1
|
Value of dynamic metabolic curves and artificial neural network prediction models based on 18F-FDG PET/CT multiphase imaging in differentiating nonspecific solitary pulmonary lesions: a pilot study. Nucl Med Commun 2022; 43:1204-1216. [DOI: 10.1097/mnm.0000000000001627] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
|
2
|
Covington MF, Koppula BR, Fine GC, Salem AE, Wiggins RH, Hoffman JM, Morton KA. PET-CT in Clinical Adult Oncology: II. Primary Thoracic and Breast Malignancies. Cancers (Basel) 2022; 14:cancers14112689. [PMID: 35681669 PMCID: PMC9179296 DOI: 10.3390/cancers14112689] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2022] [Revised: 05/20/2022] [Accepted: 05/26/2022] [Indexed: 12/24/2022] Open
Abstract
Simple Summary Positron emission tomography (PET), typically combined with computed tomography (CT), has become a critical advanced imaging technique in oncology. With PET-CT, a radioactive molecule (radiotracer) is injected in the bloodstream and localizes to sites of tumor because of specific cellular features of the tumor that accumulate the targeting radiotracer. The CT scan, performed at the same time, provides information to facilitate assessment of the amount of radioactivity from deep or dense structures, and to provide detailed anatomic information. PET-CT has a variety of applications in oncology, including staging, therapeutic response assessment, restaging, and surveillance. This series of six review articles provides an overview of the value, applications, and imaging and interpretive strategies of PET-CT in the more common adult malignancies. The second article in this series addresses the use of PET-CT in breast cancer and other primary thoracic malignancies. Abstract Positron emission tomography combined with x-ray computed tomography (PET-CT) is an advanced imaging modality with oncologic applications that include staging, therapy assessment, restaging, and surveillance. This six-part series of review articles provides practical information to providers and imaging professionals regarding the best use of PET-CT for the more common adult malignancies. The second article of this series addresses primary thoracic malignancy and breast cancer. For primary thoracic malignancy, the focus will be on lung cancer, malignant pleural mesothelioma, thymoma, and thymic carcinoma, with an emphasis on the use of FDG PET-CT. For breast cancer, the various histologic subtypes will be addressed, and will include 18F fluorodeoxyglucose (FDG), recently Food and Drug Administration (FDA)-approved 18F-fluoroestradiol (FES), and 18F sodium fluoride (NaF). The pitfalls and nuances of PET-CT in breast and primary thoracic malignancies and the imaging features that distinguish between subcategories of these tumors are addressed. This review will serve as a resource for the appropriate roles and limitations of PET-CT in the clinical management of patients with breast and primary thoracic malignancies for healthcare professionals caring for adult patients with these cancers. It also serves as a practical guide for imaging providers, including radiologists, nuclear medicine physicians, and their trainees.
Collapse
Affiliation(s)
- Matthew F. Covington
- Department of Radiology and Imaging Sciences, University of Utah, Salt Lake City, UT 84132, USA; (M.F.C.); (B.R.K.); (G.C.F.); (A.E.S.); (R.H.W.); (J.M.H.)
| | - Bhasker R. Koppula
- Department of Radiology and Imaging Sciences, University of Utah, Salt Lake City, UT 84132, USA; (M.F.C.); (B.R.K.); (G.C.F.); (A.E.S.); (R.H.W.); (J.M.H.)
| | - Gabriel C. Fine
- Department of Radiology and Imaging Sciences, University of Utah, Salt Lake City, UT 84132, USA; (M.F.C.); (B.R.K.); (G.C.F.); (A.E.S.); (R.H.W.); (J.M.H.)
| | - Ahmed Ebada Salem
- Department of Radiology and Imaging Sciences, University of Utah, Salt Lake City, UT 84132, USA; (M.F.C.); (B.R.K.); (G.C.F.); (A.E.S.); (R.H.W.); (J.M.H.)
