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Iritani Y, Kato H, Kaneko Y, Ishihara T, Ando T, Kawaguchi M, Shibata H, Ogawa T, Noda Y, Hyodo F, Matsuo M. FDG uptake in the cervical muscles after neck dissection: imaging features and postoperative natural course on 18F‑FDG‑PET/CT. Jpn J Radiol 2024:10.1007/s11604-024-01568-6. [PMID: 38658502 DOI: 10.1007/s11604-024-01568-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2023] [Accepted: 04/07/2024] [Indexed: 04/26/2024]
Abstract
PURPOSE This study aimed to assess the imaging features and postoperative natural course of 18F-fluorodeoxyglucose (FDG) uptake in the cervical muscles after neck dissection. MATERIALS AND METHODS This study included 83 patients who underwent preoperative and postoperative 18F-FDG-PET/CT and were diagnosed with head and neck malignancy after neck dissection. Postoperative 18F-FDG-PET/CT was performed within 5 years after neck dissection. Preoperative and postoperative FDG uptake of the trapezius, sternocleidomastoid, scalene, pectoralis major, and deltoid muscles was visually assessed. Increased postoperative uptake was visually defined as higher postoperative FDG uptake than the preoperative one in the corresponding muscle. The maximum standardized uptake value (SUVmax) was measured in cases with increased postoperative uptakes. RESULTS Increased postoperative uptakes were observed in 43 patients (52%). The trapezius (31/83, 37%), sternocleidomastoid (19/83, 23%), and scalene (12/83, 14%) muscles were involved, as opposed to the pectoralis major and deltoid muscles were not. Increased postoperative uptakes were observed on the dissected side in all 43 patients. Significant differences between SUVmax estimated from the mixed-effects model and postoperative months were observed in the trapezius muscle (Coefficient (β) = -0.038; 95% confidence interval (CI): [-0.047, -0.028]; p < 0.001) and sternocleidomastoid muscle (β = -0.015; 95% CI: [-0.029, -0.001]; p = 0.046). CONCLUSIONS Increased postoperative uptakes in the cervical muscles were observed on the dissected side in approximately half of the patients after neck dissection. The SUVmax in the trapezius and sternocleidomastoid muscles decreased after surgery over time.
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Affiliation(s)
- Yukako Iritani
- Department of Radiology, Gifu University, 1-1 Yanagido, Gifu, 501-1194, Japan
| | - Hiroki Kato
- Department of Radiology, Gifu University, 1-1 Yanagido, Gifu, 501-1194, Japan.
| | - Yo Kaneko
- Department of Radiology, Gifu University, 1-1 Yanagido, Gifu, 501-1194, Japan
| | - Takuma Ishihara
- Innovative and Clinical Research Promotion Center, Gifu University Hospital, Gifu, Japan
| | - Tomohiro Ando
- Department of Radiology, Gifu University, 1-1 Yanagido, Gifu, 501-1194, Japan
| | - Masaya Kawaguchi
- Department of Radiology, Gifu University, 1-1 Yanagido, Gifu, 501-1194, Japan
| | | | - Takenori Ogawa
- Department of Otolaryngology, Gifu University, Gifu, Japan
| | - Yoshifumi Noda
- Department of Radiology, Gifu University, 1-1 Yanagido, Gifu, 501-1194, Japan
| | - Fuminori Hyodo
- Department of Radiology, Gifu University, 1-1 Yanagido, Gifu, 501-1194, Japan
- Center for One Medicine Innovative Translational Research (COMIT), Institute for Advanced Study, Gifu University, Gifu, Japan
| | - Masayuki Matsuo
- Department of Radiology, Gifu University, 1-1 Yanagido, Gifu, 501-1194, Japan
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2
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Choi J, Chae Y, Kang BT, Lee S. An evaluation of the physiological uptake range of 18F-fluoro-2-deoxy-D-glucose in normal ovaries of seven dogs using positron emission tomography/computed tomography. Front Vet Sci 2024; 11:1343695. [PMID: 38371597 PMCID: PMC10869473 DOI: 10.3389/fvets.2024.1343695] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2023] [Accepted: 01/12/2024] [Indexed: 02/20/2024] Open
Abstract
Introduction This study evaluated the physiological uptake range of 18F-fluoro-2-deoxy-D-glucose (18F-FDG) in the normal ovaries of seven dogs using positron emission tomography/computed tomography (PET/CT). Materials and methods The dogs were subjected to general anesthesia and were positioned in ventral recumbency for PET/CT scans. The dosage of 18F-FDG ranged from 0.14 to 0.17 mCi/kg and was administered intravenously followed by 0.9% NaCl flushing; PET/CT images of each dog were obtained precisely 60 min after the injection of 18F-FDG. The regions of interest were drawn manually, and standardized uptake values (SUV) were calculated to evaluate the 18F-FDG uptake in each ovary. The maximum and mean SUVs (SUV max and SUV mean) for all the ovaries of the dogs were then computed. Results The range of SUV max and SUV mean of the normal ovaries of the dogs were 1.28-1.62 and 1.07-1.31 (mean ± standard deviation), respectively. Conclusion This is the first study to investigate the normal 18F-FDG uptake baseline data of normal canine ovaries using PET/CT scans. These data will help clinicians in identifying malignant tumors before anatomical changes in the ovary through PET/CT scans.
