclusions: i-FDG-PET is prognostic for PFS and OS in early-stage HL

  8. Interim PET After Two ABVD Cycles in Early-Stage Hodgkin Lymphoma: Outcomes Following the Continuation of Chemotherapy Plus Radiotherapy

    International Nuclear Information System (INIS)

    Simontacchi, Gabriele; Filippi, Andrea Riccardo; Ciammella, Patrizia; Buglione, Michela; Saieva, Calogero; Magrini, Stefano Maria; Livi, Lorenzo; Iotti, Cinzia; Botto, Barbara; Vaggelli, Luca; Re, Alessandro; Merli, Francesco; Ricardi, Umberto

    2015-01-01

    Purpose: This multicenter retrospective study was designed to evaluate the prognostic role of interim fluorodeoxyglucose-labeled positron emission tomography (i-FDG-PET) in a cohort of patients affected with early-stage Hodgkin lymphoma (HL) treated initially with adriamycin, bleomycin, vinblastine, dacarbazine (ABVD) chemotherapy followed by radiation therapy, and to assess the role of chemotherapy continuation plus radiation therapy for i-FDG-PET-positive patients. Methods and Materials: Data from 257 patients were retrieved from 4 hematology and radiation oncology departments. Inclusion criteria were stage I to IIAB HL, “intention-to-treat” AVBD plus radiation therapy, and FDG-PET at diagnosis and after the first 2 ABVD cycles. All i-FDG-PET scans underwent blinded local review by using the Deauville 5-point scoring system; patients were stratified as negative or positive using 2 Deauville score cutoff values, ≥3 or ≥4. Results: Median follow-up time was 56 months (range: 9-163 months); 5-year overall survival (OS) and disease-specific survival (DSS) for the whole cohort were 97.5% and 98.3%, respectively. Five-year progression-free survival (PFS) was 95.6%. After i-FDG-PET revision, 43 of 257 patients (16.7%) had a positive i-FDG-PET (Deauville scores: 3-5). Five-year PFS rates for i-FDG-PET-negative and i-FDG-PET-positive patients were 98.1% and 83.7%, respectively, if using a Deauville score cutoff of 3, and 97.7% and 78.6%, respectively, if using a cutoff of 4 (P=.0001). Five-year OS for i-FDG-PET-negative and i-FDG-PET-positive patients was 98.5% and 93.0%, respectively, if using a cutoff of 3, and 98.6% and 89.3%, respectively, if using a cutoff of 4 (P=.029 and P=.002). At univariate regression analysis, i-FDG-PET positivity was associated with worse OS and PFS. At multivariate analysis, performed only for PFS, i-FDG-PET positivity confirmed its negative impact (P=.002). Conclusions: i-FDG-PET is prognostic for PFS and OS in early-stage HL

  9. Serial 18F-FDG-PET/CT during radiotherapy in nasopharyngeal carcinoma: a prospective clinical study

    International Nuclear Information System (INIS)

    Lin Qin; Yang Rongshui; Sun Long; Li Yimin; Wang Lichen; Dai Mingming; Luo Zuoming; Zhao Long; Wu Hua

    2012-01-01

    Objective: The primary aim of this prospective study was to use serial 18 F-FDG PET/CT to evaluate the trend of the tumor's maximum standardized uptake value (SUV max ) during radiotherapy (RT) on patients with nasopharyngeal carcinoma (NPC). Methods: 60 patients with primary biopsy-proven NPC were prospectively enrolled into the study, approved by the institutional review board of our hospital. All patients underwent four / 18 F-FDG PET/CT scans: one initial scan before RT/ cisplatin based concurrent chemo radiotherapy, at the point of 50 Gy during RT, the end of RT, and one month after RT, respectively. Results: There was a significant difference (P max of primary site among pre treatment and post treatment at the dose of 50 Gy, at the end of RT and one month after RT. There was also significant difference (P max of neck nodes site. However, there was significant difference of the SUV max between histological WHO type Ⅱ B and type Ⅱ A in the primary site (P=0.044) (67% reduction at dose 50 Gy for type Ⅱ B vs. 55% for type Ⅱ A) but not in the lymph nodes. Conclusions: Serial 18 F-FDG-PET/CT scan demonstrates significant decreasing values of the tumor's SUV max during and after radiotherapy in NPC. The most significant reduction was at the point 50 Gy and SUV is reduced to basal level (≤2.5) at one month after RT both in primary site and lymph nodes. WHO type Ⅱ B has more dramatic response than type Ⅱ A at the primary site but not in lymph node. The study indicates that inflammation caused by RT do not significantly influence the uptake on 18 F-FDG PET in NPC. Therefore, early PET scan during or right after RT instead of conventional 3 months interval after RT is indicated to evaluate tumor response and develop individualized adaptive radiotherapy in NPC. (authors)

  10. Clinical value of {sup 11}C-methionine PET/CT in patients with plasma cell malignancy: comparison with {sup 18}F-FDG PET/CT

    Energy Technology Data Exchange (ETDEWEB)

    Nakamoto, Yuji; Kurihara, Kensuke; Nakatani, Koya; Togashi, Kaori [Kyoto University Graduate School of Medicine, Department of Diagnostic Imaging and Nuclear Medicine, Kyoto (Japan); Nishizawa, Masatoshi; Yamashita, Kouhei; Kondo, Tadakazu; Takaori-Kondo, Akifumi [Kyoto University Graduate School of Medicine, Department of Hematology and Oncology, Kyoto (Japan)

    2013-05-15

    PET/CT using FDG has been widely used for the imaging of various malignant tumours, including plasma cell malignancy (PCM), but {sup 11}C-methionine (MET), as a radiolabelled amino acid tracer, may also be useful because PCM is able to activate protein synthesis. The purpose of this study was to evaluate the clinical value of PET/CT imaging using MET in PCM, including multiple myeloma, compared with that of FDG PET/CT. The study group comprised 20 patients with histologically proven PCM who underwent FDG PET/CT and MET PET/CT scans before (n = 6) or after (n = 14) treatment. Semiquantitative analysis was performed on a lesion basis. We also visually evaluated the scans qualitatively using a five-point scale (0, negative; 1, probably negative; 2, equivocal; 3, probably positive; 4, positive) on a lesion and a patient basis. The results were compared between the two scans. Active PCM was confirmed in 15 patients, including two patients with extramedullary lesions. Uptake of MET tended to be higher (maximum standardized uptake value 10.3 {+-} 5.6, mean {+-} SD) than that of FDG (3.4 {+-} 2.7, p < 0.001), and more lesions of grade 3 or 4 were depicted by MET (MET 156 lesions vs. FDG 58 lesions). On a patient basis, two patients were accurately diagnosed only by MET. In the remaining 18 patients, consistent results were obtained, but potential upgrade of staging or restaging was necessary in 6 of 11 positive patients because more abnormal lesions were demonstrated by MET. The patient-based sensitivity, specificity and accuracy of MET for restaging were 89 %, 100 % and 93 %, respectively, while those of FDG were 78 %, 100 % and 86 %, respectively. MET revealed an equal or greater number of lesions in PCM than FDG. MET may be especially useful when negative or inconclusive findings are obtained by FDG despite highly suspicious indications of recurrence. (orig.)