- Department of Radiodiagnosis and Intervention, Faculty of Medicine, Alexandria University, Alexandria 21526, Egypt
| | - Richard H. Wiggins
- Department of Radiology and Imaging Sciences, University of Utah, Salt Lake City, UT 84132, USA; (M.F.C.); (B.R.K.); (G.C.F.); (A.E.S.); (R.H.W.); (J.M.H.)
| | - John M. Hoffman
- Department of Radiology and Imaging Sciences, University of Utah, Salt Lake City, UT 84132, USA; (M.F.C.); (B.R.K.); (G.C.F.); (A.E.S.); (R.H.W.); (J.M.H.)
| | - Kathryn A. Morton
- Department of Radiology and Imaging Sciences, University of Utah, Salt Lake City, UT 84132, USA; (M.F.C.); (B.R.K.); (G.C.F.); (A.E.S.); (R.H.W.); (J.M.H.)
- Intermountain Healthcare Hospitals, Summit Physician Specialists, Murray, UT 84123, USA
- Correspondence: ; Tel.: +1-801-581-7553
| |
Collapse
|
3
|
Chen G, Bai T, Wen LJ, Li Y. Predictive model for the probability of malignancy in solitary pulmonary nodules: a meta-analysis. J Cardiothorac Surg 2022; 17:102. [PMID: 35505414 PMCID: PMC9066878 DOI: 10.1186/s13019-022-01859-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2021] [Accepted: 04/24/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND To date, multiple predictive models have been developed with the goal of reliably differentiating between solitary pulmonary nodules (SPNs) that are malignant and those that are benign. The present meta-analysis was conducted to assess the diagnostic utility of these predictive models in the context of SPN differential diagnosis. METHODS The PubMed, Embase, Cochrane Library, CNKI, Wanfang, and VIP databases were searched for relevant studies published through August 31, 2021. Pooled data analyses were conducted using Stata v12.0. RESULTS In total, 20 retrospective studies that included 5171 SPNs (malignant/benign: 3662/1509) were incorporated into this meta-analysis. Respective pooled sensitivity, specificity, positive likelihood ratio (PLR), negative likelihood ratio (NLR), and diagnostic score values were 88% (95CI%: 0.84-0.91), 78% (95CI%: 0.74-0.80), 3.91 (95CI%: 3.42-4.46), 0.16 (95CI%: 0.12-0.21), and 3.21 (95CI%: 2.87-3.55), with an area under the summary receiver operating characteristic curve value of 86% (95CI%: 0.83-0.89). Significant heterogeneity among studies was detected with respect to sensitivity (I2 = 89.07%), NLR (I2 = 87.29%), and diagnostic score (I2 = 72.28%). In a meta-regression analysis, sensitivity was found to be impacted by the standard reference in a given study (surgery and biopsy vs. surgery only, P = 0.02), while specificity was impacted by whether studies were blinded (yes vs. unclear, P = 0.01). Sensitivity values were higher when surgery and biopsy samples were used as a standard reference, while unclear blinding status was associated with increased specificity. No significant evidence of publication bias was detected for the present meta-analysis (P = 0.539). CONCLUSIONS The results of this meta-analysis demonstrate that predictive models can offer significant diagnostic utility when establishing whether SPNs are malignant or benign.
Collapse
Affiliation(s)
- Gang Chen
- Department of Radiology, Xuzhou Central Hospital, Xuzhou, China
| | - Tian Bai
- Radiological Imaging Diagnostic Center, The Third Affiliated Hospital of Qiqihar Medical University, Qiqihar, China
| | - Li-Juan Wen
- Radiological Imaging Diagnostic Center, The Third Affiliated Hospital of Qiqihar Medical University, Qiqihar, China
| | - Yu Li
- Department of Radiology, Xuzhou Central Hospital, Xuzhou, China.
