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Rabkin Z, Israel O, Keidar Z. Do Hyperglycemia and Diabetes Affect the Incidence of False-Negative 18F-FDG PET/CT Studies in Patients Evaluated for Infection or Inflammation and Cancer? A Comparative Analysis. J Nucl Med 2010; 51:1015-20. [DOI: 10.2967/jnumed.109.074294] [Citation(s) in RCA: 104] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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Balan A, Hoey ETD, Sheerin F, Lakkaraju A, Chowdhury FU. Multi-technique imaging of sarcoidosis. Clin Radiol 2010; 65:750-60. [PMID: 20696303 DOI: 10.1016/j.crad.2010.03.014] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2009] [Revised: 03/16/2010] [Accepted: 03/22/2010] [Indexed: 01/12/2023]
Abstract
Sarcoidosis is a multisystem granulomatous disorder of unknown aetiology. The diagnosis is suggested on the basis of wide ranging clinical and radiological manifestations, and is supported by the histological demonstration of non-caseating granulomas in affected tissues. This review highlights the multisystem radiological features of the disease across a variety of imaging methods including multidetector computed tomography (CT), magnetic resonance imaging (MRI) as well as functional radionuclide techniques, particularly 2-[(18)F]-fluoro-2-deoxy-d-glucose (FDG) positron emission tomography/computed tomography (PET/CT). It is important for the radiologist to be aware of the varied radiological manifestations of sarcoidosis in order to recognize and suggest the diagnosis in the appropriate clinical setting.
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Affiliation(s)
- A Balan
- Department of Clinical Radiology, Leeds Teaching Hospitals NHS Trust, Leeds, UK
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253
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Liozon E, Monteil J, Ly KH, Vidal E. [Vasculitis assessment with [18F]FDG positron emission tomography]. Rev Med Interne 2010; 31:417-27. [PMID: 20416990 DOI: 10.1016/j.revmed.2009.06.011] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2008] [Revised: 05/27/2009] [Accepted: 06/22/2009] [Indexed: 10/19/2022]
Abstract
[18F]fluorodeoxyglucose positron emission tomography (PET) is a noninvasive metabolic imaging modality that is well-suited to the assessment of activity and extent of large vessel vasculitis. PET imaging has demonstrated its usefulness in diagnosing giant cell arteritis (notably in its silent form), Takayasu's arteritis, and unclassified aortitis. PET imaging could be more effective than magnetic resonance imaging in detecting the earliest stages of vascular wall inflammation. The visual grading of vascular [18F]FDG uptake makes it possible to discriminate arteritis from active atherosclerosis, providing therefore high specificity. High sensitivity can also be achieved provided scanning is performed during active inflammatory phase, preferably before starting corticosteroid treatment. Prospective studies are needed to determine the exact value of PET imaging in assessing other vasculitis subsets, infectious aortitis, and large vessel vasculitis outcome and response to immunosuppressive treatment.
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Affiliation(s)
- E Liozon
- Service de médecine interne A, CHU Dupuytren, 2, rue Martin-Luther-King, 87042 Limoges, France.
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254
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de Barros ALB, Cardoso VN, Mota LDG, Leite EA, de Oliveira MC, Alves RJ. A novel d-glucose derivative radiolabeled with technetium-99m: Synthesis, biodistribution studies and scintigraphic images in an experimental model of Ehrlich tumor. Bioorg Med Chem Lett 2010; 20:2478-80. [DOI: 10.1016/j.bmcl.2010.03.003] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2010] [Revised: 02/26/2010] [Accepted: 03/01/2010] [Indexed: 11/27/2022]
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255
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The clinical value of incidental 18F-fluorodeoxyglucose-avid foci detected on positron emission tomography/computed tomography. Nucl Med Commun 2010; 31:128-36. [DOI: 10.1097/mnm.0b013e328332b30e] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
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256
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F-18 Fluorodeoxyglucose and F-18 Fluorothymidine Positron Emission Tomography/Computed Tomography Imaging in a Case of Neurosarcoidosis. Clin Nucl Med 2010; 35:67-70. [DOI: 10.1097/rlu.0b013e3181c7c149] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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257
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Abstract
OBJECTIVE The purpose of this review is to assist interpreting radiologists in becoming familiar with the role of PET/CT in baseline staging and therapeutic response assessment in the management of lymphoma, in becoming aware of imaging pitfalls, and in understanding the natural behavior of lymphoma and the therapeutic options. CONCLUSION Therapeutic strategies for the management of lymphoma are constantly being refined to improve long-term survival with the lowest risk of toxicity to the patient. PET/CT is accurate for baseline staging and yields important prognostic information for determining the most appropriate initial treatment. Used for evaluation of treatment response, PET/CT can depict residual viable malignant lesions with greater accuracy than can other imaging techniques. The findings thereby influence decisions about the need for additional or alternative treatment.
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Circulating procalcitonin in aseptic carcinoma patients: a specificity study with 18F-fluorodeoxyglucose positron-emission tomography/computed tomography as benchmark. Clin Chem Lab Med 2010; 48:1163-5. [DOI: 10.1515/cclm.2010.214] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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259
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Winkeler A, Boisgard R, Martin A, Tavitian B. Radioisotopic imaging of neuroinflammation. J Nucl Med 2009; 51:1-4. [PMID: 20008995 DOI: 10.2967/jnumed.109.065680] [Citation(s) in RCA: 49] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Inflammatory responses are closely associated with many neurologic disorders and influence their outcome. In vivo imaging can document events accompanying neuroinflammation, such as changes in blood flow, vascular permeability, tightness of the blood-to-brain barrier, local metabolic activity, and expression of specific molecular targets. Here, we briefly review current methods for imaging neuroinflammation, with special emphasis on nuclear imaging techniques.
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Affiliation(s)
- Alexandra Winkeler
- CEA, I(2)BM, Service Hospitalier Frédéric Joliot, LIME, INSERM U803, 91400 Orsay, France
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261
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Bonaventure T, Goéré D, Boige V, Pocard M. Méfiez vous du TEP-scan en cas de cancer sur maladie inflammatoire chronique de l’intestin. ACTA ACUST UNITED AC 2009; 146:579-82. [DOI: 10.1016/j.jchir.2009.10.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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262
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Delbeke D, Schöder H, Martin WH, Wahl RL. Hybrid imaging (SPECT/CT and PET/CT): improving therapeutic decisions. Semin Nucl Med 2009; 39:308-40. [PMID: 19646557 DOI: 10.1053/j.semnuclmed.2009.03.002] [Citation(s) in RCA: 98] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
The incremental diagnostic value of integrated positron emission tomography-computed tomography (PET/CT) or single-photon emission computed tomography (SPECT)/CT images compared with PET or SPECT alone, or PET or SPECT correlated with a CT obtained at a different time includes the following: (1) improvement in lesion detection on both CT and PET or SPECT images, (2) improvement in the localization of foci of uptake resulting in better differentiation of physiological from pathologic uptake, (3) precise localization of the malignant foci, for example, in the skeleton vs soft tissue or liver vs adjacent bowel or node (4) characterization of serendipitous lesions, and (5) confirmation of small, subtle, or unusual lesions. The use of these techniques can occur at the time of initial diagnosis, in assessing the early response of disease to treatment, at the conclusion of treatment, and in continuing follow-up of patients. PET/CT and SPECT/CT fusion images affect the clinical management in a significant proportion of patients with a wide range of diseases by (1) guiding further procedures, (2) excluding the need of further procedures, (3) changing both inter- and intramodality therapy, including soon after treatment has been initiated, and (4) by providing prognostic information. PET/CT fusion images have the potential to provide important information to guide the biopsy of a mass to active regions of the tumor and to provide better maps than CT alone to modulate field and dose of radiation therapy. It is expected that the role of PET/CT and SPECT/CT in changing management will continue to evolve in the future and that these tools will be fundamental components of the truly "personalized medicine" we are striving to deliver.