  11. Detection of cranial meningiomas: comparison of {sup 68}Ga-DOTATOC PET/CT and contrast-enhanced MRI

    Energy Technology Data Exchange (ETDEWEB)

    Afshar-Oromieh, Ali; Giesel, Frederik L.; Haberkorn, Uwe; Haufe, Sabine; Kratochwil, Clemens [University Hospital of Heidelberg, Department of Nuclear Medicine, Heidelberg (Germany); Linhart, Heinz G. [DKFZ, National Center for Tumor Diseases (NCT), Heidelberg (Germany); Combs, Stephanie E. [University Hospital of Heidelberg, Department of Radiation Oncology and Therapy, Heidelberg (Germany); Podlesek, Dino [University Hospital of Dresden, Department of Neurosurgery, Dresden (Germany); Eisenhut, Michael [DKFZ, Department of Radiopharmacy, Heidelberg (Germany)

    2012-09-15

    PET imaging with somatostatin receptor ligands, such as {sup 68}Ga-DOTATOC, is a well-established method for detection and target volume definition of meningiomas prior to radiotherapy. Since DOTATOC PET delivers a higher contrast between meningiomas and surrounding tissues than MRI, we conducted a retrospective analysis to compare the diagnostic accuracy of contrast-enhanced MRI (CE-MRI) with {sup 68}Ga-DOTATOC PET/CT in patients with cranial meningiomas prior to radiotherapy. Over a period of 6 years, 134 patients (20-82 years of age, 107 women and 27 men) underwent cranial CE-MRI and {sup 68}Ga-DOTATOC PET/CT. To compare the two methods, the lesions considered typical of meningiomas visually were counted and analysed with respect to their location and SUVmax. In the 134 patients investigated by both modalities, 190 meningiomas were detected by {sup 68}Ga-DOTATOC PET/CT and 171 by CE-MRI. With knowledge of the PET/CT data, the MRI scans were reinvestigated, which led to the detection of 4 of the 19 incidental meningiomas, resulting in an overall detection rate of 92 % of the meningioma lesions that were found by PET/CT. Ga-DOTATOC PET/CT demonstrated an improved sensitivity in meningioma detection when compared to CE-MRI. Tumours adjacent to the falx cerebri, located at the skull base or obscured by imaging artefacts or calcification are particularly difficult to detect by MRI. Therefore {sup 68}Ga-DOTATOC PET/CT may provide additional information in patients with uncertain or equivocal results on MRI or could help to confirm a diagnosis of meningioma based on MRI or could help to confirm MRI-based diagnosis of meningiomas in cases of biopsy limitations. It is possible that not only radiotherapy and surgical planning, but also follow-up strategies would benefit from this imaging modality. (orig.)

  12. Application of PET and PET/CT imaging for cancer screening

    International Nuclear Information System (INIS)

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

    2004-01-01

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

  13. 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......-computed tomography (PET/CT) and is provided to help the physician and physicist to assist to carrying out,interpret, and document quantitative FDG PET/CT examinations,but will concentrate on the optimisation of diagnostic quality and quantitative information....

  14. Pet Allergy

    Science.gov (United States)

    ... an allergic reaction to proteins found in an animal's skin cells, saliva or urine. Signs of pet allergy ... Allergens from cats and dogs are found in skin cells the animals shed (dander), as well as in their saliva, ...

  15. Modality-specific target definition for laryngeal and hypopharyngeal cancer on FDG-PET, CT and MRI.

    Science.gov (United States)

    Ligtenberg, Hans; Jager, Elise Anne; Caldas-Magalhaes, Joana; Schakel, Tim; Pameijer, Frank A; Kasperts, Nicolien; Willems, Stefan M; Terhaard, Chris H J; Raaijmakers, Cornelis P J; Philippens, Marielle E P

    2017-04-01

    The goal of this study was to improve target definition by deriving modality-specific margins for clinical target volumes (CTV) for laryngeal and hypopharyngeal cancer on CT, MRI and 18-FDG-PET. Twenty-five patients with T3/T4 laryngeal/hypopharyngeal cancer underwent CT, MRI and 18-FDG-PET scans before laryngectomy. HE-sections were obtained from the surgical specimen and tumor was delineated (tumor HE ). The GTVs on CT and MRI were delineated in consensus. PET-based GTVs were automatically segmented. The three-dimensionally reconstructed specimen was registered to the various images. Modality-specific CTV margins were derived and added to the GTVs to achieve adequate tumor coverage. The resulting CTVs were compared with each other, to tumor HE , and to CTV CT10 constructed on CT with the clinical margin of 10mm. CTV margins of 4.3mm (CT), 6.1mm (MRI) and 5.2mm (PET) were needed to achieve adequate tumor coverage. The median volumes of the resulting modality-specific CTVs were 44ml (CT), 48ml (MRI) and 39ml (PET), while the CTV 10mm was 80ml. For laryngohypopharyngeal tumors, 45-52% target volume reduction compared with CTV 10mm is achievable when modality-specific CTV margins are used. PET-based CTVs were significantly smaller compared to CT- and MRI-based CTVs. Copyright © 2017 The Authors. Published by Elsevier B.V. All rights reserved.

  16. Multimodal correlation of dynamic [18F]-AV-1451 perfusion PET and neuronal hypometabolism in [18F]-FDG PET.

    Science.gov (United States)

    Hammes, Jochen; Leuwer, Isabel; Bischof, Gérard N; Drzezga, Alexander; van Eimeren, Thilo

    2017-12-01

    Cerebral glucose metabolism measured with [18F]-FDG PET is a well established marker of neuronal dysfunction in neurodegeneration. The tau-protein tracer [18F]-AV-1451 PET is currently under evaluation and shows promising results. Here, we assess the feasibility of early perfusion imaging with AV-1451 as a substite for FDG PET in assessing neuronal injury. Twenty patients with suspected neurodegeneration underwent FDG and early phase AV-1451 PET imaging. Ten one-minute timeframes were acquired after application of 200 MBq AV-1451. FDG images were acquired on a different date according to clinical protocol. Early AV-1451 timeframes were coregistered to individual FDG-scans and spatially normalized. Voxel-wise intermodal correlations were calculated on within-subject level for every possible time window. The window with highest pooled correlation was considered optimal. Z-transformed deviation maps (ZMs) were created from both FDG and early AV-1451 images, comparing against FDG images of healthy controls. Regional patterns and extent of perfusion deficits were highly comparable to metabolic deficits. Best results were observed in a time window from 60 to 360 s (r = 0.86). Correlation strength ranged from r = 0.96 (subcortical gray matter) to 0.83 (frontal lobe) in regional analysis. ZMs of early AV-1451 and FDG images were highly similar. Perfusion imaging with AV-1451 is a valid biomarker for assessment of neuronal dysfunction in neurodegenerative diseases. Radiation exposure and complexity of the diagnostic workup could be reduced significantly by routine acquisition of early AV-1451 images, sparing additional FDG PET.

  17. RubiShort: Reducing scan time in 82Rb heart scans to minimize movements artifacts

    DEFF Research Database (Denmark)

    Madsen, Jeppe; Vraa, Kaspar J.; Harms, Hans

    Aim: Relative and absolute myocardial blood flow (MBF) can derived from a single 82Rb PET/CT scan using list mode data to extract both static and dynamic PET series. However, patient movement and changes in breathing pattern, especially during pharmacological stress, reduce the quality of the scans...

  18. A prospective study comparing whole-body skeletal X-ray survey with 18F-FDG-PET/CT, 18F-NaF-PET/CT and whole-body MRI in the detection of bone lesions in multiple myeloma patients

    DEFF Research Database (Denmark)

    Dyrberg, Eva; Hendel, Helle W; Al-Farra, Gina

    2017-01-01

    Background: For decades, the most widely used imaging technique for myeloma bone lesions has been a whole-body skeletal X-ray survey (WBXR), but newer promising imaging techniques are evolving. Purpose: To compare WBXR with the advanced imaging techniques 18F-fluorodeoxyglucose (FDG) positron......, all patients underwent FDG-PET/CT, NaF-PET/CT, and WB-MRI. Experienced specialists performed blinded readings based on predefined anatomical regions and diagnostic criteria. Results: In a region-based analysis, a two-sided ANOVA test showed that the extent of detected skeletal disease depends...... on the scanning technique (P 

  19. Clinical Evaluation of PET Image Quality as a Function of Acquisition Time in a New TOF-PET/MRI Compared to TOF-PET/CT--Initial Results.

