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Raynor WY, Park PSU, Borja AJ, Sun Y, Werner TJ, Ng SJ, Lau HC, Høilund-Carlsen PF, Alavi A, Revheim ME. PET-Based Imaging with 18F-FDG and 18F-NaF to Assess Inflammation and Microcalcification in Atherosclerosis and Other Vascular and Thrombotic Disorders. Diagnostics (Basel) 2021; 11:diagnostics11122234. [PMID: 34943473 PMCID: PMC8700072 DOI: 10.3390/diagnostics11122234] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2021] [Revised: 11/19/2021] [Accepted: 11/23/2021] [Indexed: 01/13/2023] Open
Abstract
Positron emission tomography (PET) imaging with 18F-fluorodeoxyglucose (FDG) represents a method of detecting and characterizing arterial wall inflammation, with potential applications in the early assessment of vascular disorders such as atherosclerosis. By portraying early-stage molecular changes, FDG-PET findings have previously been shown to correlate with atherosclerosis progression. In addition, recent studies have suggested that microcalcification revealed by 18F-sodium fluoride (NaF) may be more sensitive at detecting atherogenic changes compared to FDG-PET. In this review, we summarize the roles of FDG and NaF in the assessment of atherosclerosis and discuss the role of global assessment in quantification of the vascular disease burden. Furthermore, we will review the emerging applications of FDG-PET in various vascular disorders, including pulmonary embolism, as well as inflammatory and infectious vascular diseases.
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Affiliation(s)
- William Y. Raynor
- Department of Radiology, Hospital of the University of Pennsylvania, 3400 Spruce Street, Philadelphia, PA 19104, USA; (W.Y.R.); (P.S.U.P.); (A.J.B.); (T.J.W.); (A.A.)
| | - Peter Sang Uk Park
- Department of Radiology, Hospital of the University of Pennsylvania, 3400 Spruce Street, Philadelphia, PA 19104, USA; (W.Y.R.); (P.S.U.P.); (A.J.B.); (T.J.W.); (A.A.)
- Perelman School of Medicine at the University of Pennsylvania, 3400 Civic Center Boulevard, Philadelphia, PA 19104, USA;
| | - Austin J. Borja
- Department of Radiology, Hospital of the University of Pennsylvania, 3400 Spruce Street, Philadelphia, PA 19104, USA; (W.Y.R.); (P.S.U.P.); (A.J.B.); (T.J.W.); (A.A.)
- Perelman School of Medicine at the University of Pennsylvania, 3400 Civic Center Boulevard, Philadelphia, PA 19104, USA;
| | - Yusha Sun
- Perelman School of Medicine at the University of Pennsylvania, 3400 Civic Center Boulevard, Philadelphia, PA 19104, USA;
| | - Thomas J. Werner
- Department of Radiology, Hospital of the University of Pennsylvania, 3400 Spruce Street, Philadelphia, PA 19104, USA; (W.Y.R.); (P.S.U.P.); (A.J.B.); (T.J.W.); (A.A.)
| | - Sze Jia Ng
- Department of Medicine, Crozer-Chester Medical Center, Upland, PA 19013, USA; (S.J.N.); (H.C.L.)
| | - Hui Chong Lau
- Department of Medicine, Crozer-Chester Medical Center, Upland, PA 19013, USA; (S.J.N.); (H.C.L.)
| | - Poul Flemming Høilund-Carlsen
- Department of Nuclear Medicine, Odense University Hospital, 5000 Odense C, Denmark;
- Department of Clinical Research, University of Southern Denmark, 5000 Odense C, Denmark
| | - Abass Alavi
- Department of Radiology, Hospital of the University of Pennsylvania, 3400 Spruce Street, Philadelphia, PA 19104, USA; (W.Y.R.); (P.S.U.P.); (A.J.B.); (T.J.W.); (A.A.)
| | - Mona-Elisabeth Revheim
- Department of Radiology, Hospital of the University of Pennsylvania, 3400 Spruce Street, Philadelphia, PA 19104, USA; (W.Y.R.); (P.S.U.P.); (A.J.B.); (T.J.W.); (A.A.)
- Division of Radiology and Nuclear Medicine, Oslo University Hospital, Sognsvannsveien 20, 0372 Oslo, Norway
- Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Problemveien 7, 0315 Oslo, Norway
- Correspondence: or
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Wang P, Hou G, Li F, Cheng X. Hypermetabolic Cerebral Metastases of Cardiac Myxoma on FDG PET/CT. Clin Nucl Med 2021; 46:146-147. [PMID: 33234938 DOI: 10.1097/rlu.0000000000003436] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
ABSTRACT A 66-year-old woman with a history of surgical resection of left atrial myxoma 6 months ago presented with multiple brain lesions with MRI. An FDG PET/CT was performed for further evaluation. The images showed that cerebral tumors had variable and increased FDG uptake in general, and no other abnormal FDG-avid lesions were noted. The tumor of right occipital lobe was resected and confirmed as metastatic cardiac myxoma on histology.