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Affiliation(s)
- Dominique Delbeke
- Department of Radiology and Radiological Sciences, Vanderbilt University Medical Center, Nashville, TN 37232-2675, USA.
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263
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Vijayanathan S, Butt S, Gnanasegaran G, Groves AM. Advantages and Limitations of Imaging the Musculoskeletal System by Conventional Radiological, Radionuclide, and Hybrid Modalities. Semin Nucl Med 2009; 39:357-68. [DOI: 10.1053/j.semnuclmed.2009.07.001] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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264
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Shammas A, Lim R, Charron M. Pediatric FDG PET/CT: physiologic uptake, normal variants, and benign conditions. Radiographics 2009; 29:1467-86. [PMID: 19755606 DOI: 10.1148/rg.295085247] [Citation(s) in RCA: 85] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
Positron emission tomography (PET) with 2-[fluorine-18]fluoro-2-deoxy-D-glucose (FDG) is increasingly being used in the evaluation of pediatric oncology patients. However, the normal distribution of (18)F FDG uptake in children is unique and may differ from that in adults. A number of physiologic variants are commonly encountered, including normal physiologic uptake in the head and neck, heart, breast, thymus, liver, spleen, gastrointestinal tract, genital system, urinary collecting system, bone marrow, muscles, and brown adipose tissue. Benign lesions with increased (18)F FDG uptake are also frequently seen and can be misinterpreted as malignancies. In addition, the use of combined PET/computed tomographic (CT) scanners is associated with pitfalls and artifacts such as attenuation correction and misregistration. Proper interpretation of pediatric (18)F FDG PET/CT studies requires knowledge of the normal distribution of (18)F FDG uptake in children, as well as of the aforementioned physiologic variants, benign lesions, and PET/CT-related artifacts. Knowing these potential causes of misinterpretation can increase accuracy in PET image interpretation, decrease the number of unnecessary follow-up studies or procedures, and improve patient treatment.
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Affiliation(s)
- Amer Shammas
- Department of Diagnostic Imaging, Hospital for Sick Children, University of Toronto, 555 University Ave, Toronto, ON, Canada.
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265
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Herbort CP, Rao NA, Mochizuki M. International criteria for the diagnosis of ocular sarcoidosis: results of the first International Workshop On Ocular Sarcoidosis (IWOS). Ocul Immunol Inflamm 2009; 17:160-9. [PMID: 19585358 DOI: 10.1080/09273940902818861] [Citation(s) in RCA: 361] [Impact Index Per Article: 24.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
AIM To report criteria for the diagnosis of intraocular sarcoidosis, taking into account suggestive clinical signs and appropriate laboratory investigations and biopsy results. DESIGN Concensus workshop of an international committee on nomenclature. METHODS An international group of uveitis specialists from Asia, Africa, Europe, and America met in a concensus conference in Shinagawa, Tokyo on October 28-29, 2006. Based on questionnaires that had been sent out prior to the conference, the participants discussed potential intraocular clinical signs eligible for a diagnosis of ocular sarcoidosis. A refined definition of clinical signs, which received two-thirds majority of votes, was included in the list of signs consistent with ocular sarcoidosis. Laboratory investigations were similarly discussed and those tests reaching a two-thirds majority were retained for the diagnosis of ocular sarcoidosis. Finally diagnostic criteria were proposed based on ocular signs, laboratory investigations, and biopsy results. RESULTS The concensus conference identified seven signs in the diagnosis of intraocular sarcoidosis: (1) mutton-fat keratic precipitates (KPs)/small granulomatous KPs and/or iris nodules (Koeppe/Busacca), (2) trabecular meshwork (TM) nodules and/or tent-shaped peripheral anterior synechiae (PAS), (3) vitreous opacities displaying snowballs/strings of pearls, (4) multiple chorioretinal peripheral lesions (active and/or atrophic), (5) nodular and/or segmental peri-phlebitis (+/- candlewax drippings) and/or retinal macroaneurism in an inflamed eye, 6) optic disc nodule(s)/granuloma(s) and/or solitary choroidal nodule, and (7) bilaterality. The laboratory investigations or investigational procedures that were judged to provide value in the diagnosis of ocular sarcoidosis in patients having the above intraocular signs included (1) negative tuberculin skin test in a BCG-vaccinated patient or in a patient having had a positive tuberculin skin test previously, (2) elevated serum angiotensin converting enzyme (ACE) levels and/or elevated serum lysozyme, (3) chest x-ray revealing bilateral hilar lymphadenopathy (BHL), (4) abnormal liver enzyme tests, and (5) chest CT scan in patients with a negative chest x-ray result. Four levels of certainty for the diagnosis of ocular sarcoidosis (diagnostic criteria) were recommended in patients in whom other possible causes of uveitis had been excluded: (1) biopsy-supported diagnosis with a compatible uveitis was labeled as definite ocular sarcoidosis; (2) if biopsy was not done but chest x-ray was positive showing BHL associated with a compatible uveitis, the condition was labeled as presumed ocular sarcoidosis; (3) if biopsy was not done and the chest x-ray did not show BHL but there were 3 of the above intraocular signs and 2 positive laboratory tests, the condition was labeled as probable ocular sarcoidosis; and (4) if lung biopsy was done and the result was negative but at least 4 of the above signs and 2 positive laboratory investigations were present, the condition was labeled as possible ocular sarcoidosis. CONCLUSION Various clinical signs, laboratory investigations, and biopsy results provided four diagnostic categories of sarcoid uveitis. The categorization allows prospective multinational clinical trials to be conducted using a standardized nomenclature, which serves as a platform for comparison of visual outcomes with various therapeutic modalities.
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Affiliation(s)
- Carl P Herbort
- Inflammatory Eye Diseases, Centre for Ophthalmic Specialized Care, Lausanne, Switzerland
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266
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Liu Y. Orthopedic surgery-related benign uptake on FDG-PET: case examples and pitfalls. Ann Nucl Med 2009; 23:701-8. [PMID: 19728016 DOI: 10.1007/s12149-009-0296-7] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2009] [Accepted: 07/31/2009] [Indexed: 10/20/2022]
Abstract
Orthopedic surgical procedures often create some special postoperative complications, which may demonstrate abnormally increased or focal uptake for an extended period of time on FDG PET-CT images. The distinction of normal from pathologic, benign from malignant uptake is very important to minimize the number of false positive results. To date, very little data have been published regarding surgical-related benign musculoskeletal uptake on PET-CT imaging. In this paper, we present to the readers some case examples of FDG PET-CT imaging for postoperative fracture, infection or osteomyelitis, metallic implants, aggressive bone edge, heterotopic ossification, granuloma and neuroma. We also discuss potential pitfalls to recognize these orthopedic surgery-related complications and identify benign nature of increased FDG uptake. In all cases, the patient's medical and surgical history would be of paramount importance to the radiologists/nuclear medicine physicians who interprets the scan. It is also crucial to carefully correlate FDG uptake with the anatomy on the co-registered CT images in all transaxial, coronal and sagittal views in order to identify the location and pattern of uptake.
