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Pituitary 18F-FDG Uptake Correlates With Serum TSH Levels in Subjects With Diffuse Thyroid 18F-FDG Uptake. Clin Nucl Med 2015; 40:632-6. [PMID: 26018720 DOI: 10.1097/rlu.0000000000000793] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
PURPOSE This study was to evaluate the relationship among FDG uptake in the pituitary gland (FDGp), FDG uptake in the thyroid gland (FDGt), and serum thyroid-stimulating hormone (TSH) levels in patients with diffuse FDGt incidentally noted on positron emission tomography/computed tomography (PET/CT). PATIENTS AND METHODS We retrospectively reviewed FDG PET/CT scans of 2,945 subjects who underwent health screening. Of these, 44 subjects had diffuse FDGt and available thyroid function tests. FDGt and FDGp were correlated with serum TSH. FDGp in 44 paired control subjects without FDGt and 15 thyroid cancer patients undergoing thyroid hormone withdrawal were additionally measured, and compared with FDGp in the 44 subjects with FDGt divided into 3 groups according to serum TSH levels. RESULTS In the 44 subjects, there was a strong correlation found between FDGp and TSH (P < 0.001, r = 0.618). As well, there were statistically significant differences in FDGp between the low, normal, and high TSH groups (P < 0.001). FDGp in the paired control subjects was not different from that in the normal TSH group (P = 0.384), and FDGp in the TSH-stimulated thyroid cancer patients was not different from that in the high TSH group (P = 0.463). CONCLUSION We found a strong positive correlation between pituitary FDG uptake and serum TSH. Pituitary FDG uptake seems to hold an important clue to the functional status of the thyroid in subjects with diffuse thyroid FDG uptake. Furthermore, physiologic FDG uptake in the pituitary gland caused by hypothyroidism should not be confused with pathologic conditions such as macroadenoma or metastases.
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Mills B, Awais RO, Luckett J, Turton D, Williams P, Perkins AC, Hill PJ. [(18)F]FDG-6-P as a novel in vivo tool for imaging staphylococcal infections. EJNMMI Res 2015; 5:13. [PMID: 25853019 PMCID: PMC4385282 DOI: 10.1186/s13550-015-0095-1] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2015] [Accepted: 03/04/2015] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND Management of infection is a major clinical problem. Staphylococcus aureus is a Gram-positive bacterium which colonises approximately one third of the adult human population. Staphylococcal infections can be life-threatening and are frequently complicated by multi-antibiotic resistant strains including methicillin-resistant S. aureus (MRSA). Fluorodeoxyglucose ([(18)F]FDG) imaging has been used to identify infection sites; however, it is unable to distinguish between sterile inflammation and bacterial load. We have modified [(18)F]FDG by phosphorylation, producing [(18)F]FDG-6-P to facilitate specific uptake and accumulation by S. aureus through hexose phosphate transporters, which are not present in mammalian cell membranes. This approach leads to the specific uptake of the radiopharmaceutical into the bacteria and not the sites of sterile inflammation. METHODS [(18)F]FDG-6-P was synthesised from [(18)F]FDG. Yield, purity and stability were confirmed by RP-HPLC and iTLC. The specificity of [(18)F]FDG-6-P for the bacterial universal hexose phosphate transporter (UHPT) was confirmed with S. aureus and mammalian cell assays in vitro. Whole body biodistribution and accumulation of [(18)F]FDG-6-P at the sites of bioluminescent staphylococcal infection were established in a murine foreign body infection model. RESULTS In vitro validation assays demonstrated that [(18)F]FDG-6-P was stable and specifically transported into S. aureus but not mammalian cells. [(18)F]FDG-6-P was elevated at the sites of S. aureus infection in vivo compared to uninfected controls; however, the increase in signal was not significant and unexpectedly, the whole-body biodistribution of [(18)F]FDG-6-P was similar to that of [(18)F]FDG. CONCLUSIONS Despite conclusive in vitro validation, [(18)F]FDG-6-P did not behave as predicted in vivo. However at the site of known infection, [(18)F]FDG-6-P levels were elevated compared with uninfected controls, providing a higher signal-to-noise ratio. The bacterial UHPT can transport hexose phosphates other than glucose, and therefore alternative sugars may show differential biodistribution and provide a means for specific bacterial detection.
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Affiliation(s)
- Bethany Mills
- School of Life Sciences, Centre for Biomolecular Sciences, University of Nottingham, University Boulevard, Nottingham, NG7 2RD UK
| | - Ramla O Awais
- School of Medicine, University of Nottingham, Nottingham, NG7 2RD UK
| | - Jeni Luckett
- School of Life Sciences, Centre for Biomolecular Sciences, University of Nottingham, University Boulevard, Nottingham, NG7 2RD UK ; School of Medicine, University of Nottingham, Nottingham, NG7 2RD UK
| | - Dave Turton
- PETNET Solutions, Nottingham City Hospital, Hucknall Road, Nottingham, NG5 1 PB UK
| | - Paul Williams
- School of Life Sciences, Centre for Biomolecular Sciences, University of Nottingham, University Boulevard, Nottingham, NG7 2RD UK
| | - Alan C Perkins
- School of Medicine, University of Nottingham, Nottingham, NG7 2RD UK
| | - Philip J Hill
- School of Biosciences, University of Nottingham, Sutton Bonington Campus, Sutton Bonington, LE12 5RD UK
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Vercher-Conejero JL, Pelegrí-Martinez L, Lopez-Aznar D, Cózar-Santiago MDP. Positron Emission Tomography in Breast Cancer. Diagnostics (Basel) 2015; 5:61-83. [PMID: 26854143 PMCID: PMC4665546 DOI: 10.3390/diagnostics5010061] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2014] [Revised: 03/03/2015] [Accepted: 03/04/2015] [Indexed: 12/26/2022] Open
Abstract
Gradually, FDG-PET/CT has been strengthening within the diagnostic algorithms of oncological diseases. In many of these, PET/CT has shown to be useful at different stages of the disease: diagnosis, staging or re-staging, treatment response assessment, and recurrence. Some of the advantages of this imaging modality versus CT, MRI, bone scan, mammography, or ultrasound, are based on its great diagnostic capacity since, according to the radiopharmaceutical used, it reflects metabolic changes that often occur before morphological changes and therefore allows us to stage at diagnosis. Moreover, another advantage of this technique is that it allows us to evaluate the whole body so it can be very useful for the detection of distant disease. With regard to breast cancer, FDG-PET/CT has proven to be important when recurrence is suspected or in the evaluation of treatment response. The technological advancement of PET equipment through the development of new detectors and equipment designed specifically for breast imaging, and the development of more specific radiopharmaceuticals for the study of the different biological processes of breast cancer, will allow progress not only in making the diagnosis of the disease at an early stage but also in enabling personalized therapy for patients with breast cancer.
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Affiliation(s)
- Jose Luis Vercher-Conejero
- Clinical Area of Medical Imaging, Department of Nuclear Medicine, GIBI230, Polytechnic and University Hospital La Fe, Valencia 46026, Spain.
| | - Laura Pelegrí-Martinez
- Diagnostic Imaging, Sant Joan Despí Moisès Broggi Hospital, Sant Joan Despí, Barcelona 08970, Spain.
| | - Diego Lopez-Aznar
- Department of Nuclear Medicine, Provincial Hospital Consortium, Castellón de la Plana 12002, Spain.
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Orii T, Okumura M, Yoshimura M, Kitahara H, Karasawa Y. An FDG-PET/CT-positive lesion mimicking local recurrence of colon cancer 5 years after radical colectomy. AMERICAN JOURNAL OF CASE REPORTS 2015; 16:149-52. [PMID: 25761604 PMCID: PMC4370278 DOI: 10.12659/ajcr.891129] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Patient: Female, 75 Final Diagnosis: False positive findings Symptoms: — Medication: — Clinical Procedure: — Specialty: Surgery
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Affiliation(s)
- Takashi Orii
- Department of Surgery, Show Inan General Hospital, Akaho, Komagane, Nagano, Japan
| | - Motohiro Okumura
- Department of Surgery, Show Inan General Hospital, Akaho, Komagane, Nagano, Japan
| | - Masaki Yoshimura
- Department of Surgery, Show Inan General Hospital, Akaho, Komagane, Nagano, Japan
| | - Hiroe Kitahara
- Department of Surgery, Show Inan General Hospital, Akaho, Komagane, Nagano, Japan
| | - Yukihiko Karasawa
- Department of Surgery, Show Inan General Hospital, Akaho, Komagane, Nagano, Japan
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Zhang Y, Cai F, Liu L, Liu XD. Pathological investigation of vertebral tumor metastasis from unknown primaries--a systematic analysis. Asian Pac J Cancer Prev 2015; 16:1047-9. [PMID: 25735329 DOI: 10.7314/apjcp.2015.16.3.1047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND This systematic analysis was conducted to investigate pathological diagnosis of vertebral tumor metastasis with unknown primaries. METHODS Clinical studies conducted to pathologically investigate vertebral tumor metastasis were identified using a predefined search strategy. Pooled diagnosis (PD) of each pathological confirmation was calculated. RESULTS For vertebral tumor metastasis, 5 clinical studies which included 762 patients were considered eligible for inclusion. Systematic analysis suggested that, for all patients with vertebral tumor metastasis, dominant PD was pathologically confirmed with lung cancer in 21.7% (165/762), with breast cancer in 26.6% (203/762) and with prostate cancer in 19.2% (146/762) . Other diagnosis that could be confirmed included lymphoma, multiple myeloma, renal cancer, for example, in this cohort of patients. CONCLUSIONS This systemic analysis suggested that breast, lung and prostate lesions could be the most common pathological types of cancer for vertebral tumor metastasis formunknown primaries, and other common diagnoses could include lymphoma, multiple myeloma, renal cancer.