| |
Collapse
|
4
|
Pulmonary Nodules—an Epidemic—Work Up and Management, Specific, and Unique Issues in the Elderly. CURRENT GERIATRICS REPORTS 2020. [DOI: 10.1007/s13670-020-00321-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
|
5
|
Diagnostic Performance of PET or PET/CT with Different Radiotracers in Patients with Suspicious Lung Cancer or Pleural Tumours according to Published Meta-Analyses. CONTRAST MEDIA & MOLECULAR IMAGING 2020; 2020:5282698. [PMID: 32405280 PMCID: PMC7196984 DOI: 10.1155/2020/5282698] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/26/2020] [Accepted: 04/09/2020] [Indexed: 02/07/2023]
Abstract
Purpose Several meta-analyses have reported data about the diagnostic performance of positron emission tomography or positron emission tomography/computed tomography (PET or PET/CT) with different radiotracers in patients with suspicious lung cancer (LC) or pleural tumours (PT). This review article aims at providing an overview on the recent evidence-based data in this setting. Methods A comprehensive literature search of meta-analyses published in PubMed/MEDLINE and Cochrane Library database from January 2010 through March 2020 about the diagnostic performance of PET or PET/CT with different radiotracers in patients with suspicious LC or PT was performed. This combination of keywords was used: (A) “PET” OR “positron emission tomography” AND (B) “lung” OR “pulmonary” OR “pleur∗” AND (C) meta-analysis. Only meta-analyses on PET or PET/CT in patients with suspicious LC or PT were selected. Results We have summarized the diagnostic performance of PET or PET/CT with fluorine-18 fluorodeoxyglucose (18F-FDG) and other radiotracers taking into account 17 meta-analyses. Evidence-based data demonstrated a good diagnostic performance of 18F-FDG PET or PET/CT for the characterization of solitary pulmonary nodules (SPNs) or pleural lesions with overall higher sensitivity than specificity. Evidence-based data do not support the routine use of dual time point (DTP) 18F-FDG PET/CT or fluorine-18 fluorothymidine (18F-FLT) PET/CT in the differential diagnosis of SPNs. Even if 18F-FDG PET/CT has high sensitivity and specificity as a selective screening modality for LC, its role in this setting remains unknown. Conclusions Evidence-based data about the diagnostic performance of PET/CT with different radiotracers for suspicious LC or PT are increasing, with good diagnostic performance of 18F-FDG PET/CT. More prospective multicenter studies and cost-effectiveness analyses are warranted.
Collapse
|
6
|
Fernandez C, Grills IS, Ye H, Hope AJ, Guckenberger M, Mantel F, Kestin LL, Belderbos J, Werner-Wasik M. Stereotactic Image Guided Lung Radiation Therapy for Clinical Early Stage Non-Small Cell Lung Cancer: A Long-Term Report From a Multi-Institutional Database of Patients Treated With or Without a Pathologic Diagnosis. Pract Radiat Oncol 2019; 10:e227-e237. [PMID: 31837478 DOI: 10.1016/j.prro.2019.12.003] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2019] [Revised: 11/07/2019] [Accepted: 12/02/2019] [Indexed: 12/16/2022]
Abstract
PURPOSE Early stage lung cancer is treated with stereotactic body radiation therapy (SBRT) in patients who are unable or unwilling to undergo surgical resection. Some patients' comorbidities are so severe that they are unable to even undergo a biopsy. A clinical diagnosis without biopsy before SBRT has been used, but there are limited data on its efficacy. METHODS AND MATERIALS Data on patients treated with SBRT for non-small cell lung cancer, with and without tissue confirmation, were collected from multiple institutions across Europe, Canada, and the United States. Patients with a minimum of 2 years of comprehensive follow up were selected for analysis. Treatment and patient characteristics were compared. Overall survival (OS), disease-free survival (DFS), cause-specific survival (CSS), and rates of local recurrence (LR), regional recurrence (RR), and distant metastasis (DM) were calculated and analyzed. RESULTS A total of 701 patients were identified, of which 67% had tissue confirmation of their tumors. The 3- and 5-year outcomes for OS, CSS, and DFS were 83.8%, 93.1%, 69%, and 60.6%, 86.7%, 45.5%, respectively. The rates for LR, RR, and DM at 3 and 5 years were 6.4%, 9.3%, 14.3%, and 10.5%, 14.3%, 19.7%, respectively. There were no statistically significant differences in survival outcomes or recurrences between the biopsy and no-biopsy cohorts. CONCLUSIONS SBRT for clinically diagnosed lung cancers is efficacious in appropriately selected patients, with similar outcomes as those with a pathologic diagnosis. Thorough clinical and radiographic evaluations in a multidisciplinary setting are critical to the management of these patients.