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Affiliation(s)
- Yiyan Liu
- Nuclear Medicine Section, Department of Radiology, The University Hospital, UMDNJ, Newark, NJ 07103, USA.
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267
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Abstract
CT arthrography and MR arthrography are accurate methods for the study of surface cartilage lesions and cartilage loss. They also provide information on subchondral bone and marrow changes, and ligaments and meniscal lesions that can be associated with osteoarthritis. Nuclear medicine also offers new insights in the assessment of the disease. This article discusses the strengths and limitations of CT arthrography and MR arthrography. It also highlights nuclear medicine methods that may be relevant to the study of osteoarthritis in research and clinical practice.
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268
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Wang X, Koch S. Positron emission tomography/computed tomography potential pitfalls and artifacts. Curr Probl Diagn Radiol 2009; 38:156-69. [PMID: 19464586 DOI: 10.1067/j.cpradiol.2008.01.001] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
With the recent use of 18-fluoro-2-deoxyglucose (FDG) positron emission tomography (PET) for tumor staging and treatment response, it is important to recognize many pitfalls, artifacts, and benign uptakes that are commonly encountered. Normal physiology can explain many regions of increased FDG activity, as well as incidental benign tumors and benign metabolic conditions. Recognition of characterization of benign causes and physiologic variants for FDG uptake are discussed to avoid improper characterization as a malignancy. A basic understanding of PET/computed tomographic physics is also discussed, in relation to attenuation correction artifacts caused by metallic implants and contrast agents in the gastrointestinal tract, as well as artifacts caused in fused images due to patient motion. Also presented is the rationale for expected, benign uptake in various metabolic diseases, as well as pharmacologic methods for decreasing the artifacts caused by metabolic diseases. PET/computed tomographic evaluation of the thyroid, thymus, adrenal adenomas, uterus and ovaries, infection/inflammatory changes, and postradiation/chemotherapy changes are also discussed, with expected normal changes, as well as pitfalls and artifacts.
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Affiliation(s)
- Xia Wang
- Department of Radiology, Henry Ford Health System, Detroit, MI 48202-2689, USA
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269
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Diagnostic value of [18F]-FDG PET/CT in children with fever of unknown origin or unexplained signs of inflammation. Eur J Nucl Med Mol Imaging 2009; 37:136-45. [DOI: 10.1007/s00259-009-1185-y] [Citation(s) in RCA: 57] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2009] [Accepted: 05/08/2009] [Indexed: 01/14/2023]
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270
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Halpenny DF, Burke JP, Lawlor GO, O'Connell M, O'Connell M. Role of PET and combination PET/CT in the evaluation of patients with inflammatory bowel disease. Inflamm Bowel Dis 2009; 15:951-8. [PMID: 19130618 DOI: 10.1002/ibd.20817] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
BACKGROUND Positron emission tomography (PET) is a nuclear imaging technique providing noninvasive, three-dimensional, whole-body, quantitative images. The primary use of PET is in tumor detection and staging. More recently, it has been shown to be of value in assessing patients with inflammatory processes. To date the role of PET in the management of patients with inflammatory bowel disease (IBD) has not been defined. METHODS The electronic literature (August 1966 to June 2008) on the utilization of PET in IBD was reviewed. Further references were obtained by cross-referencing from key articles. RESULTS There have been no randomized studies to date examining the role of PET in the management of patients with IBD. Comparative studies have demonstrated a high degree of correlation between PET-detected segmental (18)F-fluorodeoxyglucose uptake and sites of macroscopic and histological inflammation noted on endoscopy. Prospectively, PET performs favorably in comparison to conventional imaging modalities for IBD such as immunoscintigraphy, magnetic resonance imaging (MRI), and hydro-MRI. Several case series have highlighted the utility of PET in the diagnosis of IBD in the pediatric population. The recent development of PET/computed tomography (CT) combines the physiological sensitivity of PET with the anatomical accuracy of CT, increasing the specificity of PET. CONCLUSIONS The case series and nonrandomized studies published to date emphasize the utility of PET in assessing patients with IBD and justify further study. The development of PET/CT represents a significant advance and should be considered in the evaluation of patients with IBD.
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Affiliation(s)
- Darragh F Halpenny
- Department of Medicine, Mater Misericordiae University Hospital, Dublin, Ireland
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271
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Bhargava KK, Gupta RK, Nichols KJ, Palestro CJ. In vitro human leukocyte labeling with (64)Cu: an intraindividual comparison with (111)In-oxine and (18)F-FDG. Nucl Med Biol 2009; 36:545-9. [PMID: 19520295 DOI: 10.1016/j.nucmedbio.2009.03.001] [Citation(s) in RCA: 50] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2009] [Revised: 02/26/2009] [Accepted: 03/01/2009] [Indexed: 01/19/2023]
Abstract
UNLABELLED We investigated labeling human leukocytes [white blood cells (WBCs)] in vitro with copper-64 (Cu) comparing labeling efficiency, viability and stability of Cu-WBCs with (111)In-oxine (In) WBCs and (18)F-FDG (FDG) WBCs. METHODS Leukocytes from 10 volunteers were labeled with Cu, In and FDG. Forty milliliters of venous blood was collected and leukocyte separation was performed according to standard methods. In-WBCs and FDG-WBCs were labeled according to published methods. For Cu-WBCs, tropolone initially was used as a single chelating agent. Because of poor intracellular Cu retention (54+/-4% at 3 h and 24+/-5% at 24 h), the fluorinated, membrane-permeable divalent cation chelator quin-MF was added. WBCs were incubated in 5 ml saline containing 100 microl of 1mM quin-MF/AM in 2% dimethyl sulfoxide and 74-185 MBq Cu-tropolone for 45 min at 37 degrees C. Labeling efficiencies; in vitro cellular viabilities at 1, 3 and 24 h; and in vitro stabilities at 1, 2, 3, 4 and 24 h (except FDG-WBCs) were determined. RESULTS Mean Cu-WBCs (87+/-4%) and In-WBCs (86+/-4%) labeling efficiencies were comparable and were significantly higher than FDG-WBCs (60+/-19%, P<.001). Cell viabilities, similar at 1 h, were significantly higher for (64)Cu-WBCs at 3 and 24 h. Intracellular retention of activity was always significantly higher for In-WBCs than for Cu-WBCs and FDG-WBCs. At 24 h, intracellular retention was 88+/-4% for In-WBCs and 79+/-6% for Cu-WBCs. CONCLUSION Cu-WBC labeling efficiency and viability were comparable or superior to In-WBCs and significantly higher than FDG-WBCs. Although significantly more activity eluted from Cu-WBCs than from In-WBCs, Cu-WBC probably is adequate for imaging. These data suggest that further investigation of in vitro copper-64-labeled leukocytes for PET imaging of infection is warranted.