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Affiliation(s)
- Yan Zhang
- Department of Orthopaedic Surgery, YangPu Hospital Affiliated to Tongji University, Tongji, China E-mail :
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Peungjesada S, Aloia TA, Fox P, Chasen B, Shin S, Baiomy A, Loyer EM. 18F-FDG Uptake at the Surgical Margin after Hepatic Resection: Patterns of Uptake and Differential Diagnosis. Eur Radiol 2015; 25:2453-9. [DOI: 10.1007/s00330-015-3631-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2014] [Revised: 01/07/2015] [Accepted: 01/21/2015] [Indexed: 12/24/2022]
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Lee JR, Kim JS, Roh JL, Lee JH, Baek JH, Cho KJ, Choi SH, Nam SY, Kim SY. Detection of occult primary tumors in patients with cervical metastases of unknown primary tumors: comparison of (18)F FDG PET/CT with contrast-enhanced CT or CT/MR imaging-prospective study. Radiology 2014; 274:764-71. [PMID: 25405771 DOI: 10.1148/radiol.14141073] [Citation(s) in RCA: 57] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
PURPOSE To assess diagnostic accuracy of fluorine 18 ((18)F) fluorodeoxyglucose (FDG) combined positron emission tomography (PET) and computed tomography (CT) in the detection of occult primary tumors and determination of optimal care in patients with cervical metastasis of an unknown primary tumor (CUP) compared with contrast material-enhanced CT alone or combined contrast-enhanced CT and magnetic resonance (MR) imaging (CT/MR imaging). MATERIALS AND METHODS Institutional review board approval and written informed consent were obtained. In total, 56 patients with initially undetected tumors after endoscopic or physical examination were prospectively assessed with (18)F FDG PET/CT and contrast-enhanced CT or contrast-enhanced CT/MR imaging. The contrast-enhanced CT/MR images were read in combination. Results of guided biopsy with general anesthesia served as the reference standard. Diagnostic values of (18)F FDG PET/CT, contrast-enhanced CT, and contrast-enhanced CT/MR imaging were compared with the McNemar test. RESULTS Primary tumors were detected at 32 sites in 31 (55%) of 56 patients. There were 26 tumors in the palatine tonsil, two in the hypopharynx, two in the base of the tongue, and two in the nasopharynx. PET/CT depicted 22 (69%) of 32 primary tumors, but it failed to depict primary tumors in 10 (31%) of 32 cases. Overall, sensitivity of PET/CT (69%) in detection of primary tumors was higher than that of contrast-enhanced CT (16%) (P < .001) or contrast-enhanced CT/MR imaging (41%) (P = .039), while specificity of these methods did not differ (88%, 76%, and 59% for PET/CT, contrast-enhanced CT, and contrast-enhanced CT/MR imaging, respectively; P > .4). Diagnostic performance (area under the receiver operating characteristics curve [AUC] = 0.759) of PET/CT in tumor detection was significantly better than that of contrast-enhanced CT alone (AUC = 0.531) (P = .001) or contrast-enhanced CT/MR imaging (AUC = 0.537) (P = .036). PET/CT depicted primary tumors in eight (50%) of 16 cases of false-negative CT/MR imaging findings, one distant metastatic case, and two cases of synchronous cancer. CONCLUSION (18)F FDG PET/CT is more sensitive in detection of primary tumors than is contrast-enhanced CT or contrast-enhanced CT/MR imaging in patients with CUP; therefore, it may lead to improved therapeutic planning in these patients.
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Affiliation(s)
- Jae Ryung Lee
- From the Departments of Otolaryngology (J.R.L., J.L.R., S.H.C., S.Y.N., S.Y.K.), Nuclear Medicine (J.S.K.), Radiology (J.H.L., J.H.B.), and Pathology (K.J.C.), Asan Medical Center, University of Ulsan College of Medicine, 88 Olympic-ro 43-gil, Songpa-gu, Seoul 138-736, Republic of Korea; and Biomedical Research Institute, Korea Institute of Science and Technology, Seoul, Republic of Korea (S.Y.K.)
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Value of (18)F-FDG PET/CT in the Detection of Ovarian Malignancy. Nucl Med Mol Imaging 2014; 49:42-51. [PMID: 25774237 DOI: 10.1007/s13139-014-0303-3] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2014] [Revised: 10/14/2014] [Accepted: 10/16/2014] [Indexed: 10/24/2022] Open
Abstract
PURPOSE Ovarian cancer is a leading cause of gynecologic malignancy. As symptoms of ovarian cancer are nonspecific, only 20 % of ovarian cancers are diagnosed while they are still limited to the ovaries. Thus, early and accurate detection of disease is important for an improved prognosis. For the accurate and effective diagnosis of ovarian malignancy on (18)F-fluorodeoxyglucose ((18)F-FDG) positron emission tomography/computed tomography (PET/CT), we analyzed several parameters, including visual assessment. METHOD A total of 51 peritoneal lesions in 19 patients who showed ovarian masses with diffuse peritoneal infiltration were enrolled. Twelve patients were confirmed to have ovarian malignancy and seven patients with benign disease by pathologic examination. All patients were examined by (18)F-FDG PET/CT, and an additional 2-h delayed (18)F-FDG PET/CT was also performed for 15 patients with 42 peritoneal lesions. We measured semiquantitative parameters including maximum and mean standardized uptake values (SUVmax, SUVmean), metabolic tumor volume (MTV), and total lesion glycolysis (TLG) on a 1-h initial (18)F-FDG PET/CT image (Parameter1) and on a 2-h delayed image (Parameter2). Additionally, retention indices of each parameter were calculated, and each parameter among the malignant and benign lesions was compared by Mann-Whitney U test. We also assessed the visual characteristics of each peritoneal lesion, including metabolic extent, intensity, shape, heterogeneity, and total visual score. Associations between visual grades and malignancy were analyzed using linear by linear association methods. Moreover, a receiver operating characteristic (ROC) curve was analyzed to compare the effectiveness of significant parameters. RESULT In a comparison between the malignant and benign groups in the analysis of 51 total peritoneal lesions, SUVmax1, SUVmean1, and TLG1 showed significant differences. Also, in the analysis of 42 peritoneal lesions that underwent an additional 2-h (18)F-FDG PET/CT examination, SUVmax1,2, SUVmean1,2, TLG2, and the RI of TLG showed significant differences between the malignant and benign groups. MTV did not show significant differences in either the analysis of 51 peritoneal lesions or of 42 lesions. Regarding visual assessments, metabolic intensity, shape, heterogeneity, and total visual score showed an association with malignancy. In the ROC analysis, the AUC of the visual score was larger than the AUC of other parameters in both the analyses of 51 peritoneal lesions and of 42 lesions. CONCLUSION Although further study with a larger patient population is needed, the visual assessment of (18)F-FDG PET/CT imaging has a primary role in the detection of malignancy in ovarian cancer patients with assistance from other semi-quantitative parameters.