Collapse
Affiliation(s)
- Christian Fernandez
- Department of Radiation Oncology, Sidney Kimmel Medical College & Cancer Center at Thomas Jefferson University, Philadelphia, Pennsylvania.
| | - Inga S Grills
- Department of Radiation Oncology, William Beaumont Health, Royal Oak, Michigan
| | - Hong Ye
- Department of Radiation Oncology, William Beaumont Health, Royal Oak, Michigan
| | - Andrew J Hope
- Department of Radiation Oncology, Princess Margaret Hospital, University of Toronto, Toronto, Ontario, Canada
| | | | - Frederick Mantel
- Department of Radiation Oncology, University of Würzburg, Würzburg, Germany
| | - Larry L Kestin
- Michigan Health Professionals, Radiation Oncology Institute, Farmington Hills, Michigan
| | - Jose Belderbos
- Department of Radiation Oncology, Netherlands Cancer Institute, Amsterdam, Netherlands
| | - Maria Werner-Wasik
- Department of Radiation Oncology, Sidney Kimmel Medical College & Cancer Center at Thomas Jefferson University, Philadelphia, Pennsylvania
| |
Collapse
|
7
|
Rosenkrantz AB, Xue X, Gyftopoulos S, Kim DC, Nicola GN. Downstream Costs Associated with Incidental Pulmonary Nodules Detected on CT. Acad Radiol 2019; 26:798-802. [PMID: 30093215 DOI: 10.1016/j.acra.2018.07.005] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2018] [Revised: 07/16/2018] [Accepted: 07/16/2018] [Indexed: 10/28/2022]
Abstract
RATIONALE AND OBJECTIVES To explore downstream costs associated with incidental pulmonary nodules detected on CT. MATERIALS AND METHODS The cohort comprised 200 patients with an incidental pulmonary nodule on chest CT. Downstream events (chest CT, PET/CT, office visits, percutaneous biopsy, and wedge resection) were identified from the electronic medical record. The 2017 Fleischner Society Guidelines were used to classify radiologists' recommendations and ordering physician management for the nodules. Downstream costs for nodule management were estimated from national Medicare rates, and average costs were determined. RESULTS Average downstream cost per nodule was $393. Costs were greater when ordering physicians over-managed relative to radiologist recommendations ($940) vs. when adherent ($637) or under-managing ($166) relative to radiologists recommendations. Costs were also greater when ordering physicians over-managed relative to Fleischner Society guidelines ($860) vs. when under-managing ($208) or adherent ($292) to guidelines. Costs did not vary significantly based on whether or not radiologists recommended follow-up imaging ($167-$397), nor whether radiologists were adherent or under- or over-recommended relative to Fleischner Society guidelines ($313-$444). Costs were also higher in older patients, patients with a smoking history, and larger nodules. Five nodules underwent wedge resection and diagnosed as malignancies. No patient demonstrated recurrence or metastasis. Average cost per diagnosed malignancy was $3090. CONCLUSION Downstream costs for incidental pulmonary nodules are highly variable and particularly high when ordering physicians over-manage relative to radiologist recommendations and Fleischner Society guidelines. To reduce unnecessary utilization and cost from over-management, radiologists may need to assume a greater role in partnering with ordering physicians to ensure appropriate, guideline-adherent, and follow-up testing.
Collapse
|
8
|
Soliman M, Petrella T, Tyrrell P, Wright F, Look Hong NJ, Lu H, Zezos P, Jimenez-Juan L, Oikonomou A. The clinical significance of indeterminate pulmonary nodules in melanoma patients at baseline and during follow-up chest CT. Eur J Radiol Open 2019; 6:85-90. [PMID: 30805420 PMCID: PMC6374500 DOI: 10.1016/j.ejro.2019.02.003] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2019] [Revised: 02/04/2019] [Accepted: 02/05/2019] [Indexed: 02/07/2023] Open
Abstract
Objective This study aims to determine an appropriate timeline to monitor indeterminate pulmonary nodules (IPN) in melanoma patients to confirm metastatic origin. Materials and Methods 588 clinically non-metastatic melanoma patients underwent curative intent surgery during 3 years. Patients with baseline chest CT and at least one follow-up (FU) CT were retrospectively analyzed to assess for IPN. Patients with definitely benign nodules, metastases and non-melanoma malignancies were excluded. Change in volume from first to FU CT, initial diameter (D1) and volume (V1), distance from pleura, peripheral and perifissural location, density and clinical stage were evaluated. Nodules were volumetrically measured on CTs and were considered metastases if they increased in size between two CTs or if increase was accompanied by multiple new nodules or extrapulmonary metastases. Results 148 patients were included. Two out of 243 baseline IPN detected in 70 patients, increased significantly in volume in 3 and 5 months and were proven metastases. During FU, 86% of 40 interval IPN detected in 28 patients, were proven metastases. Interval nodule (p < 0.0001, HR:243,CI:[57.32,1033.74]), 3-month volume change (OR:1.023,CI:[1.014,1.033]), V1 (OR:1.006,CI:[1.003,1.009]), D1 (OR:1.424,CI:[1.23,1.648]), distance from pleura (OR:1.03,CI:[1.003,1.059]), and combined stage IIC + III (OR:11.29,CI:[1.514,84.174]), were associated with increased risk for metastasis. 43%, 72% and 94% of patients with IPN were confirmed with metastases in the first FU CT at 3, 6 and 12 months respectively. Conclusion Baseline IPN are most likely benign, while interval IPN are high risk for metastasis. Absence of volume increase of IPN within 6 months excluded metastasis in most patients.