    Science.gov (United States)

    Zeimpekis, Konstantinos G; Barbosa, Felipe; Hüllner, Martin; ter Voert, Edwin; Davison, Helen; Veit-Haibach, Patrick; Delso, Gaspar

    2015-10-01

    The purpose of this study was to compare only the performance of the PET component between a TOF-PET/CT (henceforth noted as PET/CT) scanner and an integrated TOF-PET/MRI (henceforth noted as PET/MRI) scanner concerning image quality parameters and quantification in terms of standardized uptake value (SUV) as a function of acquisition time (a surrogate of dose). The CT and MR image quality were not assessed, and that is beyond the scope of this study. Five brain and five whole-body patients were included in the study. The PET/CT scan was used as a reference and the PET/MRI acquisition time was consecutively adjusted, taking into account the decay between the scans in order to expose both systems to the same amount of the emitted signal. The acquisition times were then retrospectively reduced to assess the performance of the PET/MRI for lower count rates. Image quality, image sharpness, artifacts, and noise were evaluated. SUV measurements were taken in the liver and in the white matter to compare quantification. Quantitative evaluation showed strong correlation between PET/CT and PET/MRI brain SUVs. Liver correlation was good, however, with lower uptake estimation in PET/MRI, partially justified by bio-redistribution. The clinical evaluation showed that PET/MRI offers higher image quality and sharpness with lower levels of noise and artifacts compared to PET/CT with reduced acquisition times for whole-body scans while for brain scans there is no significant difference. The TOF-PET/MRI showed higher image quality compared to TOF-PET/CT as tested with reduced imaging times. However, this result accounts mainly for body imaging, while no significant differences were found in brain imaging.

  20. PET-Computed Tomography in Veterinary Medicine.

    Science.gov (United States)

    Randall, Elissa K

    2016-05-01

    PET/CT is an advanced imaging modality that is becoming more commonly used in veterinary medicine. It is most commonly used to image patients with cancer, and the most frequently used radiopharmaceutical is F-18 FDG. F-18 FDG is a glucose analog that highlights areas of increased glucose metabolism on the PET images. CT images provide excellent anatomic depiction and aid in interpretation of the PET data. Many types of cancer are hypermetabolic on PET/CT scans, but normal structures and areas of inflammation are also hypermetabolic, so knowledge of normal imaging and cytologic or histopathologic evaluation of lesions is essential. Copyright © 2016 Elsevier Inc. All rights reserved.

  1. 2-[(18)F]fluoro-2-deoxy-D-galactose PET/CT of hepatocellular carcinoma is not improved by co-administration of galactose.

    Science.gov (United States)

    Bak-Fredslund, Kirstine P; Munk, Ole Lajord; Keiding, Susanne; Sørensen, Michael

    2016-09-01

    PET with [(18)F]fluoro-2-deoxy-D-galactose ((18)F-FDGal) is a promising imaging modality for detection of hepatocellular carcinoma (HCC). However, it can be difficult to distinguish small intrahepatic HCC lesions from surrounding liver tissue. Ut the competitive inhibition that galactose shows towards hepatic (18)F-FDGal metabolism, we tested the hypothesis that co-administration of galactose, at near-saturating doses, inhibits (18)F-FDGal metabolism to a greater extent in non-malignant hepatocytes than in HCC cells. This would increase the tumor to background ratio in the (18)F-FDGal PET scans with co-administration of galactose. Three patients known to have HCC underwent two (18)F-FDGal PET/CT scans on consecutive days, one with and one without simultaneous constant intravenous infusion of galactose. On both days, (18)F-FDGal was injected in the beginning of a 45-min dynamic PET scan of the liver followed by a static PET scan from mid-thigh to the top of the skull starting 60-70min after (18)F-FDGal administration. Parametric images of the hepatic metabolic function expressed in terms of hepatic systemic clearance of (18)F-FDGal were generated from the dynamic PET recordings. Co-administration of galactose did not give significantly better discrimination of the HCC lesions from background. Parametric images of the hepatic metabolic function did not add additional useful information to the detection of HCC lesions compared to the static images of radioactivity concentrations. Co-administration of galactose did not improve the interpretation of the (18)F-FDGal PET/CT images and did not improve the detection of intrahepatic HCC lesions, either using static or parametric images. Copyright © 2016. Published by Elsevier Inc.

  2. Whole-Body Distribution of Donepezil as an Acetylcholinesterase Inhibitor after Oral Administration in Normal Human Subjects: A 11C-donepezil PET Study

    Directory of Open Access Journals (Sweden)

    Ikuko Mochida

    2017-01-01

    Full Text Available Objective(s: It is difficult to investigate the whole-body distribution of an orally administered drug by means of positron emission tomography (PET, owing to the short physical half-life of radionuclides, especially when 11C-labeled compounds are tested. Therefore, we aimed to examine the whole-body distribution of donepezil (DNP as an acetylcholinesterase inhibitor by means of 11C-DNP PET imaging, combined with the oral administration of pharmacological doses of DNP.Methods: We studied 14 healthy volunteers, divided into group A (n=4 and group B (n=10. At first, we studied four females (mean age: 57.3±4.5 y, three of whom underwent 11C-DNP PET scan at 2.5 h after the oral administration of 1 mg and 30 μg of DNP, respectively, while one patient was scanned following the oral administration of 30 μg of DNP (group A. Then, we studied five females and five males (48.3±6.1 y, who underwent 11C-DNP PET scan, without the oral administration of DNP (group B. Plasma DNP concentration upon scanning was measured by tandem mass spectrometry. Arterialized venous blood samples were collected periodically to measure plasma radioactivity and metabolites. In group A, 11C-DNP PET scan of the brain and whole body continued for 60 and 20 min, respectively. Subjects in group B underwent sequential whole-body scan for 60 min. The regional uptake of 11C-DNP was analyzed by measuring the standard uptake value (SUV through setting regions of interest on major organs with reference CT.Results: In group A, plasma DNP concentration was significantly correlated with the orally administered dose of DNP. The mean plasma concentration was 2.00 nM (n=3 after 1 mg oral administration and 0.06 nM (n=4 after 30 μg oral administration. No significant difference in plasma radioactivity or fraction of metabolites was found between groups A and B. High 11C-DNP accumulation was found in the liver, stomach, pancreas, brain, salivary glands, bone marrow, and myocardium in groups A

  3. Whole-Body Distribution of Donepezil as an Acetylcholinesterase Inhibitor after Oral Administration in Normal Human Subjects: A 11C-donepezil PET Study

    Science.gov (United States)

    Mochida, Ikuko; Shimosegawa, Eku; Kanai, Yasukazu; Naka, Sadahiro; Matsunaga, Keiko; Isohashi, Kayako; Horitsugi, Genki; Watabe, Tadashi; Kato, Hiroki; Hatazawa, Jun