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Affiliation(s)
- Jinyoung Choi
- Department of Veterinary Surgery, College of Veterinary Medicine, Chungbuk National University, Cheongju, Republic of Korea
| | - Yeon Chae
- Laboratory of Veterinary Internal Medicine, College of Veterinary Medicine, Chungbuk National University, Cheongju, Republic of Korea
| | - Byeong-Teck Kang
- Laboratory of Veterinary Internal Medicine, College of Veterinary Medicine, Chungbuk National University, Cheongju, Republic of Korea
| | - Sungin Lee
- Department of Veterinary Surgery, College of Veterinary Medicine, Chungbuk National University, Cheongju, Republic of Korea
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Kumar SA, Mittal BR, Sindhu T, Kumar R. "Bilateral Hot Forearm Sign": Ingeminating the Pattern of Physiological Uptake of 18F-Fludeoxyglucose. Indian J Nucl Med 2024; 39:61-62. [PMID: 38817722 PMCID: PMC11135376 DOI: 10.4103/ijnm.ijnm_145_23] [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: 12/20/2023] [Accepted: 12/21/2023] [Indexed: 06/01/2024] Open
Abstract
Exertion and exercise increase glucose metabolism within the skeletal muscles causing increased fludeoxyglucose (FDG) uptake on 18F-FDG positron emission tomography/computed tomography (PET/CT). Here, we present findings of 18F-FDG PET/CT in a patient with acute viral hepatitis A-induced liver failure with multiple foci of pyoderma and incessant itching resulting in increased FDG uptake in the muscles of the bilateral forearm, producing the "bilateral hot forearm sign."
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Affiliation(s)
- Srinivas Ananth Kumar
- Department of Nuclear Medicine, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Bhagwant Rai Mittal
- Department of Nuclear Medicine, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Tanigassalam Sindhu
- Department of Nuclear Medicine, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Rajender Kumar
- Department of Nuclear Medicine, Postgraduate Institute of Medical Education and Research, Chandigarh, India
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4
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Leek F, Anderson C, Robinson AP, Moss RM, Porter JC, Garthwaite HS, Groves AM, Hutton BF, Thielemans K. Optimisation of the air fraction correction for lung PET/CT: addressing resolution mismatch. EJNMMI Phys 2023; 10:77. [PMID: 38049611 PMCID: PMC10695904 DOI: 10.1186/s40658-023-00595-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2023] [Accepted: 11/20/2023] [Indexed: 12/06/2023] Open
Abstract
BACKGROUND Increased pulmonary [Formula: see text]F-FDG metabolism in patients with idiopathic pulmonary fibrosis, and other forms of diffuse parenchymal lung disease, can predict measurements of health and lung physiology. To improve PET quantification, voxel-wise air fractions (AF) determined from CT can be used to correct for variable air content in lung PET/CT. However, resolution mismatches between PET and CT can cause artefacts in the AF-corrected image. METHODS Three methodologies for determining the optimal kernel to smooth the CT are compared with noiseless simulations and non-TOF MLEM reconstructions of a patient-realistic digital phantom: (i) the point source insertion-and-subtraction method, [Formula: see text]; (ii) AF-correcting with varyingly smoothed CT to achieve the lowest RMSE with respect to the ground truth (GT) AF-corrected volume of interest (VOI), [Formula: see text]; iii) smoothing the GT image to match the reconstruction within the VOI, [Formula: see text]. The methods were evaluated both using VOI-specific kernels, and a single global kernel optimised for the six VOIs combined. Furthermore, [Formula: see text] was implemented on thorax phantom data measured on two clinical PET/CT scanners with various reconstruction protocols. RESULTS The simulations demonstrated that at [Formula: see text] iterations (200 i), the kernel width was dependent on iteration number and VOI position in the lung. The [Formula: see text] method estimated a lower, more uniform, kernel width in all parts of the lung investigated. However, all three methods resulted in approximately equivalent AF-corrected VOI RMSEs (<10%) at [Formula: see text]200i. The insensitivity of AF-corrected quantification to kernel width suggests that a single global kernel could be used. For