Collapse
Affiliation(s)
- Magdy Soliman
- Department of Medical Imaging, Sunnybrook Health Sciences Centre, University of Toronto, M4N 3M5, Toronto, ON, Canada
| | - Teresa Petrella
- Department of Medicine, Sunnybrook Health Sciences Centre, University of Toronto, M4N 3M5, Toronto, ON, Canada
| | - Pascal Tyrrell
- Department of Medical Imaging, University of Toronto, M5T 1W7, Toronto, ON, Canada
| | - Frances Wright
- Department of Surgery, Sunnybrook Health Sciences Centre, University of Toronto, M4N 3M5, Toronto, ON, Canada
| | - Nicole J Look Hong
- Department of Surgery, Sunnybrook Health Sciences Centre, University of Toronto, M4N 3M5, Toronto, ON, Canada
| | - Hua Lu
- Department of Medical Imaging, University of Toronto, M5T 1W7, Toronto, ON, Canada
| | - Petros Zezos
- Department of Medicine, North Ontario School of Medicine, ON P7B 5E1, Canada
| | - Laura Jimenez-Juan
- Department of Medical Imaging, Sunnybrook Health Sciences Centre, University of Toronto, M4N 3M5, Toronto, ON, Canada
| | - Anastasia Oikonomou
- Department of Medical Imaging, Sunnybrook Health Sciences Centre, University of Toronto, M4N 3M5, Toronto, ON, Canada
| |
Collapse
|
9
|
Models to Estimate the Probability of Malignancy in Patients with Pulmonary Nodules. Ann Am Thorac Soc 2018; 15:1117-1126. [DOI: 10.1513/annalsats.201803-173cme] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
|
10
|
do Vale RHB, Ferraro DA, Duarte PS, Carvalho G, Lima MS, Coura Filho GB, Sapienza MT, Buchpiguel CA. Bone marrow uptake of 18F-fluorodeoxyglucose in Hodgkin lymphoma without bone involvement: comparison between patients with and without B symptoms. Radiol Bras 2018; 51:76-80. [PMID: 29743733 PMCID: PMC5935399 DOI: 10.1590/0100-3984.2016.0201] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023] Open
Abstract
Objective To compare the degree of benign bone marrow uptake of
18F-fluorodeoxyglucose (18F-FDG) between Hodgkin
lymphoma patients with and without B symptoms. Materials and Methods We analyzed the medical charts of 74 Hodgkin lymphoma patients who underwent
18F-FDG positron emission tomography/computed tomography
(PET/CT) prior to the initiation of therapy between October 2010 and
September 2013. In all of the patients, the bone marrow biopsy was negative
and the 18F-FDG PET/CT images did not suggest bone marrow
involvement. Of the 74 patients evaluated, 54 presented inflammatory (B)
symptoms and 20 did not. Regions of interest (ROIs) were drawn on the
sternum, the proximal thirds of the humeri, the proximal thirds of the
femora, and both iliac wings (totaling seven ROIs per patient). To compare
the patients with and without B symptoms, in terms of standardized uptake
values (SUVs) for the seven ROIs, we used the Mann-Whitney U test. Results For six of the ROIs, the SUVs were higher in the patients with B symptoms
than in those without, and the difference was statistically significant
(p < 0.05). There was also a tendency toward a
statistically significant difference between the two groups in terms of the
SUV for the right iliac wing ROI (p = 0.06). Conclusion In our sample, the presence of B symptoms was associated with increased
18F-FDG uptake in bone marrow.