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Choo JY, Lee KY, Kim MY, Kang EY, Oh YW, Lee SH, Seo BK, Je BK. Pulmonary Tuberculosis Confirmed by Percutaneous Transthoracic Needle Biopsy: Analysis of CT Findings and Review of Correlations with Underlying Lung Disease. Balkan Med J 2014; 31:208-13. [PMID: 25625018 DOI: 10.5152/balkanmedj.2014.13187] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2014] [Accepted: 07/23/2014] [Indexed: 01/15/2023] Open
Abstract
BACKGROUND Pulmonary tuberculosis (TB) can produce unusual radiographic findings. Further, negative sputum and bronchoscopic results are common. Early diagnosis is equally as significant as treatment in the reduction of morbidity and mortality associated with pulmonary TB. AIMS The aim of this study was to assess computed tomography (CT) findings of pulmonary TB, confirmed via percutaneous transthoracic needle biopsy (PTNB), and to correlate these findings with coexisting, underlying, lung diseases if present. STUDY DESIGN Cross sectional study. METHODS We selected eighty-four patients who were diagnosed with pulmonary TB by way of PTNB. Initially, acid-fast bacilli smear test results from these patients were negative. CT findings were reviewed to detect the presence of parenchymal abnormalities as follows: nodule(s) (<3 cm in diameter), mass (any masses ≥3 cm), daughter nodules, air-space consolidation, cavitation, calcification, lymphadenopathy, mediastinal lymphadenopathy, and associated lung parenchymal disease. RESULTS The CT findings of pulmonary TB confirmed by PTNB included nodules in 44 of 84 (52.4%) cases; 15 of these 44 cases (34.1%) had daughter nodules. The second most common finding was masses in 24 cases (28.6%), nine of which also had daughter nodules. 16 cases (19.0%) displayed nonsegmental consolidation. Of these 16 cases, four had coexisting usual interstitial pneumonia; four others had emphysema. Two patients with a mass had underlying pneumoconiosis. CONCLUSION Nodules or a mass mimicking lung cancer were the most common findings on CT scans in patients with pulmonary TB, confirmed via PTNB. The second most common finding was airspace consolidation. Therefore, PNTB is useful for the accurate diagnosis of pulmonary TB in the following cases: airspace consolidation or mass associated with underlying usual interstitial pneumonia, emphysema mimicking lung malignancy or cases of bacterial pneumonia.
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Affiliation(s)
- Ji Young Choo
- Department of Radiology, Korea University College of Medicine, Seoul, South Korea
| | - Ki Yeol Lee
- Department of Radiology, Korea University College of Medicine, Seoul, South Korea
| | - Mi-Young Kim
- Department of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea
| | - Eun-Young Kang
- Department of Radiology, Korea University College of Medicine, Seoul, South Korea
| | - Yu Whan Oh
- Department of Radiology, Korea University College of Medicine, Seoul, South Korea
| | - Seung Hwa Lee
- Department of Radiology, Korea University College of Medicine, Seoul, South Korea
| | - Bo Kyung Seo
- Department of Radiology, Korea University College of Medicine, Seoul, South Korea
| | - Bo Kyung Je
- Department of Radiology, Korea University College of Medicine, Seoul, South Korea
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Lee HS, Kim JS, Roh JL, Choi SH, Nam SY, Kim SY. Clinical values for abnormal 18F-FDG uptake in the head and neck region of patients with head and neck squamous cell carcinoma. Eur J Radiol 2014; 83:1455-60. [DOI: 10.1016/j.ejrad.2014.05.020] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2014] [Revised: 05/09/2014] [Accepted: 05/12/2014] [Indexed: 12/14/2022]
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Jung JH, Kim SH, Kim MJ, Cho YK, Ahn SB, Son BK, Jo YJ, Park YS. A case report of primary duodenal tuberculosis mimicking a malignant tumor. Clin Endosc 2014; 47:346-9. [PMID: 25133123 PMCID: PMC4130891 DOI: 10.5946/ce.2014.47.4.346] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/27/2013] [Revised: 07/11/2013] [Accepted: 08/27/2013] [Indexed: 12/17/2022] Open
Abstract
Tuberculosis remains a serious infectious disease with primary features of pulmonary manifestation in Korea. However, duodenal tuberculosis is rare in gastrointestinal cases of extrapulmonary tuberculosis. Here, we report a case of primary duodenal tuberculosis mistaken as a malignant tumor and diagnosed with QuantiFERON-TB GOLD (Cellestis Ltd.) in an immunocompetent male patient.
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Affiliation(s)
- Ji Hye Jung
- Department of Internal Medicine, Eulji General Hospital, Eulji University School of Medicine, Seoul, Korea
| | - Seong Hwan Kim
- Department of Internal Medicine, Eulji General Hospital, Eulji University School of Medicine, Seoul, Korea
| | - Min Jeong Kim
- Department of Internal Medicine, Eulji General Hospital, Eulji University School of Medicine, Seoul, Korea
| | - Young Kwan Cho
- Department of Internal Medicine, Eulji General Hospital, Eulji University School of Medicine, Seoul, Korea
| | - Sang Bong Ahn
- Department of Internal Medicine, Eulji General Hospital, Eulji University School of Medicine, Seoul, Korea
| | - Byoung Kwan Son
- Department of Internal Medicine, Eulji General Hospital, Eulji University School of Medicine, Seoul, Korea
| | - Yun Ju Jo
- Department of Internal Medicine, Eulji General Hospital, Eulji University School of Medicine, Seoul, Korea
| | - Young Sook Park
- Department of Internal Medicine, Eulji General Hospital, Eulji University School of Medicine, Seoul, Korea
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Automated synthesis of 18F-fluoropropoxytryptophan for amino acid transporter system imaging. BIOMED RESEARCH INTERNATIONAL 2014; 2014:492545. [PMID: 25136592 PMCID: PMC4127279 DOI: 10.1155/2014/492545] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/30/2014] [Revised: 04/02/2014] [Accepted: 05/07/2014] [Indexed: 12/22/2022]
Abstract
Objective. This study was to develop a cGMP grade of [18F]fluoropropoxytryptophan (18F-FTP) to assess tryptophan transporters using an automated synthesizer. Methods. Tosylpropoxytryptophan (Ts-TP) was reacted with K18F/kryptofix complex. After column purification, solvent evaporation, and hydrolysis, the identity and purity of the product were validated by radio-TLC (1M-ammonium acetate : methanol = 4 : 1) and HPLC (C-18 column, methanol : water = 7 : 3) analyses. In vitro cellular uptake of 18F-FTP and 18F-FDG was performed in human prostate cancer cells. PET imaging studies were performed with 18F-FTP and 18F-FDG in prostate and small cell lung tumor-bearing mice (3.7 MBq/mouse, iv). Results. Radio-TLC and HPLC analyses of 18F-FTP showed that the Rf and Rt values were 0.9 and 9 min, respectively. Radiochemical purity was >99%. The radiochemical yield was 37.7% (EOS 90 min, decay corrected). Cellular uptake of 18F-FTP and 18F-FDG showed enhanced uptake as a function of incubation time. PET imaging studies showed that 18F-FTP had less tumor uptake than 18F-FDG in prostate cancer model. However, 18F-FTP had more uptake than 18F-FDG in small cell lung cancer model. Conclusion. 18F-FTP could be synthesized with high radiochemical yield. Assessment of upregulated transporters activity by 18F-FTP may provide potential applications in differential diagnosis and prediction of early treatment response.
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Sopena Novales P, Plancha Mansanet M, Martinez Carsi C, Sopena Monforte R. Medicina nuclear y radiofármacos. RADIOLOGIA 2014; 56 Suppl 1:29-37. [DOI: 10.1016/j.rx.2014.07.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2013] [Revised: 06/18/2014] [Accepted: 07/02/2014] [Indexed: 11/25/2022]
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Perirenal (18)F-FDG Uptake in a Patient with a Pheochromocytoma. Nucl Med Mol Imaging 2014; 48:233-6. [PMID: 25177382 DOI: 10.1007/s13139-014-0276-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2014] [Revised: 03/27/2014] [Accepted: 04/01/2014] [Indexed: 10/25/2022] Open
Abstract
Increased (18)F-fluorodeoxyglucose (FDG) uptake of brown fat on (18)F-FDG positron emission tomography (PET) originating from physiological activation is a common incidental finding and is usually located in the neck, shoulder, and supraclavicular areas. We present a case of an incidental pheochromocytoma showing diffusely increased (18)F-FDG uptake in bilateral perirenal fat tissue as well as supraclavicular and paravertebral fat tissue on (18)F-FDG PET/CT. The patient had no clinical symptoms except hypertension, and a pheochromocytoma was confirmed in a postsurgical specimen. A pheochromocytoma should be considered a cause in cases of increased (18)F-FDG uptake of perirenal brown fat.