all three methodologies, the computed global kernel resulted in an AF-corrected lung RMSE <10% at [Formula: see text]200i, while larger lung RMSEs were observed for the VOI-specific kernels. The global kernel approach was then employed with the [Formula: see text] method on measured data. The optimally smoothed GT emission matched the reconstructed image well, both within the VOI and the lung background. VOI RMSE was <10%, pre-AFC, for all reconstructions investigated. CONCLUSIONS Simulations for non-TOF PET indicated that around 200i were needed to approach image resolution stability in the lung. In addition, at this iteration number, a single global kernel, determined from several VOIs, for AFC, performed well over the whole lung. The [Formula: see text] method has the potential to be used to determine the kernel for AFC from scans of phantoms on clinical scanners.
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Affiliation(s)
- Francesca Leek
- Institute of Nuclear Medicine, University College London Hospitals NHS Trust, London, UK.
- Nuclear Medicine Metrology, National Physical Laboratory, Teddington, UK.
| | - Cameron Anderson
- Institute of Nuclear Medicine, University College London Hospitals NHS Trust, London, UK
| | - Andrew P Robinson
- Nuclear Medicine Metrology, National Physical Laboratory, Teddington, UK
- Christie Medical Physics and Engineering, The Christie NHS Foundation Trust, Manchester, UK
- Schuster Laboratory, School of Physics and Astronomy, University of Manchester, Manchester, UK
| | - Robert M Moss
- Department of Medical Physics and Biomedical Engineering, University College London, London, UK
| | - Joanna C Porter
- UCL Respiratory, University College London and Interstitial Lung Disease Service, University College London Hospitals NHS Trust, London, UK
| | - Helen S Garthwaite
- UCL Respiratory, University College London and Interstitial Lung Disease Service, University College London Hospitals NHS Trust, London, UK
| | - Ashley M Groves
- Institute of Nuclear Medicine, University College London Hospitals NHS Trust, London, UK
| | - Brian F Hutton
- Institute of Nuclear Medicine, University College London Hospitals NHS Trust, London, UK
| | - Kris Thielemans
- Institute of Nuclear Medicine, University College London Hospitals NHS Trust, London, UK
- Centre for Medical Image Computing, University College London, London, UK
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5
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Meidai L, Yujing D, Zhaoyu L, Shanshi L, Guangyu Z, Yan F, Xiuying Y, Jianhua Z. Comparison between an SGLT2 inhibitor and insulin in tumor-to-tissue contrasts in 18F-FDG PET imaging of diabetic mice. Sci Rep 2023; 13:18329. [PMID: 37884546 PMCID: PMC10603037 DOI: 10.1038/s41598-023-45094-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2023] [Accepted: 10/16/2023] [Indexed: 10/28/2023] Open
Abstract
18F-fluorodeoxyglucose positron emission tomography (18F-FDG PET) has been widely utilized for tumor diagnosis. Hyperglycemia affects the 18F-FDG uptake and reduces tumor-to-tissue contrasts, however, ideal hypoglycemic drugs are lacking. This study compared the role of insulin with the novel widely used hypoglycemic drug, sodium-glucose cotransporter 2 (SGLT2) inhibitor, on 18F-FDG PET imaging in diabetic conditions. The streptozotocin (STZ)-induced diabetic C57BL/6N mice were inoculated with B16 (mouse melanoma) cells to establish the xenograft tumor model. After the mice had been administrated with dapagliflozin (30 mg/kg, IG) or insulin (0.75 U/kg, IP) for one hour, 9.25 MBq/10 g 18F-FDG was injected. Biodistributions were detected by gamma counting and microPET imaging. The results showed dapagliflozin did not significantly affect the 18F-FDG uptake in tumors but reduced uptake in reference tissues, resulting in a significant increase in the tumor-to-skeletal muscle ratio. Conversely, insulin increased 18F-FDG uptake in tumors without significant reduction in uptake in reference tissues; Although there was an observable improvement in tumor imaging, it did not reach significantly statistical differences. This study suggests that insulin and SGLT2 inhibitor yield comparable effects on the quality of 18F-FDG PET imaging in diabetic patients. Nevertheless, SGLT2 inhibitors would be more suitable when skeletal muscle is used as reference tissue.