    2017-01-01

    Objective(s): It is difficult to investigate the whole-body distribution of an orally administered drug by means of positron emission tomography (PET), owing to the short physical half-life of radionuclides, especially when 11C-labeled compounds are tested. Therefore, we aimed to examine the whole-body distribution of donepezil (DNP) as an acetylcholinesterase inhibitor by means of 11C-DNP PET imaging, combined with the oral administration of pharmacological doses of DNP. Methods: We studied 14 healthy volunteers, divided into group A (n=4) and group B (n=10). At first, we studied four females (mean age: 57.3±4.5 y), three of whom underwent 11C-DNP PET scan at 2.5 h after the oral administration of 1 mg and 30 µg of DNP, respectively, while one patient was scanned following the oral administration of 30 µg of DNP (group A). Then, we studied five females and five males (48.3±6.1 y), who underwent 11C-DNP PET scan, without the oral administration of DNP (group B). Plasma DNP concentration upon scanning was measured by tandem mass spectrometry. Arterialized venous blood samples were collected periodically to measure plasma radioactivity and metabolites. In group A, 11C-DNP PET scan of the brain and whole body continued for 60 and 20 min, respectively. Subjects in group B underwent sequential whole-body scan for 60 min. The regional uptake of 11C-DNP was analyzed by measuring the standard uptake value (SUV) through setting regions of interest on major organs with reference CT. Results: In group A, plasma DNP concentration was significantly correlated with the orally administered dose of DNP. The mean plasma concentration was 2.00 nM (n=3) after 1 mg oral administration and 0.06 nM (n=4) after 30 µg oral administration. No significant difference in plasma radioactivity or fraction of metabolites was found between groups A and B. High 11C-DNP accumulation was found in the liver, stomach, pancreas, brain, salivary glands, bone marrow, and myocardium in groups A and B

  4. PET/MR in children. Initial clinical experience in paediatric oncology using an integrated PET/MR scanner

    OpenAIRE

    Hirsch, Franz Wolfgang; Sattler, Bernhard; Sorge, Ina; Kurch, Lars; Viehweger, Adrian; Ritter, Lutz; Werner, Peter; Jochimsen, Thies; Barthel, Henryk; Bierbach, Uta; Till, Holger; Sabri, Osama; Kluge, Regine

    2013-01-01

    Use of PET/MR in children has not previously been reported, to the best of our knowledge. Children with systemic malignancies may benefit from the reduced radiation exposure offered by PET/MR. We report our initial experience with PET/MR hybrid imaging and our current established sequence protocol after 21 PET/MR studies in 15 children with multifocal malignant diseases. The effective dose of a PET/MR scan was only about 20% that of the equivalent PET/CT examination. Simultaneous acquisition ...

  5. Pet Allergy Quiz

    Science.gov (United States)

    ... Treatments ▸ Allergies ▸ Pet Allergy ▸ Pet Allergy Quiz Share | Pet Allergy Quiz More than half of U.S. households ... cat family. Yet, millions of people suffer from pet allergies. Take this quiz to test your knowledge ...

  6. Positron Emission Tomography (PET)

    Energy Technology Data Exchange (ETDEWEB)

    Welch, M.J.

    1990-01-01

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

  7. Positron Emission Tomography (PET)

    International Nuclear Information System (INIS)

    Welch, M.J.

    1990-01-01

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

  8. Positron emission tomography scanning in malignant melanoma.

    Science.gov (United States)

    Tyler, D S; Onaitis, M; Kherani, A; Hata, A; Nicholson, E; Keogan, M; Fisher, S; Coleman, E; Seigler, H F

    2000-09-01

    Several recent studies have demonstrated the low yield of anatomically based computed tomography scans in evaluating Stage III (American Joint Committee on Cancer) patients with malignant melanoma. The purpose of this study was to investigate the efficacy and clinical utility of functionally based positron emission tomography (PET) scans in the same patient population. A prospective evaluation of 106 whole body PET scans obtained after injection of 2-fluorine-18, 2-fluoro-2-deoxy-D-glucose (FDG) was performed in 95 patients with clinically evident Stage III lymph node and/or in-transit melanoma. Areas of abnormality on FDG PET scanning were identified visually as foci of increased metabolic activity compared with background, and all positive foci were assessed pathologically. In this patient population, there were 234 areas that were evaluated pathologically of which 165 were confirmed histologically to be melanoma. PET scanning identified 144 of the 165 areas of melanoma for a sensitivity of 87.3%. The 21 areas of melanoma that were missed included 10 microscopic foci, 9 foci less than 1 cm, and 2 foci greater than 1 cm. There were 39 areas of increased PET activity that were not associated with malignancy for a 78.6% predictive value of a positive test. Of the 39 false-positive areas (false-positive rate of 56.5%), 13 could be attributed to recent surgery, 3 to arthritis, 3 to infection, 2 to superficial phlebitis, 1 to a benign skin nevus, and 1 to a colonic polyp. Pathologic evaluation of the remaining false-positive areas failed to reveal a definitive etiology for their increased activity on PET scan. With the application of pertinent clinical information, the predictive value of a positive PET scan could be improved to 90. 6%. The specificity of PET scanning in this study was only 43.5% because very few prophylactic lymph node dissections were performed. Thirty-six of the total 183 abnormal areas (19.7%) on PET scanning proved to be unsuspected areas of

  9. Acute and sustained effects of methylphenidate on cognition and presynaptic dopamine metabolism: an [18F]FDOPA PET study.

    Science.gov (United States)

    Schabram, Ina; Henkel, Karsten; Mohammadkhani Shali, Siamak; Dietrich, Claudia; Schmaljohann, Jörn; Winz, Oliver; Prinz, Susanne; Rademacher, Lena; Neumaier, Bernd; Felzen, Marc; Kumakura, Yoshitaka; Cumming, Paul; Mottaghy, Felix M; Gründer, Gerhard; Vernaleken, Ingo

    2014-10-29

    Methylphenidate (MPH) inhibits the reuptake of dopamine and noradrenaline. PET studies with MPH challenge show increased competition at postsynaptic D2/3-receptors, thus indirectly revealing presynaptic dopamine release. We used [(18)F]fluorodopamine ([(18)F]FDOPA)-PET in conjunction with the inlet-outlet model (IOM) of Kumakura et al. (2007) to investigate acute and long-term changes in dopamine synthesis capacity and turnover in nigrostriatal fibers of healthy subjects with MPH challenge. Twenty healthy human females underwent two dynamic [(18)F]FDOPA PET scans (124 min; slow bolus-injection; arterial blood sampling), with one scan in untreated baseline condition and the other after MPH administration (0.5 mg/kg, p.o.), in randomized order. Subjects underwent cognitive testing at each PET session. Time activity curves were obtained for ventral putamen and caudate and were analyzed according to the IOM to obtain the regional net-uptake of [(18)F]FDOPA (K; dopamine synthesis capacity) as well as the [(18)F]fluorodopamine washout rate (kloss, index of dopamine turnover). MPH substantially decreased kloss in putamen (-22%; p = 0.003). In the reversed treatment order group (MPH/no drug), K was increased by 18% at no drug follow-up. The magnitude of K at the no drug baseline correlated with cognitive parameters. Furthermore, individual kloss changes correlated with altered cognitive performance under MPH. [(18)F]FDOPA PET in combination with the IOM detects an MPH-evoked decrease in striatal dopamine turnover, in accordance with the known acute pharmacodynamics of MPH. Furthermore, the scan-ordering effect on K suggested that a single MPH challenge persistently increased striatal dopamine synthesis capacity. Attenuation of dopamine turnover by MPH is linked to enhanced cognitive performance in healthy females. Copyright © 2014 the authors 0270-6474/14/3414769-08$15.00/0.