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Affiliation(s)
- Kuldeep K Bhargava
- North Shore Long Island Jewish Health System, Manhasset and New Hyde Park, NY 11040, USA
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272
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Rim of FDG Uptake Around a Pulmonary Infarct on PET/CT in a Patient With Unsuspected Pulmonary Embolism. Clin Nucl Med 2009; 34:285-6. [DOI: 10.1097/rlu.0b013e31819e52bc] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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273
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Masamed R, Meleis A, Lee E, Hathout G. Cerebral toxoplasmosis: case review and description of a new imaging sign. Clin Radiol 2009; 64:560-3. [DOI: 10.1016/j.crad.2008.09.016] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2008] [Revised: 09/23/2008] [Accepted: 09/25/2008] [Indexed: 02/07/2023]
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274
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de Barros ALB, Cardoso VN, Mota LDG, Leite EA, Oliveira MCD, Alves RJ. Synthesis and biological evaluation of technetium-labeled d-glucose-MAG3 derivative as agent for tumor diagnosis. Bioorg Med Chem Lett 2009; 19:2497-9. [DOI: 10.1016/j.bmcl.2009.03.059] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2008] [Revised: 03/11/2009] [Accepted: 03/12/2009] [Indexed: 11/26/2022]
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275
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276
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277
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Spectrum of Focal Benign Musculoskeletal18F-FDG Uptake at PET/CT of the Shoulder and Pelvis. AJR Am J Roentgenol 2009; 192:1029-35. [DOI: 10.2214/ajr.08.1686] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
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278
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Tsuji AB, Sogawa C, Sugyo A, Sudo H, Toyohara J, Koizumi M, Abe M, Hino O, Harada YN, Furukawa T, Suzuki K, Saga T. Comparison of conventional and novel PET tracers for imaging mesothelioma in nude mice with subcutaneous and intrapleural xenografts. Nucl Med Biol 2009; 36:379-88. [PMID: 19423005 DOI: 10.1016/j.nucmedbio.2009.01.018] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2008] [Revised: 01/27/2009] [Accepted: 01/31/2009] [Indexed: 12/17/2022]
Abstract
INTRODUCTION Malignant mesothelioma is a highly aggressive tumor originating in the pleura, peritoneum and pericardium, and the prognosis of patients undergoing current treatment remains poor. To develop new therapies, it is important to have a noninvasive imaging system for evaluating the efficacy of such prospective treatments. We have established clinically relevant mouse models and evaluated conventional and novel positron emission tomography (PET) tracers. METHODS Epithelioid and sarcomatoid mesothelioma cells were inoculated subcutaneously and intrapleurally into nude mice. Biodistribution and PET imaging studies were conducted by injecting [(18)F]fluoro-2-deoxy-D-glucose (FDG), 3'-[(18)F]fluoro-3'-doxythymidine (FLT) or 4'-methyl-[(11)C]thiothymidine (S-dThd) into the mouse models. In vitro cellular uptake of [(14)C]FDG and [(3)H]FLT and thymidine kinase 1 (TK(1)) activity in both cell lines were measured. Expression of glucose transporter 1 (GLUT-1) and Ki-67 in xenografted tumors was evaluated by immunohistochemical staining. RESULTS In epithelioid mesothelioma models, biodistribution experiments showed that tumor uptake of [(11)C]S-dThd was significantly higher than that of [(18)F]FDG. On the other hand, in sarcomatoid models, [(18)F]FDG showed significantly higher accumulation than the other two tracers. These differential uptakes of the three tracers were confirmed by PET imaging. The cellular uptake of [(14)C]FDG and [(3)H]FLT and TK(1) activity in sarcomatoid cells were higher than those of epithelioid cells. GLUT-1 protein was strongly expressed in sarcomatoid but not in epithelioid tumor. We observed a high percentage of Ki-67-positive cells in both epithelioid and sarcomatoid tumors. CONCLUSIONS We established nude mouse models of epithelioid and sarcomatoid subtypes of mesothelioma. PET tracers applicable for the evaluation of epithelioid and sarcomatoid mesothelioma would vary: [(18)F]FLT and [(11)C]S-dThd seemed suitable for the epithelioid subtype and [(18)F]FDG seemed suitable for the sarcomatoid subtype in our mouse models. Our results indicated that cellular uptake and TK(1) activity in vitro are not always consistent with tracer uptake of [(18)F]FLT and [(11)C]S-dThd in vivo. These mouse models and PET imaging might be useful tools for evaluating new and effective treatments in mesothelioma.
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Affiliation(s)
- Atsushi B Tsuji
- Diagnostic Imaging Group, Molecular Imaging Center, National Institute of Radiological Sciences, Chiba 263-8555, Japan
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279
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Memon AA, Jakobsen S, Dagnaes-Hansen F, Sorensen BS, Keiding S, Nexo E. Positron Emission Tomography (PET) Imaging with [11C]-Labeled Erlotinib: A Micro-PET Study on Mice with Lung Tumor Xenografts. Cancer Res 2009; 69:873-8. [DOI: 10.1158/0008-5472.can-08-3118] [Citation(s) in RCA: 130] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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280
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Cai W, Guzman R, Hsu AR, Wang H, Chen K, Sun G, Gera A, Choi R, Bliss T, He L, Li ZB, Maag ALD, Hori N, Zhao H, Moseley M, Steinberg GK, Chen X. Positron Emission Tomography Imaging of Poststroke Angiogenesis. Stroke 2009; 40:270-7. [DOI: 10.1161/strokeaha.108.517474] [Citation(s) in RCA: 41] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background and Purpose—
Vascular endothelial growth factor (VEGF) and VEGF receptors (VEGFRs) play important roles during neurovascular repair after stroke. In this study, we imaged VEGFR expression with positron emission tomography (PET) to noninvasively analyze poststroke angiogenesis.
Methods—
Female Sprague-Dawley rats after distal middle cerebral artery occlusion surgery were subjected to weekly MRI,
18
F-FDG PET, and
64
Cu-DOTA-VEGF
121
PET scans. Several control experiments were performed to confirm the VEGFR specificity of
64
Cu-DOTA-VEGF
121
uptake in the stroke border zone. VEGFR, BrdU, lectin staining, and
125
I-VEGF
165
autoradiography on stroke brain tissue slices were performed to validate the in vivo findings.
Results—
T2-weighed MRI correlated with the “cold spot” on
18
F-FDG PET for rats undergoing distal middle cerebral artery occlusion surgery. The
64
Cu-DOTA-VEGF
121
uptake in the stroke border zone peaked at ≈10 days after surgery, indicating neovascularization as confirmed by histology (VEGFR-2, BrdU, and lectin staining). VEGFR specificity of
64
Cu-DOTA-VEGF
121
uptake was confirmed by significantly lower uptake of
64
Cu-DOTA-VEGF
mutant
in vivo and intense
125
I-VEGF
165
uptake ex vivo in the stroke border zone. No appreciable uptake of
64
Cu-DOTA-VEGF
121
was observed in the brain of sham-operated rats.
Conclusions—
For the first time to our knowledge, we successfully evaluated the VEGFR expression kinetics noninvasively in a rat stroke model. In vivo imaging of VEGFR expression could become a significant clinical tool to plan and monitor therapies aimed at improving poststroke angiogenesis.