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Affiliation(s)
- Liang Meidai
- Department of Nuclear Medicine, Peking University First Hospital, Beijing, 100034, People's Republic of China
- Beijing Key Laboratory of Drug Target and Screening Research, Institute of Materia Medica of Peking, Union Medical College, Beijing, 100050, People's Republic of China
| | - Du Yujing
- Department of Nuclear Medicine, Peking University First Hospital, Beijing, 100034, People's Republic of China
- Department of Nuclear Medicine, Beijing Chaoyang Hospital, Capital Medical University, Beijing, 100020, People's Republic of China
| | - Liu Zhaoyu
- Beijing Key Laboratory of Drug Target and Screening Research, Institute of Materia Medica of Peking, Union Medical College, Beijing, 100050, People's Republic of China
| | - Li Shanshi
- Department of Radiation Oncology, Peking University First Hospital, Beijing, 100034, People's Republic of China
| | - Zhao Guangyu
- Department of Nuclear Medicine, Peking University First Hospital, Beijing, 100034, People's Republic of China
| | - Fan Yan
- Department of Nuclear Medicine, Peking University First Hospital, Beijing, 100034, People's Republic of China
| | - Yang Xiuying
- Beijing Key Laboratory of Drug Target and Screening Research, Institute of Materia Medica of Peking, Union Medical College, Beijing, 100050, People's Republic of China.
| | - Zhang Jianhua
- Department of Nuclear Medicine, Peking University First Hospital, Beijing, 100034, People's Republic of China.
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Okuyama C, Kusano K, Ito M, Takase A, Goda S, Kagawa S. Characteristic Muscular FDG Uptake Patterns Related to the Transportation Means Used by Patients to Visit the Hospital. Clin Nucl Med 2023; 48:549-552. [PMID: 36928161 DOI: 10.1097/rlu.0000000000004622] [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: 03/18/2023]
Abstract
ABSTRACT It is well-known that physiological FDG uptake in the skeletal muscles is affected by serum insulin levels and the extent to which the muscles contract before the examination. Patients are instructed to refrain from strenuous exercise, talking too much, and taking meals at least 4 hours before the administration of the tracer. Even if the patient does not intend to exercise, muscular accumulation related to specific behaviors can still be visualized in the images. In this manuscript, we present FDG PET/CT images from 4 cases reflecting the mode of transportation used by the patients to visit the hospital.
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Affiliation(s)
- Chio Okuyama
- From the Division of PET Imaging, Shiga Medical Center Research Institute, Moriyama, Japan
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7
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Liu H, Xiang F, Deng J, Li K, Chen Y. Early Detection of Gastric Intramucosal Adenocarcinoma on 68Ga-FAPI PET/CT. Clin Nucl Med 2023; Publish Ahead of Print:00003072-990000000-00574. [PMID: 37220235 DOI: 10.1097/rlu.0000000000004713] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/25/2023]
Abstract
ABSTRACT 18F-FDG PET/CT may sometimes not be an ideal imaging method for gastric adenocarcinoma. Because of the unstable physiological uptake of 18F-FDG in the gastrointestinal tract and muscles, it may interfere with the detection of lesions. We present a case of gastric intramucosal adenocarcinoma detected by 68Ga-FAPI PET/CT in a patient with nasopharyngeal carcinoma.