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Pilomatricoma of the cheek: a benign tumor mimicking metastatic squamous cell carcinoma on FDG PET/CT. Am J Otolaryngol 2014; 35:452-5. [PMID: 24457127 DOI: 10.1016/j.amjoto.2013.12.007] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2013] [Accepted: 12/15/2013] [Indexed: 11/21/2022]
Abstract
BACKGROUND Pilomatricomas are benign skin tumors originating from hair matrix cells in the dermal layer of the skin, especially in the head and neck region. They may mimick malignant lesions on fine-needle aspirate cytology. METHODS This is a case report of a pilomatricoma of the cheek which was initially diagnosed as squamous cell carcinoma on fine-needle aspirate cytology. As part of the staging work-up, a PET/CT scan was performed, revealing a FDG-avid superficial cheek lesion and also an ipsilateral FDG-avid level II cervical lymph node, giving the impression of metastatic squamous cell carcinoma. RESULTS The cheek lesion, as well as the cervical lymph node was excised. The final histology showed benign pilomatricoma and reactive lymphadenopathy. CONCLUSION Pilomatricoma should be considered as an uncommon differential diagnosis for an FDG-avid cutaneous lesion on PET/CT, even in the presence of ipsilateral FDG-avid cervical lymphadenopathy.
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Zhu J, Wang Y, Li Z, Fang S, Zhang J. Synthesis and biological evaluation of novel 99mTc-oxo and 99mTc-nitrido complexes with phenylalanine dithiocarbamate for tumor imaging. J Radioanal Nucl Chem 2014. [DOI: 10.1007/s10967-014-3160-8] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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117
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Putzier M, Haschke F. [Diagnostic standards for extradural tumors and metastases of the spinal column]. DER ORTHOPADE 2014; 42:691-9. [PMID: 23949685 DOI: 10.1007/s00132-013-2064-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
Because of the heterogeneous clinical and paraclinical symptoms accompanied by the urgent necessity to rapidly find a diagnosis, the differential diagnostic delineation of spinal tumors from back pain related to other reasons is a special challenge in the orthopedic practice. Employing an algorithm based on anamnesis, clinical, radiological and paraclinical examinations, a guideline-related biopsy as well as histological processing of the biopsy material, tumor lesions can usually be classified regarding entity, dignity and extent. Following this a treatment strategy can be defined. Because of the necessity of an interdisciplinary approach the diagnostic algorithm should be planned during a tumor conference and performed in specialized centers.
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Affiliation(s)
- M Putzier
- Centrum für Muskuloskeletale Chirurgie, Klinik für Orthopädie, Charité-Universitätsmedizin Berlin, Charitéplatz 1, 10117, Berlin, Deutschland.
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Ozguven MA, Karacalioglu AO, Ince S, Emer MO. Altered biodistribution of FDG in patients with type-2 diabetes mellitus. Ann Nucl Med 2014; 28:505-11. [DOI: 10.1007/s12149-014-0840-y] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2013] [Accepted: 03/10/2014] [Indexed: 12/12/2022]
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Probst S, Wiehr S, Mantlik F, Schmidt H, Kolb A, Münch P, Delcuratolo M, Stubenrauch F, Pichler BJ, Iftner T. Evaluation of positron emission tomographic tracers for imaging of papillomavirus-induced tumors in rabbits. Mol Imaging 2014; 13. [PMID: 24622808 DOI: 10.2310/7290.2013.00070] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
In this study, simultaneous positron emission tomography (PET)/magnetic resonance (MR) imaging was employed to evaluate the feasibility of the PET tracers 2-deoxy-2-18F-fluoro-d-glucose (18F-FDG), 11C-choline, and 18F-fluorothymidine (18F-FLT) to detect papillomavirus-induced tumors in an established rabbit model system. The combined PET/MR allowed the analysis of tracer uptake of the tumors using the morphologic information acquired by MR. New Zealand White rabbits were infected with cottontail rabbit papillomavirus genomes and were imaged for up to 10 months with a simultaneous PET/MR system during the course of infection. The uptake characteristics of the PET tracers 11C-choline and 18F-FLT of tumors and reference tissues were examined relative to the clinical standard, 18F-FDG. Tracer biodistribution of various organs was measured by gamma-counting after the last PET scan and compared to the in vivo PET/MR 18F-FDG uptake. Increased tracer uptake was found 2 months postinfection in primary tumors with 18F-FDG and 11C-choline, whereas 18F-FLT failed to detect the tumors at all measured time points. Our data show that the PET tracer 18F-FDG is superior for imaging papillomavirus-induced tumors in rabbits compared to 11C-choline and 18F-FLT. However, 11C-choline imaging, which has previously been applied to detect various tumor entities in patients, appears to be an alternative to 18F-FDG.
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120
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Alan Selçuk N, Fenercioğlu A, Selçuk HH, Uluçay C, Yencilek E. Multifoci Bone Tuberculosis and Lymphadenitis in Mediastinum Mimics Malignancy on FDG-PET/CT: A Case Report. Mol Imaging Radionucl Ther 2014; 23:39-42. [PMID: 24653936 PMCID: PMC3957972 DOI: 10.4274/mirt.145] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2012] [Accepted: 08/09/2012] [Indexed: 12/23/2022] Open
Abstract
Positron Emission Tomography with 2-deoxy-[F-18]-fluoro-D-glucose (FDG-PET) has become a reliable diagnostic tool in clinical practice similar to Magnetic Resonance (MR) imaging and Computed Tomography (CT). FDG-PET has especially been used to differentiate malignant from benign lesions, and for staging and follow- up malignant tumors. However, FDG-PET has some pitfalls in cancer screening and FDG tracer accumulates at sites of infection and inflammation. Bone tuberculosis may be confused with malignant tumors of bone and its metastases, and can accumulate focally increased FDG in active period. We present a 60-year-old woman with lytic bone lesions and mediastinal hypermetabolic foci, initially suspected to be malignant by means of FDG-PET and the other imaging modalities; however, bone biopsy confirmed the diagnosis of bone tuberculosis. Conflict of interest:None declared.
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Affiliation(s)
- Nalan Alan Selçuk
- Yeditepe University Hospital, Department of Nuclear Medicine, İstanbul, Turkey
| | - Ayşen Fenercioğlu
- Yeditepe University Hospital, Department of Family Medicine, İstanbul, Turkey
| | | | - Cağatay Uluçay
- Yeditepe University Hospital, Department of Orthopedic Surgery, Istanbul, Turkey
| | - Esin Yencilek
- Haydarpaşa Numune Training and Research Hospital, Department of Radiology, Istanbul, Turkey
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121
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Liu Y. Fluorodeoxyglucose uptake in absence of CT abnormality on PET-CT: What is it? World J Radiol 2013; 5:460-467. [PMID: 24379932 PMCID: PMC3874502 DOI: 10.4329/wjr.v5.i12.460] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/16/2013] [Revised: 10/29/2013] [Accepted: 11/19/2013] [Indexed: 02/06/2023] Open
Abstract
The purpose of this article is to provide a pictorial review of the findings and interpretative pitfalls about focal fluorodeoxyglucose (FDG) uptake in the absence of corresponding computer tomography (CT) lesion or abnormality on an integrated positron emission tomography (PET)-CT. The integrated CT images in the PET-CT scanner allow correct co-registration and fused imaging of anatomical and functional data. On FDG PET-CT imaging, a real pathologic process often demonstrates abnormal uptake associated with a visible corresponding CT lesion or abnormality. When focal uptake is seen on PET imaging but no corresponding anatomic abnormality is visualized on the integrated CT, one should always be aware of possible mis-registration or mismatch of the PET and CT images due to the patient’s respiratory or body motion. While most of the hot spots in the absence of corresponding anatomic abnormalities are artefactual or secondary to benign etiologies, some may represent small sized or early staged neoplasm or metastases, especially in the gastrointestinal tract and skeletons. Caution should be exercised to simply diagnose a pathology based on the presence of the uptake only, or exclude the disease based on the absence of anatomic abnormality.