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Affiliation(s)
- Weibo Cai
- From The Molecular Imaging Program at Stanford (W.C., A.R.H, H.W., L.H., K.C., Z-B.L., M.M., X.C.), Department of Radiology, Stanford University, Calif; Departments of Radiology and Medical Physics (W.C.), University of Wisconsin–Madison, Wis; Department of Neurosurgery (R.G., G.S., A.G., R.C., T.B., A-L.D.M., N.H., H.Z., G.K.S.), Stanford University, Calif
| | - Raphael Guzman
- From The Molecular Imaging Program at Stanford (W.C., A.R.H, H.W., L.H., K.C., Z-B.L., M.M., X.C.), Department of Radiology, Stanford University, Calif; Departments of Radiology and Medical Physics (W.C.), University of Wisconsin–Madison, Wis; Department of Neurosurgery (R.G., G.S., A.G., R.C., T.B., A-L.D.M., N.H., H.Z., G.K.S.), Stanford University, Calif
| | - Andrew R. Hsu
- From The Molecular Imaging Program at Stanford (W.C., A.R.H, H.W., L.H., K.C., Z-B.L., M.M., X.C.), Department of Radiology, Stanford University, Calif; Departments of Radiology and Medical Physics (W.C.), University of Wisconsin–Madison, Wis; Department of Neurosurgery (R.G., G.S., A.G., R.C., T.B., A-L.D.M., N.H., H.Z., G.K.S.), Stanford University, Calif
| | - Hui Wang
- From The Molecular Imaging Program at Stanford (W.C., A.R.H, H.W., L.H., K.C., Z-B.L., M.M., X.C.), Department of Radiology, Stanford University, Calif; Departments of Radiology and Medical Physics (W.C.), University of Wisconsin–Madison, Wis; Department of Neurosurgery (R.G., G.S., A.G., R.C., T.B., A-L.D.M., N.H., H.Z., G.K.S.), Stanford University, Calif
| | - Kai Chen
- From The Molecular Imaging Program at Stanford (W.C., A.R.H, H.W., L.H., K.C., Z-B.L., M.M., X.C.), Department of Radiology, Stanford University, Calif; Departments of Radiology and Medical Physics (W.C.), University of Wisconsin–Madison, Wis; Department of Neurosurgery (R.G., G.S., A.G., R.C., T.B., A-L.D.M., N.H., H.Z., G.K.S.), Stanford University, Calif
| | - Guohua Sun
- From The Molecular Imaging Program at Stanford (W.C., A.R.H, H.W., L.H., K.C., Z-B.L., M.M., X.C.), Department of Radiology, Stanford University, Calif; Departments of Radiology and Medical Physics (W.C.), University of Wisconsin–Madison, Wis; Department of Neurosurgery (R.G., G.S., A.G., R.C., T.B., A-L.D.M., N.H., H.Z., G.K.S.), Stanford University, Calif
| | - Atul Gera
- From The Molecular Imaging Program at Stanford (W.C., A.R.H, H.W., L.H., K.C., Z-B.L., M.M., X.C.), Department of Radiology, Stanford University, Calif; Departments of Radiology and Medical Physics (W.C.), University of Wisconsin–Madison, Wis; Department of Neurosurgery (R.G., G.S., A.G., R.C., T.B., A-L.D.M., N.H., H.Z., G.K.S.), Stanford University, Calif
| | - Raymond Choi
- From The Molecular Imaging Program at Stanford (W.C., A.R.H, H.W., L.H., K.C., Z-B.L., M.M., X.C.), Department of Radiology, Stanford University, Calif; Departments of Radiology and Medical Physics (W.C.), University of Wisconsin–Madison, Wis; Department of Neurosurgery (R.G., G.S., A.G., R.C., T.B., A-L.D.M., N.H., H.Z., G.K.S.), Stanford University, Calif
| | - Tonya Bliss
- From The Molecular Imaging Program at Stanford (W.C., A.R.H, H.W., L.H., K.C., Z-B.L., M.M., X.C.), Department of Radiology, Stanford University, Calif; Departments of Radiology and Medical Physics (W.C.), University of Wisconsin–Madison, Wis; Department of Neurosurgery (R.G., G.S., A.G., R.C., T.B., A-L.D.M., N.H., H.Z., G.K.S.), Stanford University, Calif
| | - Lina He
- From The Molecular Imaging Program at Stanford (W.C., A.R.H, H.W., L.H., K.C., Z-B.L., M.M., X.C.), Department of Radiology, Stanford University, Calif; Departments of Radiology and Medical Physics (W.C.), University of Wisconsin–Madison, Wis; Department of Neurosurgery (R.G., G.S., A.G., R.C., T.B., A-L.D.M., N.H., H.Z., G.K.S.), Stanford University, Calif
| | - Zi-Bo Li
- From The Molecular Imaging Program at Stanford (W.C., A.R.H, H.W., L.H., K.C., Z-B.L., M.M., X.C.), Department of Radiology, Stanford University, Calif; Departments of Radiology and Medical Physics (W.C.), University of Wisconsin–Madison, Wis; Department of Neurosurgery (R.G., G.S., A.G., R.C., T.B., A-L.D.M., N.H., H.Z., G.K.S.), Stanford University, Calif
| | - Anne-Lise D. Maag
- From The Molecular Imaging Program at Stanford (W.C., A.R.H, H.W., L.H., K.C., Z-B.L., M.M., X.C.), Department of Radiology, Stanford University, Calif; Departments of Radiology and Medical Physics (W.C.), University of Wisconsin–Madison, Wis; Department of Neurosurgery (R.G., G.S., A.G., R.C., T.B., A-L.D.M., N.H., H.Z., G.K.S.), Stanford University, Calif
| | - Nobutaka Hori
- From The Molecular Imaging Program at Stanford (W.C., A.R.H, H.W., L.H., K.C., Z-B.L., M.M., X.C.), Department of Radiology, Stanford University, Calif; Departments of Radiology and Medical Physics (W.C.), University of Wisconsin–Madison, Wis; Department of Neurosurgery (R.G., G.S., A.G., R.C., T.B., A-L.D.M., N.H., H.Z., G.K.S.), Stanford University, Calif
| | - Heng Zhao
- From The Molecular Imaging Program at Stanford (W.C., A.R.H, H.W., L.H., K.C., Z-B.L., M.M., X.C.), Department of Radiology, Stanford University, Calif; Departments of Radiology and Medical Physics (W.C.), University of Wisconsin–Madison, Wis; Department of Neurosurgery (R.G., G.S., A.G., R.C., T.B., A-L.D.M., N.H., H.Z., G.K.S.), Stanford University, Calif
| | - Michael Moseley
- From The Molecular Imaging Program at Stanford (W.C., A.R.H, H.W., L.H., K.C., Z-B.L., M.M., X.C.), Department of Radiology, Stanford University, Calif; Departments of Radiology and Medical Physics (W.C.), University of Wisconsin–Madison, Wis; Department of Neurosurgery (R.G., G.S., A.G., R.C., T.B., A-L.D.M., N.H., H.Z., G.K.S.), Stanford University, Calif
| | - Gary K. Steinberg
- From The Molecular Imaging Program at Stanford (W.C., A.R.H, H.W., L.H., K.C., Z-B.L., M.M., X.C.), Department of Radiology, Stanford University, Calif; Departments of Radiology and Medical Physics (W.C.), University of Wisconsin–Madison, Wis; Department of Neurosurgery (R.G., G.S., A.G., R.C., T.B., A-L.D.M., N.H., H.Z., G.K.S.), Stanford University, Calif
| | - Xiaoyuan Chen
- From The Molecular Imaging Program at Stanford (W.C., A.R.H, H.W., L.H., K.C., Z-B.L., M.M., X.C.), Department of Radiology, Stanford University, Calif; Departments of Radiology and Medical Physics (W.C.), University of Wisconsin–Madison, Wis; Department of Neurosurgery (R.G., G.S., A.G., R.C., T.B., A-L.D.M., N.H., H.Z., G.K.S.), Stanford University, Calif
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281
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Kao PF, Chou YH. Clinical Applications and Usefulness of Integrated Single Photon Emission Computed Tomography/Computed Tomography Imaging. Tzu Chi Med J 2008. [DOI: 10.1016/s1016-3190(08)60048-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
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282
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Morii T, Mochizuki K, Sano H, Fujino T, Harasawa A, Satomi K. Occult myofibroblastic sarcoma detected on FDG-PET performed for cancer screening. Ann Nucl Med 2008; 22:811-5. [PMID: 19039560 DOI: 10.1007/s12149-008-0194-4] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2008] [Accepted: 07/21/2008] [Indexed: 12/15/2022]
Abstract
We present a rare case of occult low-grade myofibroblastic sarcoma (LGMFS) detected by marked 2-[fluorine-18]-fluoro-2-deoxy-D-glucose (FDG) uptake on positron emission tomography (PET). A 46-year-old woman presented with abnormal FDG uptake in her back when FDG-PET was performed for cancer screening. The maximum standard uptake values (SUVmax) were 9.8. Physical examination and laboratory investigations revealed no abnormalities. Magnetic resonance images demonstrated an ill-defined 2 x 3 cm mass in the multifidus muscle. Excisional biopsy led to a pathological diagnosis of LGMFS. Additional wide resection was performed for local control. No local recurrence or distant metastasis was observed 12 months after the initial operation. This is the first report describing FDG-PET findings of LGMFS, suggesting a discrepancy between histological grade and SUV intensity in this low-grade entity.