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8
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Shah UA, Ballinger TJ, Bhandari R, Dieli-Conwright CM, Guertin KA, Hibler EA, Kalam F, Lohmann AE, Ippolito JE. Imaging modalities for measuring body composition in patients with cancer: opportunities and challenges. J Natl Cancer Inst Monogr 2023; 2023:56-67. [PMID: 37139984 PMCID: PMC10157788 DOI: 10.1093/jncimonographs/lgad001] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2022] [Revised: 12/15/2022] [Accepted: 12/30/2022] [Indexed: 05/05/2023] Open
Abstract
Body composition assessment (ie, the measurement of muscle and adiposity) impacts several cancer-related outcomes including treatment-related toxicities, treatment responses, complications, and prognosis. Traditional modalities for body composition measurement include body mass index, body circumference, skinfold thickness, and bioelectrical impedance analysis; advanced imaging modalities include dual energy x-ray absorptiometry, computerized tomography, magnetic resonance imaging, and positron emission tomography. Each modality has its advantages and disadvantages, thus requiring an individualized approach in identifying the most appropriate measure for specific clinical or research situations. Advancements in imaging approaches have led to an abundance of available data, however, the lack of standardized thresholds for classification of abnormal muscle mass or adiposity has been a barrier to adopting these measurements widely in research and clinical care. In this review, we discuss the different modalities in detail and provide guidance on their unique opportunities and challenges.
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Affiliation(s)
- Urvi A Shah
- Department of Medicine, Myeloma Service, Memorial Sloan Kettering Cancer Center, New York, NY, USA
- Department of Medicine, Weill Cornell Medical College, New York, NY, USA
| | - Tarah J Ballinger
- Department of Medicine, Indiana University Simon Comprehensive Cancer Center, Indianapolis, IN, USA
| | - Rusha Bhandari
- Department of Pediatrics, City of Hope, Duarte, CA, USA
- Department of Population Science, City of Hope, Duarte, CA, USA
| | - Christina M Dieli-Conwright
- Division of Population Sciences, Department of Medical Oncology, Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA, USA
| | - Kristin A Guertin
- Department of Public Health Sciences, University of Connecticut Health, Farmington, CT, USA
| | - Elizabeth A Hibler
- Department of Preventive Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | - Faiza Kalam
- Department of Preventive Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | - Ana Elisa Lohmann
- Department of Medical Oncology, Schulich School of Medicine and Dentistry, University of Western Ontario, London, ON, Canada
| | - Joseph E Ippolito
- Department of Radiology, Washington University School of Medicine, St. Louis, MO, USA
- Department of Biochemistry and Molecular Biophysics, Washington University School of Medicine, St Louis, MO, USA
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Kamaleshwaran KK, Ramkumar E, Senthilkumar E. F-18 Fluorodeoxyglucose Positron Emission Tomography/Computed Tomography Muscle Uptake in Antiglutamic Acid Decarboxylase Antibody-positive Stiff-person Syndrome. Indian J Nucl Med 2023; 38:162-164. [PMID: 37456188 PMCID: PMC10348489 DOI: 10.4103/ijnm.ijnm_94_22] [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: 05/30/2022] [Revised: 08/12/2022] [Accepted: 09/06/2022] [Indexed: 07/18/2023] Open
Abstract
Antiglutamic acid decarboxylase-65 (anti-GAD65) autoantibodies have been identified in variety of rare neurologic disorders most frequently in stiff-person syndrome (SPS), condition characterized by muscle rigidity and overlying painful spasms, typically affecting axial and limb musculature. In anti-GAD65-related neurologic disorder, malignancy screening is often performed with 18F-fluorodeoxyglucose positron emission tomography/computed tomography (FDG PET/CT). Here, we present an interesting image of 18FFDG PET/CT whole body showing muscle uptake and FDG brain showing thalamic hypometabolism in SPS.