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Adams BN, Musa FB, Taylor J, Holcomb K. AlloDerm graft mimicking uterine carcinosarcoma recurrence on PET/CT. J OBSTET GYNAECOL 2013; 34:102-3. [PMID: 24359070 DOI: 10.3109/01443615.2013.841131] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Affiliation(s)
- B N Adams
- Departments of Obstetrics and Gynecology New York Presbyterian Hospital - Weill Cornell Medical Center
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Arana Yi C, McCue P, Rosen M, Machtay M, Axelrod R, Morris GJ. Sarcoidosis Mimicking Metastatic Bone Disease in Head and Neck Cancer. Semin Oncol 2013; 40:529-34. [DOI: 10.1053/j.seminoncol.2013.05.015] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
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Wu C, Li F, Niu G, Chen X. PET imaging of inflammation biomarkers. Theranostics 2013; 3:448-66. [PMID: 23843893 PMCID: PMC3706689 DOI: 10.7150/thno.6592] [Citation(s) in RCA: 131] [Impact Index Per Article: 11.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2013] [Accepted: 05/24/2013] [Indexed: 01/04/2023] Open
Abstract
Inflammation plays a significant role in many disease processes. Development in molecular imaging in recent years provides new insight into the diagnosis and treatment evaluation of various inflammatory diseases and diseases involving inflammatory process. Positron emission tomography using (18)F-FDG has been successfully applied in clinical oncology and neurology and in the inflammation realm. In addition to glucose metabolism, a variety of targets for inflammation imaging are being discovered and utilized, some of which are considered superior to FDG for imaging inflammation. This review summarizes the potential inflammation imaging targets and corresponding PET tracers, and the applications of PET in major inflammatory diseases and tumor associated inflammation. Also, the current attempt in differentiating inflammation from tumor using PET is also discussed.
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Berthet L, Cochet A, Kanoun S, Berriolo-Riedinger A, Humbert O, Toubeau M, Dygai-Cochet I, Legouge C, Casasnovas O, Brunotte F. In Newly Diagnosed Diffuse Large B-Cell Lymphoma, Determination of Bone Marrow Involvement with 18F-FDG PET/CT Provides Better Diagnostic Performance and Prognostic Stratification Than Does Biopsy. J Nucl Med 2013; 54:1244-50. [DOI: 10.2967/jnumed.112.114710] [Citation(s) in RCA: 128] [Impact Index Per Article: 11.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
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Kobayashi K, Bhargava P, Raja S, Nasseri F, Al-Balas HA, Smith DD, George SP, Vij MS. Image-guided biopsy: what the interventional radiologist needs to know about PET/CT. Radiographics 2013; 32:1483-501. [PMID: 22977031 DOI: 10.1148/rg.325115159] [Citation(s) in RCA: 57] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Positron emission tomography (PET)/computed tomography (CT) with fluorine 18 fluorodeoxyglucose (FDG) is increasingly used in evaluation of oncology patients. Because PET/CT can demonstrate malignancy before morphologic changes are evident, application of PET/CT information to image-guided biopsy can facilitate early histologic diagnosis and staging. However, because FDG uptake is not specific to cancer, PET/CT findings may raise questions about whether uptake in a lesion is an indication for biopsy. To properly select patients for image-guided biopsy, interventional radiologists should be familiar with the biologic significance of FDG uptake and various causes of false-positive uptake. PET/CT images may also become a source of confusion in the interpretation of biopsy results. Various causes of false-positive and false-negative FDG uptake need to be considered, especially when there is a discrepancy between biopsy results and PET/CT findings. False-negative FDG uptake can result from cancers that are too small to be observed or not FDG avid. False-positive FDG uptake can be due to underlying inflammation from recent treatment. Conversely, complete resolution of FDG uptake in a treated lesion does not necessarily indicate absence of viable cells. When questions about PET/CT findings arise in the context of image-guided biopsy, discussion with experienced nuclear imaging physicians is essential.
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Affiliation(s)
- Katsuhiro Kobayashi
- Diagnostic and Therapeutic Care Line, Section of Radiology, Michael E. DeBakey Veterans Affairs Medical Center, Baylor College of Medicine, Houston, TX 77030, USA.
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128
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Metastatic liposarcoma of the heart. Case series and brief literature review. Herz 2013; 38:938-42. [PMID: 23436031 DOI: 10.1007/s00059-013-3768-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2012] [Revised: 01/22/2013] [Accepted: 01/24/2013] [Indexed: 10/27/2022]
Abstract
Secondary cardiac tumors are 20-40 times more frequent than primary lesions. Primary cardiac lesions are represented by myxomas when related to benign tumors, and by sarcomas in terms of malignant disease. Metastases to the heart from liposarcomas are very rare. We present three cases of secondary liposarcomas involving the left atrium, the right atrium, and the pericardium.
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129
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Kong FL, Zhang Y, Young DP, Yu DF, Yang DJ. Development of (99m)Tc-EC-tyrosine for early detection of breast cancer tumor response to the anticancer drug melphalan. Acad Radiol 2013; 20:41-51. [PMID: 22963724 DOI: 10.1016/j.acra.2012.08.005] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2012] [Revised: 08/01/2012] [Accepted: 08/01/2012] [Indexed: 02/03/2023]
Abstract
RATIONALE AND OBJECTIVES Radiolabeled tyrosine analogues that have been successfully used in tumor imaging accumulate in tumor cells via an upregulated L-type amino acid transporter system. The anticancer drug melphalan is an L-type amino acid transporter substrate. Therefore, radiolabeled tyrosine analogues may have great potential in evaluating treatment responses to melphalan. In this study, a (99m)Tc-labeled tyrosine analogue, (99m)Tc tyrosine using N,N'-ethylene-di-L-cysteine (EC) as a chelator, was developed and its potential for noninvasively assessing tumors' early response to melphalan determined. MATERIALS AND METHODS EC-tyrosine was synthesized in a three-step procedure and labeled with (99m)Tc. To assess cellular uptake kinetics, the percentage uptake of (99m)Tc-EC-tyrosine in the rat breast cancer cell line 13762 was measured. Planar imaging was performed in rats with 13762 cell-derived tumors. To determine the transport mechanisms of (99m)Tc-EC-tyrosine, a competitive inhibition study using L-tyrosine as an inhibitor was performed in vitro and in vivo. To assess tumors' response to melphalan, tumor-bearing rats were treated with different doses of melphalan, and planar imaging was performed 0 and 3 days after treatment. Immunohistochemical analyses were conducted to determine expressions of L-type amino acid transporter 1 and cellular proliferation marker Ki-67. RESULTS L-tyrosine significantly inhibited (99m)Tc-EC-tyrosine uptake in vitro and in vivo. Tumor volume decreased in a dose-dependent manner with melphalan, and tumor/muscle ratios of (99m)Tc-EC-tyrosine were significantly reduced in treated groups. Immunohistochemical data indicated that about 70% of tumor cells in the melphalan-treated groups underwent apoptosis, and the changes in tumor/muscle ratios reflected the decreased percentage of viable cells in treated tumors. CONCLUSIONS These findings suggest that (99m)Tc-EC-tyrosine has great potential for monitoring tumor response to melphalan in breast tumor-bearing rats.
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Affiliation(s)
- Fan-Lin Kong
- Department of Experimental Diagnostic Imaging, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA.
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130
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Allen BC, Mohammed TL, Tan CD, Miller DV, Williamson EE, Kirsch JS. Metastatic melanoma to the heart. Curr Probl Diagn Radiol 2012; 41:159-64. [PMID: 22818836 DOI: 10.1067/j.cpradiol.2011.09.001] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Melanoma is a common neoplasm with a propensity to metastasize to the heart. Although cardiac metastasis is rarely diagnosed ante mortem, using a multimodality approach, several imaging findings may be seen. Echocardiography is often the initial imaging method used to detect cardiac metastases and their complications. On computed tomography, intraluminal filling defects and myocardial/pericardial nodules may be seen. On magnetic resonance imaging, metastatic melanoma is classically hyperintense on T1 images and hypointense on T2 images, a result of the T1 shortening of melanin; however, this is seen in a minority of cases. As melanoma metastases are fluorine-18-fluorodeoxyglucose avid, fluorine-18-fluorodeoxyglucose positron emission tomography may also be used to detect cardiac metastases.
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Affiliation(s)
- Brian C Allen
- Department of Radiology, Wake Forest Baptist Medical Center, Winston Salem, NC 27157, USA.