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Affiliation(s)
- Takeshi Morii
- Department of Orthopaedic Surgery, Kyorin University, 6-20-2 Shinkawa, Mitaka, Tokyo, 181-8611, Japan.
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283
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Drug-induced pneumonitis detected earlier by 18F-FDG-PET than by high-resolution CT: a case report with non-Hodgkin's lymphoma. Ann Nucl Med 2008; 22:719-22. [PMID: 18982476 DOI: 10.1007/s12149-008-0183-7] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2007] [Accepted: 01/25/2008] [Indexed: 11/27/2022]
Abstract
Drug-induced pneumonitis is a serious and an unpredictable side effect of chemotherapy in patients with malignant lymphoma. We present the case of a 51-year-old man who developed drug-induced pneumonitis during chemotherapy for non-Hodgkin's lymphoma in which pneumonitis was detected earlier by 18F-fluorodeoxyglucose positron emission tomography (18F-FDG-PET) than by high-resolution computed tomography (HRCT). After five courses of chemotherapy, 18F-FDG-PET was performed for assessing residual lesions, and diffuse lung uptake was incidentally observed. No symptoms were present, and HRCT performed immediately following PET revealed no abnormalities. Mild dyspnea appeared 3 days after PET, and additional HRCT revealed patchy ground-glass opacities disseminated with the appearance of interlobular septum thickening. Drug-induced pneumonitis was finally diagnosed, and treatment was initiated. 18F-FDG-PET can be an imaging modality for detecting drug-induced pneumonitis at an extremely early stage in which HRCT is incapable of revealing any abnormal changes.
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284
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Martin SM, O'Donnell RT, Kukis DL, Abbey CK, McKnight H, Sutcliffe JL, Tuscano JM. Imaging and pharmacokinetics of (64)Cu-DOTA-HB22.7 administered by intravenous, intraperitoneal, or subcutaneous injection to mice bearing non-Hodgkin's lymphoma xenografts. Mol Imaging Biol 2008; 11:79-87. [PMID: 18949521 DOI: 10.1007/s11307-008-0148-1] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2007] [Revised: 03/13/2008] [Accepted: 03/26/2008] [Indexed: 12/26/2022]
Abstract
PURPOSE The aim of the study is to compare the tumor-specific targeting, pharmacokinetics, and biodistribution of (64)Cu-DOTA-HB22.7 when administered to xenograft-bearing mice intravenously (IV), intraperitoneally (IP), and subcutaneously (SQ). PROCEDURES Mice bearing human non-Hodgkin's lymphoma (NHL) xenografts were injected IV, IP, or SQ with (64)Cu-DOTA-HB22.7. Xenograft targeting was evaluated by micro positron emission tomography (microPET) and confirmed by organ biodistribution studies. Blood measurements of (64)Cu were performed to determine the pharmacokinetics and clearance of (64)Cu-DOTA-HB22.7. RESULTS (64)Cu-DOTA-HB22.7 demonstrated equivalent tumor targeting within 24-48 h, regardless of the route of administration. Organ biodistribution confirmed tumor-specific targeting. Blood pharmacokinetics demonstrated that (64)Cu-DOTA-HB22.7 accessed the bloodstream after IP and SQ administration to a similar degree as IV administration, albeit at a slower rate. CONCLUSIONS These findings establish (64)Cu-DOTA-HB22.7 as a potential radioimmunotherapeutic and/or NHL-specific imaging agent. These findings provide evidence that IP and SQ administration can achieve results equivalent to IV administration and may lead to more efficient, reproducible treatment plans for antibody-based therapeutics.
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Affiliation(s)
- Shiloh M Martin
- Division of Hematology and Oncology, Department of Internal Medicine, University of California, Davis Cancer Center, Davis, CA, USA
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285
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Lustberg MB, Aras O, Meisenberg BR. FDG PET/CT findings in acute adult mononucleosis mimicking malignant lymphoma. Eur J Haematol 2008; 81:154-6. [DOI: 10.1111/j.1600-0609.2008.01088.x] [Citation(s) in RCA: 49] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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286
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Kurdziel K, Ravizzini G, Croft B, Tatum J, Choyke P, Kobayashi H. The evolving role of nuclear molecular imaging in cancer. ACTA ACUST UNITED AC 2008; 2:829-842. [PMID: 19122861 DOI: 10.1517/17530059.2.7.829] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
BACKGROUND: Novel therapies targeted to specific tumor pathways are entering the clinic. The need for in vivo monitoring of resulting molecular changes, particularly with respect to the tumor microenvironment, is growing. Molecular imaging is evolving to include a variety of imaging methods to enable in vivo monitoring of cellular and molecular processes. OBJECTIVES: This article reviews the emerging role of molecular imaging in the development of improved therapeutic strategies that provide better patient selection for therapeutic personalization (i.e. determine which therapies have the greatest chance of success given the individual patient's disease genetic, and phenotypical profile). METHODS: In order to illustrate the utility of integrating molecular imaging into therapy development strategies, current and emerging applications of nuclear molecular imaging strategies will be compared with conventional strategies. Proposed methods of integrating molecular imaging techniques into cancer therapeutic development and limitations of these techniques will be discussed. RESULTS/CONCLUSION: Molecular imaging provides a variety of new tools to accelerate the development of cancer therapies. The recent drive to develop molecular imaging probes and standardize molecular imaging techniques is creating the scaffolding for the evolving paradigm shift to personalized cancer therapy.