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Affiliation(s)
- Peipei Wang
- From the Department of Nuclear Medicine, Peking Union Medical College Hospital Chinese Academy of Medical Sciences and Peking Union Medical College; and Beijing Key Laboratory of Molecular Targeted Diagnosis and Therapy in Nuclear Medicine, Beijing China
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Ma G, Wang D, He Y, Zhang R, Zhou Y, Ying K. Pulmonary embolism as the initial manifestation of right atrial myxoma: A case report and review of the literature. Medicine (Baltimore) 2019; 98:e18386. [PMID: 31861001 PMCID: PMC6940114 DOI: 10.1097/md.0000000000018386] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/11/2019] [Revised: 10/31/2019] [Accepted: 11/14/2019] [Indexed: 12/11/2022] Open
Abstract
RATIONALE Pulmonary embolisms (PEs) are caused by emboli, which mostly originate from deep venous thrombi that travel to and suddenly block the pulmonary arteries. The emboli are usually thrombi, and right atrial myxoma emboli are rare. PATIENT CONCERNS A 55-year-old man presented with shortness of breath and syncope. We proceeded with computed tomography pulmonary angiography (CTPA) and transthoracic echocardiogram (TTE), the results of which suggested that the diagnosis was a right atrial mass. DIAGNOSIS A definitive diagnosis compatible with a right atrial myxoma (RAM) with tumoral pulmonary emboli after surgical excision was made. INTERVENTION Right atrial and pulmonary artery embolectomy. OUTCOMES The patient followed an uneventful course during the 6 years of follow-up after surgery. According to a review of the literature, RAMs are often not diagnosed in a timely manner or even go completely undiagnosed. TTE, transesophageal echocardiography (TEE), CT, magnetic resonance imaging (MRI), and positron emission tomography/computed tomography may be helpful in the preoperative diagnosis. Surgical removal of the masses from the atrium and pulmonary arteries was relatively uneventful. LESSONS RAMs should be considered unlikely reasons for fatal pulmonary embolisms.
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Affiliation(s)
| | | | - Yongtao He
- Department of Pathology, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, China
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18 F-FDG PET/CT in a cardiac metastasis in a patient with history of malignant neuroectodermal tumour of the chest wall: Case report and review of the literature. Rev Esp Med Nucl Imagen Mol 2018. [DOI: 10.1016/j.remnie.2017.12.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Marroquín JA, Hernández AC, Pilkington JP, Saviatto A, Tabuenca MJ, Estenoz JM. 18F-FDG PET/CT in a cardiac metastasis in a patient with history of malignant neuroectodermal tumour of the chest wall: Case report and review of the literature. Rev Esp Med Nucl Imagen Mol 2017. [PMID: 28648525 DOI: 10.1016/j.remn.2017.04.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
The case presented is a 25-year-old male with a malignant neuroectodermal tumour on the left chest wall (Askin tumour), treated with surgery after neoadyuvant chemotherapy and followed by consolidation chemotherapy. After 9 years of disease free survival, the patient developed an acute pulmonary embolism. The echocardiogram, thoracic CT, and cardiac MRI scans revealed a mass in the right atrium. Recurrence of an Askin tumour versus an atrium myxoma was suspected. 18F-FDG PET/CT showed an intense hypermetabolic right atrium mass with extension to the right ventricle highly suggestive of malignancy. The result of the histopathology examination after biopsy and subsequently exeresis of the right atrium mass was consistent with a metastasis of the primary tumour.
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Affiliation(s)
- J A Marroquín
- Servicio de Medicina Nuclear, Hospital Universitario 12 de Octubre , Madrid, España.
| | - A C Hernández
- Servicio de Medicina Nuclear, Hospital Universitario 12 de Octubre , Madrid, España
| | - J P Pilkington
- Servicio de Medicina Nuclear, Hospital Universitario 12 de Octubre , Madrid, España
| | - A Saviatto
- Servicio de Medicina Nuclear, Hospital Universitario 12 de Octubre , Madrid, España
| | - M J Tabuenca
- Servicio de Medicina Nuclear, Hospital Universitario 12 de Octubre , Madrid, España
| | - J M Estenoz
- Servicio de Medicina Nuclear, Hospital Universitario 12 de Octubre , Madrid, España
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Abstract
Primary cardiac sarcomas are extremely rare tumors. In this case report, we presented the condition of a 37-year-old male patient diagnosed with myxofibrosarcoma after histopathologic evaluation of the left atrium mass excision. FDG PET/CT was performed and showed recurrent hypermetabolic lesions in the left atrial wall and right anterior mediastinal region.
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