  10. Diagnostic and prognostic value of 18F-FDG PET/CT in recurrent germinal tumor carcinoma

    Energy Technology Data Exchange (ETDEWEB)

    Alongi, Pierpaolo [IRCSS San Raffaele Scientific Institute, Nuclear Medicine Department, Milan (Italy); San Raffaele G. Giglio Institute, Department of Radiological Sciences, Nuclear Medicine Unit, Cefalu (Italy); Evangelista, Laura [Veneto Institute of Oncology IOV - IRCCS, Nuclear Medicine and Molecular Imaging Unit, Padua (Italy); Caobelli, Federico [Basel University Hospital, Department of Nuclear Medicine, Basel (Switzerland); Spallino, Marianna [University of Milano-Bicocca, Milan (Italy); Gianolli, Luigi; Picchio, Maria [IRCSS San Raffaele Scientific Institute, Nuclear Medicine Department, Milan (Italy); Midiri, Massimo [San Raffaele G. Giglio Institute, Department of Radiological Sciences, Nuclear Medicine Unit, Cefalu (Italy); University of Palermo, Department of Radiology, DIBIMED, Palermo (Italy)

    2018-01-15

    The aim of this bicentric retrospective study was to assess the diagnostic performance, the prognostic value, the incremental prognostic value and the impact on therapeutic management of {sup 18}F-FDG PET/CT in patients with suspected recurrent germinal cell testicular carcinoma (GCT). From the databases of two centers including 31,500 {sup 18}F-FDG PET/CT oncological studies, 114 patients affected by GCT were evaluated in a retrospective study. All 114 patients underwent {sup 18}F-FDG PET/CT for suspected recurrent disease. Diagnostic performance of visually interpreted {sup 18}F-FDG PET/CT and potential impact on the treatment decision were assessed using histology (17 patients), other diagnostic imaging modalities (i.e., contrast enhanced CT in 89 patients and MRI in 15) and clinical follow-up (114 patients) as reference. Progression-free survival (PFS) and overall survival (OS) rates were computed by means of Kaplan-Meier survival analysis. The progression rate (Hazard Ratio-HR) was determined using univariate Cox regression analysis by considering various clinical variables. Recurrent GCT was confirmed in 47 of 52 patients with pathological {sup 18}F-FDG PET/CT findings, by means of histology in 18 patients and by other diagnostic imaging modalities/follow-up in 29. Sensitivity, specificity, accuracy, positive and negative likelihood ratio (LR+ and LR-, respectively), pre-test Odds-ratio and post-test Odds-ratio of {sup 18}FDG PET/CT were 86.8%, 90.2%, 88.4%, 8.85, 0.14, 0.85, 8.85, respectively.{sup 18}F-FDG PET/CT impacted significantly on therapeutic management in 26/114 (23%) cases (from palliative to curative in 12 patients, from ''wait and watch'' to new chemotherapy in six patients and the ''wait-and-watch'' approach in eight patients with unremarkable findings). At 2 and 5-year follow-up, PFS was significantly longer in patients with a negative than a pathological {sup 18}F-FDG PET/CT scan (98% and 95% vs 48% and

  11. PET/CT comparing 68Ga-DOTATATE and other radiopharmaceuticals and in comparison with CT/MRI for the localization of sporadic metastatic pheochromocytoma and paraganglioma

    International Nuclear Information System (INIS)

    Janssen, Ingo; Chen, Clara C.; Millo, Corina M.; Herscovitch, Peter; Ling, Alexander; Taieb, David; Lin, Frank I.; Adams, Karen T.; Wolf, Katherine I.; Pacak, Karel; Fojo, Antonio T.; Buchmann, Inga; Kebebew, Electron

    2016-01-01

    Pheochromocytomas/paragangliomas (PPGLs) and their metastases are tumors that predominantly express somatostatin receptor 2 (SSR2). 68 Ga-DOTA(0)-Tyr(3)-octreotate ( 68 Ga-DOTATATE) is a PET radiopharmaceutical with both high and selective affinity for SSRs. The purpose of this study was to evaluate the utility of 68 Ga-DOTATATE in comparison with other specific and nonspecific radiopharmaceuticals recommended in the current guidelines for the localization of metastatic sporadic PPGL by PET/CT. This prospective study included 22 patients (15 men, 7 women; aged 50.0 ± 13.9 years) with confirmed metastatic PPGL, a negative family history for PPGL, and negative genetic testing, who underwent 68 Ga-DOTATATE, 18 F-fluoro-2-deoxy-D-glucose ( 18 F-FDG) PET/CT, and CT/MRI. Only 12 patients underwent an additional 18 F-fluorodihydroxyphenylalanine ( 18 F-FDOPA) PET/CT scan and only 11 patients underwent an additional 18 F-fluorodopamine ( 18 F-FDA) PET/CT scan. The rates of detection of metastatic lesions were compared among all the imaging studies. A composite of all functional and anatomical imaging studies served as the imaging comparator. 68 Ga-DOTATATE PET/CT showed a lesion-based detection rate of 97.6 % (95 % confidence interval, CI, 95.8 - 98.7 %). 18 F-FDG PET/CT, 18 F-FDOPA PET/CT, 18 F-FDA PET/CT, and CT/MRI showed detection rates of 49.2 % (CI 44.5 - 53.6 %; p < 0.01), 74.8 % (CI 69.0 - 79.9 %; p < 0.01), 77.7 % (CI 71.5 - 82.8 %; p < 0.01), and 81.6 % (CI 77.8 - 84.8 %; p < 0.01), respectively. The results of this study demonstrate the superiority of 68 Ga-DOTATATE PET/CT in the localization of sporadic metastatic PPGLs compared to all other functional and anatomical imaging modalities, and suggest modification of future guidelines towards this new imaging modality. (orig.)

  12. Diagnostic imaging of exotic pets

    International Nuclear Information System (INIS)

    Silverman, S.

    1993-01-01

    Radiographic, ultrasonographic, and computed tomographic (CT) imaging are important diagnostic modalities in exotic pets. The use of appropriate radiographic equipment, film-screen combinations, and radiographic projections enhances the information obtained from radiographs. Both normal findings and common radiographic abnormalities are discussed. The use of ultrasonography and CT scanning for exotic small mammals and reptiles is described

  13. How much can a negative FDG-PET be trusted?

    International Nuclear Information System (INIS)

    Wang Shuxia

    2004-01-01

    Purpose: False-negative FDG-PET constituted 22.7% of all clinically identified negative PET in a ten year retrospective review about FDG-PET on irradiated brain tumour. Uncovering possible influencing factors of false-negative FDG-PET may have significant value. Material and methods: 10 patients with a first negative and then a second positive PET during very short time separation and 6 patients with surgically confirmed false-negative PET were traced. Histological type, irradiation parameter, steroids effect were discussed. To define temporary irradiation effect on FDG uptake, interval between radiation treatment to PET examination of these two groups were compared with 24 surgically confirmed true-positive PET, 5 surgically confirmed true-negative PET Results: 80% negative-positive PET transformation happened within 31 weeks. No statistically significant difference with regard to time from irradiation could be found between groups. Steroids medication closely before PET examination was about the same before the first negative and second positive PET scan. 5/6 surgically confirmed false-negative PET patients did not take steroids before PET examination. Conclusion: Tumour histology type, temporary irradiation effect and steroids medication did not constitute the reasons for false negative PET in our patient series. PET could not identify tumour relapse in the very early stage. Therefore, if clinically indicated, second FDG-PET might be a better selection to pick up tumour relapse instead of exploratory surgery or biopsy. In that case, the suitable time point for the second PET could be within 31 weeks after the first PET examination. Keywords: false-negative, FDG-PET, influencing factor, irradiation effect, steroids. (author)

  14. Bone metabolic activity in hyperostosis cranialis interna measured with {sup 18}F-fluoride PET

    Energy Technology Data Exchange (ETDEWEB)

    Waterval, Jerome J.; Dongen, Thijs M.A. van; Stokroos, Robert J.; Manni, Johannes J. [Maastricht University Medical Center, Department of Otorhinolaryngology and Head and Neck Surgery, Maastricht (Netherlands); Teule, Jaap G.J.; Kemerink, Gerrit J.; Brans, Boudewijn [Maastricht University Medical Center, Department of Nuclear Medicine, Maastricht (Netherlands); Nieman, Fred H.M. [Maastricht University Medical Center, Department of Clinical Epidemiology and Medical Technology Assessment, Maastricht (Netherlands)