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131
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Gao H, Kiesewetter DO, Zhang X, Huang X, Guo N, Lang L, Hida N, Wang H, Wang H, Cao F, Niu G, Chen X. PET of glucagonlike peptide receptor upregulation after myocardial ischemia or reperfusion injury. J Nucl Med 2012; 53:1960-8. [PMID: 23139087 DOI: 10.2967/jnumed.112.109413] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
UNLABELLED Glucagonlike peptide (GLP-1) and its receptor (GLP-1R) exhibit cardioprotective effects after myocardial ischemia and reperfusion (MI/R) in both animal studies and clinical trials. However, the kinetics of GLP-1R expression in the infarcted/ischemic myocardium has not yet been explored. The purpose of this study was to monitor the presence and time course of regional myocardial GLP-1R expression after MI/R with noninvasive PET. METHODS Male Sprague-Dawley rats underwent a 45-min transient left coronary artery occlusion, followed by reperfusion. The myocardial infarction was confirmed by electrocardiogram and cardiac ultrasound. In vivo PET was performed to determine myocardial uptake of (18)F-FBEM-Cys(40)-exendin-4 at different time points after reperfusion. The localization of (18)F-FBEM-Cys(40)-exendin-4 accumulation was determined by coregistering (18)F-FDG PET and CT images. Ex vivo autoradiography, GLP-1R immunohistochemical staining, and Western blot analysis were performed to confirm the PET results. RESULTS Myocardial origin and infarcted/ischemic area localization of (18)F-FBEM-Cys(40)-exendin-4 accumulation was confirmed by coregistration of small-animal CT and (18)F-FDG images. At 8 h after MI/R, tracer uptake in the infarcted/ischemic region was 0.37 ± 0.05 percentage injected dose per gram, significantly higher than that in the control group (P < 0.01). The localized tracer uptake decreased, relative to the 8-h time point, but was still significantly higher than the control group on days 1 and 3 after MI/R. At 2 wk after MI/R, the tracer uptake in the affected area showed no significant difference, compared with that in the healthy myocardium. Autoradiography showed the same trend of (18)F-FBEM-Cys(40)-exendin-4 uptake in the myocardial infarcted/ischemic area. The specificity of tracer uptake into ischemic myocardium was supported by decreased tracer uptake after the rats were pretreated with an excess amount of unlabeled exendin-4. Immunohistochemical staining and Western blotting of GLP-1R protein of excised cardiac sections confirmed that the change in uptake observed by PET corresponded to a change in GLP-1R expression. CONCLUSION Noninvasive PET using (18)F-FBEM-Cys(40)-exendin-4 revealed a dynamic pattern of GLP-1R upregulation in the infarcted/ischemic area after MI/R. The imaging results will deepen our understanding of the mechanism of the cardioprotective effect of GLP-1 and its analogs and potentially provide guidance for optimization of the time frame of therapeutic intervention.
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Affiliation(s)
- Haokao Gao
- Department of Cardiology, Xijing Hospital, Fourth Military Medical University, Xi'an, China.
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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. Eur J Nucl Med Mol Imaging 2012; 40:12-21. [DOI: 10.1007/s00259-012-2249-y] [Citation(s) in RCA: 108] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2012] [Accepted: 09/03/2012] [Indexed: 12/19/2022]
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133
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Preoperative evaluation of patients with squamous cell carcinoma of the oral cavity: fluorine-18 fluorodeoxyglucose positron emission tomography/computed tomography and ultrasonography versus histopathology. Oral Surg Oral Med Oral Pathol Oral Radiol 2012; 114:516-25. [DOI: 10.1016/j.oooo.2012.06.004] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2012] [Revised: 05/28/2012] [Accepted: 06/01/2012] [Indexed: 11/19/2022]
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Reactive tonsillar enlargement showing strong 18F-FDG uptake during the follow-up of follicular lymphoma. Head Neck Pathol 2012; 7:258-62. [PMID: 23011892 PMCID: PMC3738754 DOI: 10.1007/s12105-012-0400-5] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/08/2012] [Accepted: 09/14/2012] [Indexed: 10/27/2022]
Abstract
The 18F-fluorodeoxyglucose positron emission tomography/computed tomography (FDG-PET/CT) has become a standard procedure for the diagnosis, staging, and restaging in lymphoma patients. However, a relative high rate of false-positive results has been reported. We report a case of a 40-year-old man with a previous history of a nodal follicular lymphoma, stage IVA, treated with R-CHOP, which showed strong 18F-FDG uptake in the Waldeyer's tonsillar ring during his follow-up, being considered highly suspicious of relapsed lymphoma. A surgical removal of the palatine tonsils and adenoids was performed, which showed reactive follicular hyperplasia. Furthermore, bone marrow biopsy revealed absence of neoplasia. The patient is still in follow-up with no signs of recurrent lymphoma. This case illustrates that, despite the high sensitivity for the detection of recurrent lymphoma, 18F-FDG uptake should be interpreted with great caution and confirmatory studies should be performed before any therapy.
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Pretreatment staging positron emission tomography/computed tomography in patients with inflammatory breast cancer influences radiation treatment field designs. Int J Radiat Oncol Biol Phys 2012; 83:1381-6. [PMID: 22284689 DOI: 10.1016/j.ijrobp.2011.10.040] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2011] [Revised: 10/18/2011] [Accepted: 10/21/2011] [Indexed: 02/03/2023]
Abstract
PURPOSE Positron emission tomography/computed tomography (PET/CT) is increasingly being utilized for staging of inflammatory breast cancer (IBC). The purpose of this study was to define how pretreatment PET/CT studies affected postmastectomy radiation treatment (PMRT) planning decisions for IBC. METHODS AND MATERIALS We performed a retrospective analysis of 62 patients diagnosed with IBC between 2004 and 2009, who were treated with PMRT in our institution and who had a staging PET/CT within 3 months of diagnosis. Patients received a baseline physical examination, staging mammography, ultrasonographic examination of breast and draining lymphatics, and chest radiography; most patients also had a bone scan (55 patients), liver imaging (52 patients), breast MRI (46 patients), and chest CT (25 patients). We compared how PET/CT findings affected PMRT, assuming that standard PMRT would target the chest wall, level III axilla, supraclavicular fossa, and internal mammary chain (IMC). Any modification of target volumes, field borders, or dose prescriptions was considered a change. RESULTS PET/CT detected new areas of disease in 27 of the 62 patients (44%). The areas of additional disease included the breast (1 patient), ipsilateral axilla (1 patient), ipsilateral supraclavicular (4 patients), ipsilateral infraclavicular (1 patient), ipsilateral IMC (5 patients), ipsilateral subpectoral (3 patients), mediastinal (8 patients), other distant/contralateral lymph nodes (15 patients), or bone (6 patients). One patient was found to have a non-breast second primary tumor. The findings of the PET/CT led to changes in PMRT in 11 of 62 patients (17.7%). These changes included additional fields in 5 patients, adjustment of fields in 2 patients, and higher doses to the supraclavicular fossa (2 patients) and IMC (5 patients). CONCLUSIONS For patients with newly diagnosed IBC, pretreatment PET/CT provides important information concerning involvement of locoregional lymph nodes, mediastinal lymph nodes, and unsuspected sites of distant metastasis. This information is important in the design of radiotherapy treatment fields and, therefore, we recommend that PET/CT be a component of initial staging for IBC.
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Khunweeraphong N, Nagamori S, Wiriyasermkul P, Nishinaka Y, Wongthai P, Ohgaki R, Tanaka H, Tominaga H, Sakurai H, Kanai Y. Establishment of stable cell lines with high expression of heterodimers of human 4F2hc and human amino acid transporter LAT1 or LAT2 and delineation of their differential interaction with α-alkyl moieties. J Pharmacol Sci 2012; 119:368-80. [PMID: 22850614 PMCID: PMC7128428 DOI: 10.1254/jphs.12124fp] [Citation(s) in RCA: 60] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023] Open
Abstract
System L is a major transport system for cellular uptake of neutral amino acids. Among system L transporters, L-type amino acid transporter 1 (LAT1) is responsible for the nutrient uptake in cancer cells, whereas L-type amino acid transporter 2 (LAT2) is a transporter for non-cancer cells. In this study, we have established HEK293 cell lines stably expressing high levels of human LAT1 and LAT2 forming heterodimers with native human 4F2hc of the cells. We have found that l-[14C]alanine is an appropriate substrate to examine the function of LAT2, whereas l-[14C]leucine is used for LAT1. By using l-[14C]alanine on LAT2, we have for the first time directly evaluated the function of human LAT2 expressed in mammalian cells and obtained its reliable kinetics. Using α-alkyl amino acids including α-methyl-alanine and α-ethyl-l-alanine, we have demonstrated that α-alkyl groups interfere with the interaction with LAT2. These cell lines with higher practical advantages would be useful for screening and analyzing compounds to develop LAT1-specific drugs that can be used for cancer diagnosis and therapeutics. The strategy that we took to establish the cell lines would also be applicable to the other heterodimeric transporters with important therapeutic implications.