Collapse
Affiliation(s)
| | - Daniela Andrade Ferraro
- MD, Division of Nuclear Medicine, Instituto do Câncer do Estado de São Paulo (Icesp), São Paulo, SP, Brazil
| | - Paulo Schiavom Duarte
- MD, PhD, Division of Nuclear Medicine, Instituto do Câncer do Estado de São Paulo (Icesp), São Paulo, SP, Brazil
| | - Giovana Carvalho
- MD, Division of Nuclear Medicine, Instituto do Câncer do Estado de São Paulo (Icesp), São Paulo, SP, Brazil
| | - Marcos Santos Lima
- MD, Division of Nuclear Medicine, Instituto do Câncer do Estado de São Paulo (Icesp), São Paulo, SP, Brazil
| | - George Barbério Coura Filho
- MD, PhD, Division of Nuclear Medicine, Instituto do Câncer do Estado de São Paulo (Icesp), São Paulo, SP, Brazil
| | - Marcelo Tatit Sapienza
- MD, PhD, Division of Nuclear Medicine, Instituto do Câncer do Estado de São Paulo (Icesp), São Paulo, SP, Brazil
| | - Carlos Alberto Buchpiguel
- MD, PhD, Division of Nuclear Medicine, Instituto do Câncer do Estado de São Paulo (Icesp), São Paulo, SP, Brazil
| |
Collapse
|
11
|
Affiliation(s)
- Michael Simon
- Department of Medicine (Simon), Maimonides Medical Center, Brooklyn, NY; McMaster University (Zukotynski), Hamilton, Ont.; Department of Radiology & Biomedical Imaging (Naeger), University of California, San Francisco, Calif
| | - Katherine Zukotynski
- Department of Medicine (Simon), Maimonides Medical Center, Brooklyn, NY; McMaster University (Zukotynski), Hamilton, Ont.; Department of Radiology & Biomedical Imaging (Naeger), University of California, San Francisco, Calif
| | - David M Naeger
- Department of Medicine (Simon), Maimonides Medical Center, Brooklyn, NY; McMaster University (Zukotynski), Hamilton, Ont.; Department of Radiology & Biomedical Imaging (Naeger), University of California, San Francisco, Calif.
| |
Collapse
|
12
|
Meirelles GDSP, Capobianco J, de Oliveira MAC. Pitfalls and artifacts in the interpretation of oncologic PET/CT of the chest. Radiol Bras 2017; 50:55-59. [PMID: 28298733 PMCID: PMC5347504 DOI: 10.1590/0100-3984.2015.0194] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
PET/CT is widely used for the evaluation of patients with thoracic malignancies.
Although the levels of 18F-fluorodeoxyglucose (FDG) uptake are
usually high in neoplastic diseases, they can also be physiological, due to
artifacts. In addition, FDG uptake can occur in benign conditions such as
infectious, inflammatory, and iatrogenic lesions. Furthermore, some malignant
tumors, such as adenocarcinoma in situ (formerly known as bronchoalveolar
carcinoma) and carcinoid tumors, may not show FDG uptake. Here, we illustrate
the main pitfalls and artifacts in the interpretation of the results of
oncologic PET/CT of the chest, outlining strategies for avoiding
misinterpretation.
Collapse
Affiliation(s)
| | - Julia Capobianco
- MD, Specialist in PET/CT, Radiologist for the Grupo Fleury, São Paulo, SP, Brazil
| | | |
Collapse
|
13
|
Hochhegger B. PET/CT used in the evaluation of pulmonary nodules suspicious for lung cancer in regions where infectious lung disease is endemic: to be or not to be? Radiol Bras 2016; 49:199. [PMID: 27403022 PMCID: PMC4938452 DOI: 10.1590/0100-3984.2016.49.3.ce1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023] Open
Affiliation(s)
- Bruno Hochhegger
- Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA), Porto Alegre, RS, Brazil
| |
Collapse
|