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Affiliation(s)
- Ka Kurdziel
- Center for Cancer Research, National Cancer Institute, National Institutes of Health, Building 10, Room 1B40, Bethesda, MD, 20892-1088, USA
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287
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Ledezma CJ, Chen W, Sai V, Freitas B, Cloughesy T, Czernin J, Pope W. 18F-FDOPA PET/MRI fusion in patients with primary/recurrent gliomas: initial experience. Eur J Radiol 2008; 71:242-8. [PMID: 18511228 DOI: 10.1016/j.ejrad.2008.04.018] [Citation(s) in RCA: 88] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2007] [Revised: 03/05/2008] [Accepted: 04/21/2008] [Indexed: 11/28/2022]
Abstract
BACKGROUND AND PURPOSE (18)F-FDOPA PET demonstrates higher sensitivity and specificity for gliomas than traditional [(18)F] FDG PET imaging. However, PET provides limited anatomic localization. The purpose of this study was to determine whether (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 (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 (18)F-FDOPA PET and MRI but lacked additional pathologic follow-up. Fused (18)F-FDOPA PET and MRI images were analyzed for concordance and correlated with histopathologic data. RESULTS Fusion technology facilitated precise anatomical localization of (18)F-FDOPA activity. In group I, all 21 cases showed pathology-confirmed tumor. Of these, (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 (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. (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, (18)F-FDOPA activity preceded tumor detection on MRI. CONCLUSION (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, (18)F-FDOPA activity may identify tumor not visible on MRI.
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Affiliation(s)
- Carlos J Ledezma
- Department of Radiological Sciences, David Geffen School of Medicine, University of California Los Angeles, 10833 Le Conte Avenue, Los Angeles, CA 90095, USA.
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288
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18F-FDG PET/CT in sarcoidosis management: review and report of 20 cases. Eur J Nucl Med Mol Imaging 2008; 35:1537-43. [PMID: 18418595 DOI: 10.1007/s00259-008-0770-9] [Citation(s) in RCA: 142] [Impact Index Per Article: 8.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2007] [Accepted: 03/04/2008] [Indexed: 10/22/2022]
Abstract
PURPOSE To evaluate the interest of (18)F-fluoro-2-deoxy-D: -glucose positron emission tomography/computed tomography ((18)F-FDG PET/CT) for diagnosis and therapeutic follow-up of patients with sarcoidosis. METHODS Twenty consecutive patients with biopsy-proven sarcoidosis were retrospectively included, in particular, 13 and seven cases of thoracic and extra-thoracic sarcoidosis, respectively. All patients underwent (18)F-FDG PET/CT, and 12 of them also (67)Ga scintigraphy. Five patients were re-examined by (18)F-FDG PET/CT to assess response to corticosteroid (CS) treatment. RESULTS Sensitivity of (18)F-FDG PET/CT in detecting active sarcoidosis localizations was determined considering only biopsy-proven sites. For thoracic, sinonasal, and pharyngo-laryngeal localizations, (18)F-FDG PET/CT sensitivity was 100%, 100%, and 80%, respectively. Overall sensitivity for all 36 biopsy-proven localizations improved from 78% to 87% after excluding skin involvement. Considering only the 12 patients who underwent both scintigraphic examinations, overall sensitivity of (67)Ga scintigraphy and (18)F-FDG PET/CT was 58% and 79%, respectively and improved to 67% and 86% after excluding all sites of skin involvement. To evaluate the efficacy of CS treatment, five enrolled patients underwent second (18)F-FDG PET/CT. Complete regression of all foci of pathological tracer uptake was showed in two cases, permitting CS withdrawal after 2 and 6 months. Improvement but incomplete regression of mediastino-pulmonary disease occurred in two patients treated with CS for 19 and 21 months. Disease progression was assessed in one patient treated with decreasing doses of CS during 16 months. CONCLUSION (18)F-FDG PET/CT allows to obtain a complete morpho-functional cartography of inflammatory active localizations and to follow treatment efficacy in patients with sarcoidosis, particularly in atypical, complex, and multisystemic forms.
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289
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Mariani G, Pauwels EK, AlSharif A, Marchi S, Boni G, Barreca M, Bellini M, Grosso M, de Bortoli N, Mumolo G, Costa F, Rubello D, Strauss HW. Radionuclide Evaluation of the Lower Gastrointestinal Tract. J Nucl Med 2008; 49:776-87. [DOI: 10.2967/jnumed.107.040113] [Citation(s) in RCA: 41] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
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290
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291
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292
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Imaging of Sarcoidosis: Self-Assessment Module. AJR Am J Roentgenol 2008; 190:S7-10. [DOI: 10.2214/ajr.07.7059] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
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293
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Ruiz Laiglesia FJ, Olivera González S, Torrubia Pérez CB. [Diagnostic limitations of positron emission tomography. What are we seeking?]. Rev Clin Esp 2008; 208:87-9. [PMID: 18261395 DOI: 10.1157/13115204] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Positron emission tomography is an imaging technique based on the use of radiopharmaceuticals. The most extended one is the glucose analogue 18F fluorodeoxyglucose (FDG) that is deposited where there is an increase of glycolytic metabolism, whether this is caused by neoplastic, inflammatory or infectious diseases. It is used in oncology for the initial staging, to assess response to treatment, residual disease, recurrent diagnosis and restaging, but specifically among the different types of tumor. It also has a field in the study of large vessel vasculitis, in granulomatous diseases and in dementias.
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Affiliation(s)
- F J Ruiz Laiglesia
- Servicio de Medicina Interna, Hospital Clínico Universitario Lozano Blesa, Zaragoza, España
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294
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Papo T. Granulomatoses systémiques. Mise en perspective. Rev Med Interne 2008; 29:3-4. [PMID: 17689838 DOI: 10.1016/j.revmed.2007.07.006] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2007] [Accepted: 07/16/2007] [Indexed: 10/23/2022]
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295
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Dornfeld K, Hopkins S, Simmons J, Spitz DR, Menda Y, Graham M, Smith R, Funk G, Karnell L, Karnell M, Dornfeld M, Yao M, Buatti J. Posttreatment FDG-PET uptake in the supraglottic and glottic larynx correlates with decreased quality of life after chemoradiotherapy. Int J Radiat Oncol Biol Phys 2007; 71:386-92. [PMID: 18164842 DOI: 10.1016/j.ijrobp.2007.09.052] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2007] [Revised: 09/21/2007] [Accepted: 09/27/2007] [Indexed: 10/22/2022]
Abstract
PURPOSE Inflammation and increased metabolic activity associated with oxidative stress in irradiated normal tissues may contribute to both complications following radiotherapy and increased glucose uptake as detected by posttherapy fluorodeoxyglucose (FDG)-PET imaging. We sought to determine whether increased glucose uptake in normal tissues after chemoradiotherapy is associated with increased toxicity. METHODS AND MATERIALS Consecutive patients with locoregionally advanced head and neck cancers treated with intensity-modulated radiation therapy and free of recurrence at 1 year were studied. FDG-PET imaging was obtained at 3 and 12 months posttreatment. Standardized uptake value (SUV) levels were determined at various head and neck regions. Functional outcome was measured using a quality of life questionnaire and weight loss and type of diet tolerated 1 year after therapy. A one-tailed Pearson correlation test was used to examine associations between SUV levels and functional outcome measures. RESULTS Standardized uptake value levels in the supraglottic and glottic larynx from FDG-PET imaging obtained 12 months posttreatment were inversely associated with quality of life measures and were correlated with a more restricted diet 1 year after therapy. SUV levels at 3 months after therapy did not correlate with functional outcome. Increases in SUV levels in normal tissues between 3 and 12 months were commonly found in the absence of recurrence. CONCLUSION Altered metabolism in irradiated tissues persists 1 year after therapy. FDG-PET scans may be used to assess normal tissue damage following chemoradiotherapy. These data support investigating hypermetabolic conditions associated with either inflammation, oxidative stress, or both, as causal agents for radiation-induced normal tissue damage.