    2011-05-15

    {sup 18}F-Fluoride PET/CT is a relatively undervalued diagnostic test to measure bone metabolism in bone diseases. Hyperostosis cranialis interna (HCI) is a (hereditary) bone disease characterised by endosteal hyperostosis and osteosclerosis of the skull and the skull base. Bone overgrowth causes entrapment and dysfunction of several cranial nerves. The aim of this study is to compare standardised uptake values (SUVs) at different sites in order to quantify bone metabolism in the affected anatomical regions in HCI patients. Nine affected family members, seven non-affected family members and nine non-HCI non-family members underwent {sup 18}F-fluoride PET/CT scans. SUVs were systematically measured in the different regions of interest: frontal bone, sphenoid bone, petrous bone and clivus. Moreover, the average {sup 18}F-fluoride uptake in the entire skull was measured by assessing the uptake in axial slides. Visual assessment of the PET scans of affected individuals was performed to discover the process of disturbed bone metabolism in HCI. {sup 18}F-Fluoride uptake is statistically significantly higher in the sphenoid bone and clivus regions of affected family members. Visual assessment of the scans of HCI patients is relevant in detecting disease severity and the pattern of disturbed bone metabolism throughout life. {sup 18}F-Fluoride PET/CT is useful in quantifying the metabolic activity in HCI and provides information about the process of disturbed bone metabolism in this specific disorder. Limitations are a narrow window between normal and pathological activity and the influence of age. This study emphasises that {sup 18}F-fluoride PET/CT may also be a promising diagnostic tool for other metabolic bone disorders, even those with an indolent course. (orig.)

  15. {sup 18}F-FDG PET/CT evaluation of children and young adults with suspected spinal fusion hardware infection

    Energy Technology Data Exchange (ETDEWEB)

    Bagrosky, Brian M. [University of Colorado School of Medicine, Department of Pediatric Radiology, Children' s Hospital Colorado, 12123 E. 16th Ave., Box 125, Aurora, CO (United States); University of Colorado School of Medicine, Department of Radiology, Division of Nuclear Medicine, Aurora, CO (United States); Hayes, Kari L.; Fenton, Laura Z. [University of Colorado School of Medicine, Department of Pediatric Radiology, Children' s Hospital Colorado, 12123 E. 16th Ave., Box 125, Aurora, CO (United States); Koo, Phillip J. [University of Colorado School of Medicine, Department of Radiology, Division of Nuclear Medicine, Aurora, CO (United States)

    2013-08-15

    Evaluation of the child with spinal fusion hardware and concern for infection is challenging because of hardware artifact with standard imaging (CT and MRI) and difficult physical examination. Studies using {sup 18}F-FDG PET/CT combine the benefit of functional imaging with anatomical localization. To discuss a case series of children and young adults with spinal fusion hardware and clinical concern for hardware infection. These people underwent FDG PET/CT imaging to determine the site of infection. We performed a retrospective review of whole-body FDG PET/CT scans at a tertiary children's hospital from December 2009 to January 2012 in children and young adults with spinal hardware and suspected hardware infection. The PET/CT scan findings were correlated with pertinent clinical information including laboratory values of inflammatory markers, postoperative notes and pathology results to evaluate the diagnostic accuracy of FDG PET/CT. An exempt status for this retrospective review was approved by the Institution Review Board. Twenty-five FDG PET/CT scans were performed in 20 patients. Spinal fusion hardware infection was confirmed surgically and pathologically in six patients. The most common FDG PET/CT finding in patients with hardware infection was increased FDG uptake in the soft tissue and bone immediately adjacent to the posterior spinal fusion rods at multiple contiguous vertebral levels. Noninfectious hardware complications were diagnosed in ten patients and proved surgically in four. Alternative sources of infection were diagnosed by FDG PET/CT in seven patients (five with pneumonia, one with pyonephrosis and one with superficial wound infections). FDG PET/CT is helpful in evaluation of children and young adults with concern for spinal hardware infection. Noninfectious hardware complications and alternative sources of infection, including pneumonia and pyonephrosis, can be diagnosed. FDG PET/CT should be the first-line cross-sectional imaging study in

  16. Estudio PET/TC en patología inflamatoria-infecciosa PET/CT in infectious and inflammatory pathology

    Directory of Open Access Journals (Sweden)

    Cecilia Carrera

    2012-06-01

    utilidad para el diagnóstico y seguimiento de pacientes con FOD. Cambia la conducta en la vasculitis sin necesidad de realizar una biopsia y es considerado el método Gold Standard. Además, es útil en el monitoreo del tratamiento y seguimiento en la sarcoidosis.Objective. To demonstrate the utility of PET/CT in infectious and inflammatory diseases. Materials and Methods. We evaluated retrospectively five patients with infectious and inflammatory pathology, by PET/CT scan (hybrid SIEMENS-BIOGRAPH 16, Siemens, Erlangen, Germany in the period between january 2009 and may 2011. Results. Case 1: a 68-year-old woman presented with a 6- months duration fever, fatigue, and weight loss. The rheumatologic examination showed a decrease in both radial pulses with no other associated symptoms. She underwent a temporal artery biopsy, which confirmed temporal arteritis. A PET/CT scan showed significant uptake in the thoracic aorta and major branches. Case 2: An 85-year-old patient with fever of unknown origin (FUO was studied suspecting osteomyelitis of the hip, but on the contrary, PET/CT demonstrated an avid enhancement indicative of gluteal cellulitis and pneumonia, ruling out bone infection. Case 3: a 35-year-old woman with evening fever. PET/CT scan showed enlarged multiple FDG-avid mediastinal, axillary and retroperitoneal lymph nodes, as well as diffuse involvement of the spleen with multiple calcifications. Diagnosis of cytomegalovirus infection was confirmed by positive immunoglobulin G and M. Case 4: a 39-year-old patient with HIV-infection presented with hypercalcemia. PET/CT scan showed buttocks silicone implants with associated avid inflammatory process, confirmed by biopsy. Case 5: a 45-year-old female with previous history of breast cancer under follow-up presented in recent CT scans enlarged mediastinal and supraclavicular lymph nodes, as well as diffuse multifocal splenic involvement, all of them avid on PET / CT examination. Sarcoidosis was confirmed by a

  17. Value of the dual phase 18F-FDG PET/CT with oral diuretic in the diagnosis of bladder cancer before therapy

    International Nuclear Information System (INIS)

    Li Hongsheng; Wu Hubing; Wang Qiaoyu; Han Yanjiang; Wang Quanshi

    2014-01-01

    Background: PET with 18 F-FDG has been considered of limited value for the detection of bladder cancer because of the urinary excretion of the tracer. Purpose: To investigate the clinical value of dual phase 18 F-FDG PET/CT with oral diuretic in the diagnosis of bladder cancer. Methods: 107 patients with suspected bladder cancer were enrolled in the present study from May, 2003 to May, 2012. Each patient underwent the whole body 18 F-FDG PET/CT scans routinely. After that, all patients received the forced diuresis by orally administration of furosemide (40 mg) and drinking a lot of water. Two hours later, after several times of urination, the patients underwent an additional delayed pelvic PET/CT scans. The intravesical radioactivity was compared between the routine and delayed the scans and the visualization of the tumor was evaluated. The diagnostic efficacy was determined based on the pathological examinations and the clinical following-up. Results: With the forced diuresis, intravesical 18 F-FDG activity decreased significantly in 96.3% of the patients. The lesions on the wall of urinary bladder were visualized clearly in the delayed PET images, which weren't seen in the rout/ne PET images. 18 F-FDG PET/CT was positive in 75 patients who all then received the operation. 69 patients were diagnosed pathologically to have the bladder cancer and 6 patients to have benign diseases. 18 F-FDG PET/CT was negative in another 32 patients. Four patients of them were then diagnosed to be bladder cancer. Another 28 patients were clinically followed up more than 6 months and none of them was found to have bladder cancer. The sensitivity, specificity and accuracy of the dual phase PET/CT imaging for diagnosing the bladder cancer were 94.5%(69/73), 82.4%(28/34) and 90.7%(97/107), respectively. Conclusion: The forced diuresis using oral furosemide can significantly reduce the intravesical radioactivity and improve the detectability of 18 F-FDG PET/CT for the bladder cancer