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Affiliation(s)
- Narakorn Khunweeraphong
- Division of Bio-system Pharmacology, Department of Pharmacology, Graduate School of Medicine, Osaka University, Japan
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137
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The use of multiple time point dynamic positron emission tomography/computed tomography in patients with oral/head and neck cancer does not predictably identify metastatic cervical lymph nodes. J Oral Maxillofac Surg 2012; 71:162-77. [PMID: 22742956 DOI: 10.1016/j.joms.2012.03.028] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2012] [Revised: 03/20/2012] [Accepted: 03/21/2012] [Indexed: 11/24/2022]
Abstract
PURPOSE To determine whether the time course of 18-fluorine fluorodeoxyglucose (18F-FDG) activity in multiple consecutively obtained 18F-FDG positron emission tomography (PET)/computed tomography (CT) scans predictably identifies metastatic cervical adenopathy in patients with oral/head and neck cancer. It is hypothesized that the activity will increase significantly over time only in those lymph nodes harboring metastatic cancer. PATIENTS AND METHODS A prospective cohort study was performed whereby patients with oral/head and neck cancer underwent consecutive imaging at 9 time points with PET/CT from 60 to 115 minutes after injection with (18)F-FDG. The primary predictor variable was the status of the lymph nodes based on dynamic PET/CT imaging. Metastatic lymph nodes were defined as those that showed an increase greater than or equal to 10% over the baseline standard uptake values. The primary outcome variable was the pathologic status of the lymph node. RESULTS A total of 2,237 lymph nodes were evaluated histopathologically in the 83 neck dissections that were performed in 74 patients. A total of 119 lymph nodes were noted to have hypermetabolic activity on the 90-minute (static) portion of the study and were able to be assessed by time points. When we compared the PET/CT time point (dynamic) data with the histopathologic analysis of the lymph nodes, the sensitivity, specificity, positive predictive value, negative predictive value, and accuracy were 60.3%, 70.5%, 66.0%, 65.2%, and 65.5%, respectively. CONCLUSIONS The use of dynamic PET/CT imaging does not permit the ablative surgeon to depend only on the results of the PET/CT study to determine which patients will benefit from neck dissection. As such, we maintain that surgeons should continue to rely on clinical judgment and maintain a low threshold for executing neck dissection in patients with oral/head and neck cancer, including those patients with N0 neck designations.
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138
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Coolen J, De Keyzer F, Nafteux P, De Wever W, Dooms C, Vansteenkiste J, Roebben I, Verbeken E, De Leyn P, Van Raemdonck D, Nackaerts K, Dymarkowski S, Verschakelen J. Malignant Pleural Disease: Diagnosis by Using Diffusion-weighted and Dynamic Contrast-enhanced MR Imaging—Initial Experience. Radiology 2012; 263:884-92. [DOI: 10.1148/radiol.12110872] [Citation(s) in RCA: 71] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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139
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Abdoli M, Dierckx RAJO, Zaidi H. Metal artifact reduction strategies for improved attenuation correction in hybrid PET/CT imaging. Med Phys 2012; 39:3343-60. [DOI: 10.1118/1.4709599] [Citation(s) in RCA: 66] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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Development of tyrosine-based radiotracer 99mTc-N4-Tyrosine for breast cancer imaging. J Biomed Biotechnol 2012; 2012:671708. [PMID: 22496612 PMCID: PMC3303751 DOI: 10.1155/2012/671708] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2011] [Accepted: 12/13/2011] [Indexed: 01/03/2023] Open
Abstract
The purpose of this study was to develop an efficient way to synthesize 99mTc-O-[3-(1,4,8,11-tetraazabicyclohexadecane)-propyl]-tyrosine (99mTc-N4-Tyrosine), a novel amino acid-based radiotracer, and evaluate its potential in breast cancer gamma imaging. Precursor N4-Tyrosine was synthesized using a 5-step procedure, and its total synthesis yield was 38%. It was successfully labeled with 99mTc with high radiochemical purity (>95%). Cellular uptake of 99mTc-N4-Tyrosine was much higher than that of 99mTc-N4 and the clinical gold standard 18F-2-deoxy-2-fluoro-glucose (18F-FDG) in rat breast tumor cells in vitro. Tissue uptake and dosimetry estimation in normal rats revealed that 99mTc-N4-Tyrosine could be safely administered to humans. Evaluation in breast tumor-bearing rats showed that although 99mTc-N4-Tyrosine appeared to be inferior to 18F-FDG in distinguishing breast tumor tissue from chemical-induced inflammatory tissue, it had high tumor-to-muscle uptake ratios and could detect breast tumors clearly by planar scintigraphic imaging. 99mTc-N4-Tyrosine could thus be a useful radiotracer for use in breast tumor diagnostic imaging.
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141
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Vaz AP, Fernandes G, Souto Moura C, Bastos P, Queiroga H, Hespanhol V. Integrated PET/CT in non small cell lung cancer staging--clinical and pathological agreement. REVISTA PORTUGUESA DE PNEUMOLOGIA 2012; 18:109-14. [PMID: 22405953 DOI: 10.1016/j.rppneu.2012.01.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2011] [Accepted: 01/10/2012] [Indexed: 12/25/2022] Open
Abstract
INTRODUCTION Integrated PET/CT has become a fundamental tool in the preoperative assessment of non small lung cancer (NSCLC) providing useful anatomical and metabolic information to characterize tumoral lesions and to detect unsuspected metastatic disease. AIM To compare the agreement between clinical and pathological staging before and after the use of PET/CT. MATERIAL AND METHODS Retrospective study of patients with NSCLC who underwent potentially curative surgery throughout 10.5 years. Cohen's kappa coefficient was used to evaluate staging agreement. RESULTS One hundred and fifty patients were evaluated, 78% males, with a mean age of 65 (±9.6) years. Thirteen percent were submitted to neoadjuvant chemotherapy. PET/CT was performed in 41%. Global agreement between clinical and pathological staging was 51% (kappa=0.3639). There was a statistically significant difference between the staging results in patients who underwent PET/CT, when compared to the subgroup who did not (p=0.003). For those with PET/CT false negatives occurred in less 39%, false positives in more 12% and clinical and pathological staging coincided in more 27%. The overall results reflected an improvement in the agreement between clinical and pathological staging in the PET/CT subgroup (67%, kappa=0.5737 vs 40%, kappa=0.2292). PET/CT accuracy was enhanced when patients re-staged after neoadjuvant therapy were excluded and a substantial staging agreement was obtained for those who had the exam only for staging purposes (73%, kappa=0.6323). CONCLUSION Inclusion of PET/CT in NSCLC preoperative assessment improved the accuracy of the clinical staging, with a good level of agreement with pathological staging.
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Affiliation(s)
- A P Vaz
- Serviço de Pneumologia, Centro Hospitalar de São João, Porto, Portugal.
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Sharma R, Aboagye E. Development of radiotracers for oncology--the interface with pharmacology. Br J Pharmacol 2012; 163:1565-85. [PMID: 21175573 DOI: 10.1111/j.1476-5381.2010.01160.x] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
There is an increasing role for positron emission tomography (PET) in oncology, particularly as a component of early phase clinical trials. As a non-invasive functional imaging modality, PET can be used to assess both pharmacokinetics and pharmacodynamics of novel therapeutics by utilizing radiolabelled compounds. These studies can provide crucial information early in the drug development process that may influence the further development of novel therapeutics. PET imaging probes can also be used as early biomarkers of clinical response and to predict clinical outcome prior to the administration of therapeutic agents. We discuss the role of PET imaging particularly as applied to phase 0 studies and discuss the regulations involved in the development and synthesis of novel radioligands. The review also discusses currently available tracers and their role in the assessment of pharmacokinetics and pharmacodynamics as applied to oncology.
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Affiliation(s)
- Rohini Sharma
- Comprehensive Cancer Imaging Centre, Imperial College London Hammersmith Campus, Du Cane Road, London, UK
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143
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Schoffelen R, van der Graaf WT, Sharkey RM, Franssen GM, McBride WJ, Chang CH, Laverman P, Goldenberg DM, Oyen WJ, Boerman OC. Pretargeted immuno-PET of CEA-expressing intraperitoneal human colonic tumor xenografts: a new sensitive detection method. EJNMMI Res 2012; 2:5. [PMID: 22284761 PMCID: PMC3298693 DOI: 10.1186/2191-219x-2-5] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2011] [Accepted: 01/27/2012] [Indexed: 01/13/2023] Open
Abstract
BACKGROUND In this study, pretargeted immuno-positron-emission tomography [PET] with a bispecific monoclonal anti-carcinoembryonic antigen [CEA] (CEACAM5) × anti-hapten antibody (bispecific monoclonal antibody [bsmAb]) and a small (1.5 kD) peptide labeled with 68Ga was compared to fludeoxyglucose [18F-FDG]-PET for detecting intraperitoneal [i.p.] CEA-expressing human colonic tumor xenografts in nude mice. METHODS Two groups of female BALB/c nude mice were inoculated with LS174T human colonic tumor cells i.p. One group received 5 MBq 18F-FDG, and the other received intravenous injections of the bsmAb, followed 16 h later with 5 MBq of 68Ga-labeled peptide. One hour after the radiolabeled peptide or FDG was given, micro-PET/computed tomography images were acquired. Thereafter, the uptake of the 68Ga or 18F in dissected tissue was determined. RESULTS Within 1 h, high uptake of the 68Ga-labeled peptide in the tumor lesions (23.4 ± 7.2% ID/g) and low background activity levels were observed (e.g., tumor-to-intestine ratio, 58 ± 22). This resulted in a clear visualization of all intra-abdominal tumor lesions ≥ 10 μL and even some tumors as small as 5 μL (2 mm diameter). 18F-FDG efficiently localized in the tumors (8.7 ± 3.1% ID/g) but also showed physiological uptake in various normal tissues (e.g., tumor-to-intestine ratio, 3.9 ± 1.1). CONCLUSIONS Pretargeted immuno-PET with bsmAb and a 68Ga-labeled peptide could be a very sensitive imaging method for imaging colonic cancer, disclosing occult lesions.