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Affiliation(s)
- Ken Dornfeld
- Department of Radiation Oncology, The Carver College of Medicine, University of Iowa, Iowa City, IA, USA .
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Gross S, Moss BL, Piwnica-Worms D. Veni, vidi, vici: in vivo molecular imaging of immune response. Immunity 2007; 27:533-8. [PMID: 17967405 DOI: 10.1016/j.immuni.2007.10.006] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
"I came, I saw, I conquered," Julius Caesar proclaimed, highlighting the importance of direct visualization as a winning strategy. Continuing the "From the Field" series (see Editorial [2007] 26, 131), Gross et al. summarize how modern molecular imaging techniques can successfully dissect the complexities of immune response in vivo.
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Affiliation(s)
- Shimon Gross
- Molecular Imaging Center, Mallinckrodt Institute of Radiology, Washington University School of Medicine, St. Louis, MO 63110, USA
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297
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Benign nonphysiologic lesions with increased 18F-FDG uptake on PET/CT: characterization and incidence. AJR Am J Roentgenol 2007; 189:1203-10. [PMID: 17954662 DOI: 10.2214/ajr.07.2083] [Citation(s) in RCA: 105] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
OBJECTIVE The objective of our study was to characterize benign lesions showing increased 18F-FDG uptake and to determine their incidence on whole-body FDG PET/CT performed in oncologic patients. In addition, the performance of PET alone and PET/CT in characterizing lesions as benign was compared. MATERIALS AND METHODS A retrospective review of 1,134 consecutive reports of PET/CT studies performed in patients with proven or suspected malignancy over a 6-month period yielded 289 patients with 313 lesions that showed increased FDG uptake but were suspected to be benign (nonphysiologic) or indeterminate. Lesions were subjectively categorized on the basis of the intensity of FDG uptake (mild, moderate, or marked) as compared with background activity. For each lesion, a decision was made as to whether a benign diagnosis could be obtained by the CT part of the study, the PET pattern, or clinical correlation, or whether histologic sampling was necessary. The performance of PET alone and PET/CT for characterizing lesions as benign was compared. Two hundred twenty-nine of the lesions were assessed further: 210 were benign and 19, malignant. The final diagnosis was determined by pathology (n = 67), PET/CT follow-up (n = 58), correlative imaging (n = 59), clinical correlation (n = 32), or typical benign pattern on PET/CT (n = 13). RESULTS The causes for benign uptake of FDG were inflammatory processes (n = 154, 73.3%), benign tumors (n = 23, 11%), hematoma or seroma (n = 17, 8.1%), fracture (n = 7, 3.3%), fat necrosis (n = 3, 1.4%), and others (n = 6, 2.9%). For lesions with moderate or marked uptake of FDG (n = 117, 55.7%), a benign diagnosis could have been suggested on either PET or CT (e.g., a "hot" osteophyte) in 33 lesions (28.2%), on CT alone (e.g., peritoneal fat necrosis) in 38 lesions (32.5%), on PET alone (e.g., sialadenitis) in 10 lesions (8.5%), or by clinical correlation (e.g., dental abscess) in four lesions (3.4%). A benign diagnosis could not be established without histology (e.g., colonic polyp) in 32 lesions (27.4%). The performance of PET/CT was superior to that of PET alone in characterizing lesions as benign (p < 0.001). CONCLUSION Benign lesions with increased FDG uptake are found in more than 25% of the PET/CT studies performed in patients with proven or suspected malignancy, with inflammation being the most common cause. Lesion characterization on the CT portion of the PET/CT study increases the specificity of PET/CT reporting, especially for lesions with moderate or marked FDG uptake.
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298
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Margolis DJA, Hoffman JM, Herfkens RJ, Jeffrey RB, Quon A, Gambhir SS. Molecular Imaging Techniques in Body Imaging. Radiology 2007; 245:333-56. [DOI: 10.1148/radiol.2452061117] [Citation(s) in RCA: 105] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
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299
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Klingensmith WC, Perlman D, Baum K. Intrapatient comparison of 2-deoxy-2-[F-18]fluoro-D-glucose with positron emissiontomography/computed tomography to Tc-99m fanolesomab (NeutroSpec) for localization of infection. Mol Imaging Biol 2007; 9:295-9. [PMID: 17516124 DOI: 10.1007/s11307-007-0097-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
PURPOSE This study evaluated the efficacy of 2-deoxy-2-[F-18]fluoro-D: -glucose (FDG) with positron emission tomography/computed tomography (PET/CT) in comparison with Tc-99m fanolesomab (NeutroSpec) for imaging infection. PROCEDURES Twelve patients with possible infection were studied with both FDG-PET/CT and Tc-99m fanolesomab. One patient was studied twice for a total of 13 paired studies. The final determination of the presence or absence of infection and the site(s) of infection at the time of imaging was made by an infectious disease physician using culture results and other relevant information. The sensitivity, specificity, and accuracy were calculated for each imaging study on a per paired study basis and a per lesion basis. In addition, the quality of lesion depicted was compared between the two studies. RESULTS Three patients were determined not to have infection. Ten paired studies, in nine patients, were determined to have one or more sites of infection: seven had one site and three had two sites. On a per paired study basis the sensitivity, specificity, and accuracy of FDG-PET/CT were all 100%; for Tc-99m fanolesomab these parameters were 30, 100, and 46%, respectively (P < 0.01 for sensitivity and accuracy). On a per site basis the results for FDG-PET/CT were all 100% and for Tc-99m fanolesomab they were 23, 100, and 38% (P < 0.01 for sensitivity and accuracy). In the three sites of infection shown by both studies, FDG-PET/CT was judged to be superior in spatial resolution and anatomic localization compared to Tc-99m fanolesomab in all three sites. CONCLUSION FDG-PET/CT is superior to Tc-99m fanolesomab for detecting and localizing sites of infection.
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Affiliation(s)
- William C Klingensmith
- Hewit Biomolecular Imaging Center, Department of Radiology, Porter Hospital, Denver, CO 80210, USA.
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300
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Abstract
Diseases of the aorta are imaged using different modalities according to the cause and clinical situation. Current imaging strategies for the clinically most pertinent aortic diseases are analysed. These disease entities may be differentiated into congenital, acquired and inflammatory diseases. Traumatic and non-traumatic aortic aneurysms and dissections are emphasised in context with endovascular treatment options and subsequent follow-up.
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Affiliation(s)
- P Reimer
- Radiologie Gefässzentrum Karlsruhe, Klinikum Karlsruhe, Akademisches Lehrkrankenhaus der Universität Freiburg, Moltkestrasse 90, 76133, Karlsruhe, Germany.
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