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

    International Nuclear Information System (INIS)

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

    2002-01-01

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

  19. Unusual Presentation of Bladder Paraganglioma: Comparison of 131I MIBG SPECT/CT and 68Ga DOTANOC PET/CT

    International Nuclear Information System (INIS)

    Jain, Tarun Kumar; Basher, Rajender Kumar; Gupta, Nitin; Shukla, Jaya; Singh, Shrawan Kumar; Mittal, Bhagwant Rai

    2016-01-01

    Extraadrenal chromaffin cell-related tumors or paragangliomas are rare, especially in the bladder, accounting for less than 1% of cases. We report a 16-year-old boy who presented with hematuria and paroxysmal headache and was found to have a prostatic growth infiltrating the urinary bladder on anatomical imaging. Iodine-131 ( 131 I) metaiodobenzylguanidine (MIBG) whole-body scanning and subsequently gallium-68 ( 68 Ga) DOTANOC positron emission tomography/computed tomography (PET/CT) were performed. The MIBG scan revealed a non-tracer-avid soft-tissue mass, while DOTANOC PET/CT revealed a tracer-avid primary soft-tissue mass involving the urinary bladder and prostate with metastasis to the iliac lymph nodes. He underwent surgical management; histopathology of the surgical specimen revealed a bladder paraganglioma, whereas the prostate was found to be free of tumor

  20. PET/CT and dedicated PET in breast cancer: Implications for classification, staging, and response monitoring

    NARCIS (Netherlands)

    Koolen, B.B.

    2013-01-01

    De PET-CT, een scan die gebruik maakt van radioactiviteit om tumoren in beeld te brengen, is een zinvol instrument voor beeldvorming van patiënten met borstkanker, met name van patiënten met een tumor groter dan drie centimeter of tumor-positieve lymfeklieren. De PET-CT is vooral van waarde voor de

  1. 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

  2. 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

  3. Investigation of (11)C-PiB equivocal PET findings.

    Science.gov (United States)

    Hosokawa, Chisa; Ishii, Kazunari; Hyodo, Tomoko; Sakaguchi, Kenta; Usami, Kimio; Shimamoto, Kenji; Yamazoe, Yuzuru; Hosono, Makoto; Hanada, Kazushi; Ueda, Masami; Saigo, Kazuma; Murakami, Takamichi

    2015-02-01

    We have encountered occasional equivocal findings when assessing cerebral cortical amyloid retention with (11)C-Pittsburgh compound B (PiB) PET. We investigated the diagnostic significance of equivocal PiB PET findings. This retrospective study included 101 consecutive patients complaining of cognitive disorders (30 Alzheimer's disease, 25 mild cognitive impairment, 8 Lewy body disease, 7 frontotemporal lobar degeneration, 31 others) who underwent both (11)C-PiB PET and (18)F-fluorodeoxy-D-glucose (FDG) PET. We visually classified PiB-positive, PiB-equivocal or PiB-negative ratings according to cortical uptake. For quantitative assessments of PiB PET, standard uptake values referred to cerebellar cortex (SUVR) were calculated in regional template volume of interests (frontal, temporoparietal, precuneus/posterior cingulate cortex, cerebral white matter and cerebellar cortex). The results of visual assessment were compared with the regional and mean cortical SUVRs and cortical-to-white matter ratio of PiB uptake, as well as clinical and FDG PET findings. Among the 101 scans, 41 were PiB negative, 11 were PiB equivocal, and 49 were rated PiB positive in the visual assessments. The mean cortical SUVR and cortical-to-white matter ratio were 0.97 ± 0.07 and 0.57 ± 0.21 in PiB-negative, 1.51 ± 0.17 and 0.75 ± 0.06 in PiB equivocal and 2.10 ± 0.33 and 0.97 ± 0.11 in PiB-positive group, respectively. Nine of 11 subjects with PiB-equivocal findings had cognitive impairments and FDG distribution compatible with Alzheimer's disease or dementia with Lewy bodies. We considered equivocal visual findings on PiB PET equivalent to PiB-positive with slight cortical uptake. In addition, slight cortical amyloid deposits were considered to cause cerebral metabolic abnormality and cognitive impairment. Although mean cortical SUVR was more sensitive than visual assessment because of low cortical-to-white matter contrast due to non-specific accumulation in white matter, it is

  4. 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-[ 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

  5. {sup 18}F-FDOPA PET/MRI fusion in patients with primary/recurrent gliomas: Initial experience

    Energy Technology Data Exchange (ETDEWEB)

    Ledezma, Carlos J. [Department of Radiological Sciences, David Geffen School of Medicine, University of California Los Angeles, 10833 Le Conte Avenue, Los Angeles, CA 90095 (United States)], E-mail: ledezmacjl@gmail.com; Chen, Wei [Department of Molecular and Medical Pharmacology, David Geffen School of Medicine, University of California Los Angeles, 10833 Le Conte Avenue, Los Angeles, CA 90095 (United States)], E-mail: weichen@mednet.ucla.edu; Sai, Victor [School of Medicine, David Geffen School of Medicine, University of California Los Angeles, 10833 Le Conte Avenue, Los Angeles, CA 90095 (United States)], E-mail: vsai@ucla.edu; Freitas, Bonnie [Department of Radiological Sciences, David Geffen School of Medicine, University of California Los Angeles, 10833 Le Conte Avenue, Los Angeles, CA 90095 (United States)], E-mail: bfreitas@mednet.ucla.edu; Cloughesy, Tim [Department of Neurology, David Geffen School of Medicine, University of California Los Angeles, 10833 Le Conte Avenue, Los Angeles, CA 90095 (United States)], E-mail: tcloughe@ucla.edu; Czernin, Johannes [Department of Molecular and Medical Pharmacology, David Geffen School of Medicine, University of California Los Angeles, 10833 Le Conte Avenue, Los Angeles, CA 90095 (United States)], E-mail: jczernin@mednet.ucla.edu; Pope, Whitney [Department of Radiological Sciences, David Geffen School of Medicine, University of California Los Angeles, 10833 Le Conte Avenue, Los Angeles, CA 90095 (United States)], E-mail: wpope@mednet.ucla.edu

    2009-08-15

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

  6. Breast Fibroadenoma With Increased Activity on 68Ga DOTATATE PET/CT.

    Science.gov (United States)

    Papadakis, Georgios Z; Millo, Corina; Sadowski, Samira M; Karantanas, Apostolos H; Bagci, Ulas; Patronas, Nicholas J

    2017-02-01

    Fibroadenoma is the most common benign breast tumor in women of reproductive age, carrying little to no risk of breast cancer development. We report on a case of a woman with history of neuroendocrine tumor who on follow-up imaging tests underwent whole-body PET/CT study using Ga DOTATATE. The scan showed increased focal activity in the right breast, which was biopsied revealing a fibroadenoma. The presented data suggests cell surface overexpression of somatostatin receptors by this benign breast tumor. Moreover, this finding emphasizes the need for cautious interpretation of Ga DOTATATE-avid breast lesions that could mimic malignancy in neuroendocrine tumor patients.