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Affiliation(s)
- Rafke Schoffelen
- Dept, of Nuclear Medicine, Radboud University Nijmegen Medical Centre, 6500 HB, Nijmegen, 9101, The Netherlands.
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Thekkek N, Maru DM, Polydorides AD, Bhutani MS, Anandasabapathy S, Richards-Kortum R. Pre-clinical evaluation of fluorescent deoxyglucose as a topical contrast agent for the detection of Barrett's-associated neoplasia during confocal imaging. Technol Cancer Res Treat 2012; 10:431-41. [PMID: 21895028 PMCID: PMC4527376 DOI: 10.7785/tcrt.2012.500220] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
The availability of confocal endomicroscopy motivates the development of optical contrast agents that can delineate the morphologic and metabolic features of gastrointestinal neoplasia. This study evaluates 2-NBDG, a fluorescent deoxyglucose, the uptake of which is associated with increased metabolic activity, in the identification of Barrett’s-associated neoplasia. Surveillance biopsies from patients with varying pathologic grades of Barrett’s esophagus were incubated ex vivo at 37°C with 2-NBDG and imaged with a fluorescence confocal microscope. Images were categorized as neoplastic (high grade dysplasia, esophageal adenocarcinoma) or metaplastic (intestinal metaplasia, low grade dysplasia) based on the degree of glandular 2-NBDG uptake. Classification accuracy was assessed using histopathology as the gold standard. Forty-four biopsies were obtained from twenty-six patients; 206 sites were imaged. The glandular mean fluorescence intensity of neoplastic sites was significantly higher than that of metaplastic sites (p < 0.001). Chronic inflammation was associated with increased 2-NBDG uptake in the lamina propria but not in glandular epithelium. Sites could be classified as neoplastic or not with 96% sensitivity and 90% specificity based on glandular mean fluorescence intensity. Classification accuracy was not affected by the presence of inflammation. By delineating the metabolic and morphologic features of neoplasia, 2-NBDG shows promise as a topical contrast agent for confocal imaging. Further in vivo testing is needed to determine its performance in identifying neoplasia during confocal endomicroscopic imaging.
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Affiliation(s)
- N Thekkek
- Department of Bioengineering, Rice University, 6100 Main St., MS 142, Houston, TX 77005, USA
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145
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Sato R, Ichiyasu H, Saeki S, Sakata S, Sasaki JI, Fujii K, Saita N, Kohrogi H. FDG-PET and chemotherapy for successful diagnosis and treatment of cardiac metastasis from non-small cell lung cancer. Intern Med 2012; 51:1909-12. [PMID: 22821111 DOI: 10.2169/internalmedicine.51.7330] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Non-small cell lung cancer was metastasized at the septal side of right atrium in 59-year-old woman who had undergone surgery for lung cancer 11 years ago. The cardiac metastasis was found by whole-body 18F-fluoro-deoxy-glucose positron emission tomography/computed tomography (FDG-PET/CT), and cytologically confirmed by myocardial aspiration biopsy with right heart catheterization. The patient was treated with 4 cycles of carboplatin/pemetrexed followed by maintenance therapy with pemetrexed. The metastatic cardiac tumor shrank, and the atrioventricular (AV) block in ECG was improved. In this case, FDG-PET and chemotherapy were valuable for diagnosis and treatment of cardiac metastasis from non-small cell lung cancer.
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Affiliation(s)
- Ryo Sato
- Department of Respiratory Medicine, Kumamoto University Hospital, Japan
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146
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Hahn S, Bauer S, Heusner TA, Ebeling P, Hamami ME, Stahl A, Forsting M, Bockisch A, Antoch G. Postoperative FDG-PET/CT staging in GIST: Is there a benefit following R0 resection? Eur J Radiol 2011; 80:670-4. [DOI: 10.1016/j.ejrad.2010.09.017] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2010] [Revised: 09/18/2010] [Accepted: 09/20/2010] [Indexed: 11/16/2022]
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Prognostic significance of mediastinal 18F-FDG uptake in PET/CT in advanced ovarian cancer. Eur J Nucl Med Mol Imaging 2011; 39:474-80. [PMID: 22109667 DOI: 10.1007/s00259-011-1984-9] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2011] [Accepted: 10/21/2011] [Indexed: 10/15/2022]
Abstract
PURPOSE To evaluate the prognostic significance of increased mediastinal (18)F-FDG uptake in PET/CT for the staging of advanced ovarian cancer. METHODS We retrospectively evaluated patients managed for FIGO stage III/IV ovarian cancer between 1 January 2006 and 1 June 2009. Patients were included if they had undergone (18)F-FDG PET/CT and surgery for initial staging. Exclusion criteria were age younger than 18 years, inability to undergo general anaesthesia, recurrent ovarian cancer, and borderline or nonepithelial malignancy. Whole-body PET/CT was performed after intravenous (18)F-FDG injection. The location of abnormal hot spots and (18)F-FDG maximal standard uptake values (SUV(max)) were recorded. We compared the complete cytoreduction and survival rates in groups defined based on mediastinal (18)F-FDG uptake and SUV(max) values. Kaplan-Meier curves of overall survival and disease-free survival were compared using the log-rank test. Hazard ratios with their 95% confidence intervals were computed. Adjusted hazard ratios were obtained using a multivariate Cox model. RESULTS We included 53 patients, of whom 17 (32%) had increased mediastinal (18)F-FDG uptake. Complete cytoreduction was achieved in 14 (87.5%) of the 16 patients managed with primary surgery and in 21 (75%) of the 28 patients managed with interval surgery. Complete cytoreduction was achieved significantly more often among patients without increased mediastinal (18)F-FDG uptake (80.6% vs. 35.3%; p = 0.001). Disease-free survival was comparable between the two groups. By univariate analysis, overall mortality was significantly higher among patients with increased mediastinal (18)F-FDG uptake (hazard ratio 5.70, 95% confidence interval 1.74-18.6). The only factor significantly associated with overall survival by multivariate analysis was complete cytoreduction (adjusted hazard ratio 0.24, 95% confidence interval 0.07-0.89). CONCLUSION Increased mediastinal (18)F-FDG uptake was common in patients with advanced ovarian cancer. However, complete cytoreduction, which was significantly more frequent among patients without mediastinal (18)F-FDG uptake, was the only factor independently associated with survival.
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Cottone L, Valtorta S, Capobianco A, Belloli S, Rovere-Querini P, Fazio F, Manfredi AA, Moresco RM. Evaluation of the Role of Tumor-Associated Macrophages in an Experimental Model of Peritoneal Carcinomatosis Using 18F-FDG PET. J Nucl Med 2011; 52:1770-7. [DOI: 10.2967/jnumed.111.089177] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
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149
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Yeh CL, Liou JY, Chen SW, Chen YK. Infective endocarditis detected by 18F-fluoro-2-deoxy-d-glucose positron emission tomography/computed tomography in a patient with occult infection. Kaohsiung J Med Sci 2011; 27:528-31. [DOI: 10.1016/j.kjms.2011.06.018] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2010] [Accepted: 10/08/2010] [Indexed: 10/17/2022] Open
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150
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Song J, Leonardo L, Wang Y, Joseph V. Cardiac tamponade secondary to left ventricular wall rupture during an urgent thoracolumbar spinal decompression and fusion surgery. J Cardiothorac Vasc Anesth 2011; 27:98-100. [PMID: 22033352 DOI: 10.1053/j.jvca.2011.09.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/01/2011] [Indexed: 11/11/2022]
Affiliation(s)
- Jing Song
- Department of Anesthesiology, Montefiore Medical Center, Bronx, NY, USA.
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