  7. Retroperitoneal bronchogenic cyst presenting paraadrenal tumor incidentally detected by {sup 18}F-FDG PET/CT

    Energy Technology Data Exchange (ETDEWEB)

    Yoon, Ye Ri; Choi, Ji Youn; Lee, Sang Mi; Kim, Yeo Joo; Cho, Hyun Deuk; Lee, Jeong Won; Jeon, Youn Soo [Soonchunhyang University Cheonan Hospital, Cheonan (Korea, Republic of)

    2015-03-15

    A follow-up 18F-fluorodeoxyglucose ({sup 18}F-FDG) PET/CT scan of a 57-year-old asymptomatic male who had undergone total thyroidectomy for thyroid cancer revealed a 5.0 x 4.0-cm, well-defined, ovoid-shaped mass around the left adrenal gland without definite FDG uptake. On the adrenal CT scan, the left paraadrenal tumor showed high attenuation on the precontrast scan without enhancement. The average Hounsfield unit (HU) was 58.1 on the precontrast scan and 58.4 on the postcontrast scan. The patient underwent laparoscopic adrenalectomy for resection of the left paraadrenal tumor. The final histopathologic examination revealed a bronchogenic cyst. Although retroperitoneal bronchogenic cysts are rare, they should be considered in the differential diagnosis of retroperitoneal cystic tumors. The preoperative diagnosis is difficult, but a contrast-enhanced CT scan or {sup 18}F-FDG PET/CT scan may be useful for differentiating hyperattenuated cysts from other soft tissue masses.

  8. Evaluating {sup 90}Y-glass microsphere treatment response of unresectable colorectal liver metastases by [{sup 18}F]FDG PET: a comparison with CT or MRI

    Energy Technology Data Exchange (ETDEWEB)

    Wong, Ching-yee Oliver; Raman, Subha; Gates, Vanessa L.; Dworkin, Howard J. [Department of Nuclear Medicine, William Beaumont Hospital, Royal Oak, MI (United States); Salem, Riad [Department of Interventional Radiology, William Beaumont Hospital, Royal Oak, MI (United States)

    2002-06-01

    The purpose of this prospective study was to evaluate yttrium-90 glass microsphere treatment of unresectable liver metastases by fluorine-18 fluorodeoxyglucose positron emission tomography ([{sup 18}F]FDG PET), and to compare the effectiveness of [{sup 18}F]FDG PET for this purpose with that of computed tomography (CT) or magnetic resonance imaging (MRI) and determination of the serum carcinoembryonic antigen (CEA) level. Thirteen hepatic lobes from eight consecutive patients with colorectal cancer referred for {sup 90}Y-glass microsphere treatment of unresectable liver metastases who underwent both baseline (pretreatment) and 3-month posttreatment PET were studied. All patients also had correlative pre- and posttreatment CT or MRI for evaluation of the anatomic response and serum CEA determination for assessment of the total tumor load, as well as pretreatment hepatic intra-arterial technetium-99m macroaggregated albumin scan for lung shunting evaluation and hepatic arteriography for assessment of vascular anatomy and treatment. {sup 90}Y-glass microspheres were infused via an intra-arterial catheter under low pressure. Dedicated whole-body PET scans were analyzed visually and compared by lesion and by lobe with CT or MRI. A metabolic response after {sup 90}Y treatment to single or both hepatic lobes, assessed by PET, was present in a significantly higher proportion of the lobes than was an anatomic response, evaluated by CT or MRI (12 vs 2 lobes respectively, P<0.0002). Posttreatment PET showed no, stable, progressive, and new extrahepatic metastases in two, three, one, and two patients respectively. Following treatment, serum CEA decreased significantly, correlating with PET but not with CT or MRI. Thus, the study demonstrated a significant difference between the metabolic and the anatomic response after {sup 90}Y-glass microsphere treatment for unresectable liver metastases in colorectal cancer. PET appears to be an accurate indicator of treatment response

  9. PET/CT and PET/MRI in head and neck malignancy.

    Science.gov (United States)

    Szyszko, T A; Cook, G J R

    2018-01-01

    Combined 2-[ 18 F]-fluoro-2-deoxy-d-glucose (FDG) positron-emission tomography (PET)/computed tomography (CT) has an established role in the staging of difficult cases of head and neck (HN) squamous cell carcinoma (SCC), looking for an unknown primary, assessing response post-chemotherapy at 3-6 months, and differentiating relapse from treatment effects in patients suspected to have tumour recurrence. The PET NECK trial, comparing PET/CT surveillance versus neck dissection in advanced head and neck cancer showed survival was similar among patients who underwent PET/CT-guided surveillance and those who underwent planned neck dissection, but surveillance was more cost-effective. There is growing interest in the use of hypoxia PET tracers, especially in targeting radiotherapy, where the radiotherapy dose can be boosted in regions of hypoxia; the use of 68 Ga peptide tracers in neuroendocrine malignancy and also in the growing field of combined PET/magnetic resonance imaging (MRI). PET/MRI has the advantage of increased anatomical detail and radiation dose reduction combined with the molecular and metabolic data from PET, although PET/CT has the advantage in better sensitivity for imaging lung metastases. Thus far, there is good agreement between PET/CT and PET/MRI with high correlation between semi-quantitative measurements in primary, nodal, osseous, and soft-tissue lesions imaging. PET/MRI may indeed provide greater accuracy than the currently available imaging procedures in the staging and later treatment response evaluation in HNSCC. Copyright © 2017. Published by Elsevier Ltd.

  10. Spectrum of neurocognitive dysfunction in Indian population on FDG PET/CT imaging

    International Nuclear Information System (INIS)

    Sharma, Rajnish; Tripathi, Madhavi; D’Souza, Maria M; Jaimini, Abhinav; Varshney, Raunak; Panwar, Puja; Kaushik, Aruna; Saw, Sanjeev; Seher, Romana; Pandey, Santosh; Singh, Dinesh; Solanki, Yachna; Mishra, Anil K; Mondal, Anupam; Tripathi, RP

    2011-01-01

    A variety of neurodegenerative disorders produce significant abnormal brain function which can be detected using fluorodeoxyglucose positron emission tomography (FDG PET) scan even when structural changes are not detected on CT or MRI Scan. A study was undertaken at our institute to evaluate the FDG PET/CT findings in Indian population suffering from mild cognitive impairment (MCI), Alzheimer's disease (AD), fronto-temporal dementia (FTD), dementia with lewy body disease (DLBD) and other miscellaneous causes of dementia. 117 subjects having neurocognitive deficits and 36 normals were included in our study. All patients underwent a detailed history and clinical examination. This was followed by a mini mental state examination. Subsequently an FDG brain PET scan and an MRI were done. In the patient population included in our study group 36 were normal, 39 had MCI, 40 had AD, 14 had FTD, and 13 had DLBD and 11 dementia due to other miscellaneous causes. MCI patients showed primarily reduced tracer uptake in the mesio-temporal cortex. AD patients showed reduced tracer concentration in temporo-parietal lobes, while patients with advanced diseases showed frontal lobe disease additionally. In subjects of FTD, reduced radiotracer uptake in the fronto-temporal lobes was noted. In addition, FTD patients also showed basal ganglia defects. In contrast the DLBD patients showed globally reduced FDG uptake including severely affecting the occipital cortices. In the current study the F18-FDG PET scans have been shown to be highly useful in the diagnosis of various neurocognitive disorders of the brain. AD was found to be the most common dementia in the Indian population followed by MCI. Diffuse Lewy body disease, FTD and other miscellaneous categories of dementia had a near similar incidence

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2004-07-01

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