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Affiliation(s)
| | - Elumalai Ramkumar
- Department of Nuclear Medicine, Kovai Medical Center and Hospital Limited, Coimbatore, Tamil Nadu, India
| | - Elumalai Senthilkumar
- Department of Neurology, Kovai Medical Center and Hospital Limited, Coimbatore, Tamil Nadu, India
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10
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Diplopia Related to a Pediatric Cervical Rhabdoid Tumor in 18F-FDG PET. Clin Nucl Med 2022; 47:e689-e691. [PMID: 35867984 DOI: 10.1097/rlu.0000000000004327] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
ABSTRACT Increased muscle uptake is commonly seen with 18F-FDG PET/CT because of an important physiological muscle glucose metabolism. Muscle uptake can express a recent significant muscle activity. However, the absence of muscle uptake is almost never described or interpreted. We describe the case of an 8-year-old boy with extrarenal rhabdoid tumor in the right carotid space. An MRI and an 18F-FDG PET/CT were performed for the diagnostic workup. There was no uptake in the lateral rectus oculomotor muscle unlike all other oculomotor muscles. The ophthalmological examination found a diplopia confirmed by the Lancaster test.
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Abstract
Though metastasis and malignant infiltration of the peripheral nervous system is relatively rare, physicians should have a familiarity with their presentations to allow for prompt diagnosis and initiation of treatment. This article will review the clinical presentations, diagnostic evaluation, and treatment of neoplastic involvement of the cranial nerves, nerve roots, peripheral nerves, and muscle. Due to the proximity of the neural structure traversing the skull base, metastasis to this region results in distinctive syndromes, most often associated with breast, lung, and prostate cancer. Metastatic involvement of the nerve roots is uncommon, apart from leptomeningeal carcinomatosis and bony metastasis with resultant nerve root damage, and is characterized by significant pain, weakness, and numbness of an extremity. Neoplasms may metastasize or infiltrate the brachial and lumbosacral plexuses resulting in progressive and painful sensory and motor deficits. Differentiating neoplastic involvement from radiation-induced injury is of paramount importance as it dictates treatment and prognosis. Neurolymphomatosis, due to malignant lymphocytic infiltration of the cranial nerves, nerve roots, plexuses, and peripheral nerves, deserves special attention given its myriad presentations, often mimicking acquired demyelinating neuropathies.
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12
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Positron emission tomography and magnetic resonance imaging of the brain in experimental human malaria, a prospective cohort study. Sci Rep 2022; 12:5696. [PMID: 35383257 PMCID: PMC8983718 DOI: 10.1038/s41598-022-09748-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2021] [Accepted: 02/01/2022] [Indexed: 12/25/2022] Open
Abstract
Cerebral malaria is the most serious manifestation of severe falciparum malaria. Sequestration of infected red blood cells and microvascular dysfunction are key contributing processes. Whether these processes occur in early stage disease prior to clinical manifestations is unknown. To help localize and understand these processes during the early stages of infection, we performed 18-F fluorodeoxyglucose positron emission tomography/magnetic resonance imaging in volunteers with Plasmodium falciparum induced blood stage malaria (IBSM) infection, and compared results to individuals with P. vivax infection, in whom coma is rare. Seven healthy, malaria-naïve participants underwent imaging at baseline, and at early symptom onset a median 9 days following inoculation (n = 4 P. falciparum, n = 3 P. vivax). Participants with P. falciparum infection demonstrated marked lability in radiotracer uptake across all regions of the brain, exceeding expected normal variation (within subject coefficient of variation (wCV): 14.4%) compared to the relatively stable uptake in participants with P. vivax infection (wCV: 3.5%). No consistent imaging changes suggestive of microvascular dysfunction were observed in either group. Neuroimaging in early IBSM studies is safe and technically feasible, with preliminary results suggesting that differences in brain tropism between P. falciparum and P. vivax may occur very early in infection.
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13
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Atlas of non-pathological solitary or asymmetrical skeletal muscle uptake in [ 18F]FDG-PET. Jpn J Radiol 2022; 40:755-767. [PMID: 35344131 PMCID: PMC9345840 DOI: 10.1007/s11604-022-01264-3] [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: 03/02/2022] [Accepted: 03/08/2022] [Indexed: 11/25/2022]
Abstract
Positron emission tomography (PET) using 2-deoxy-2-[18F]fluoro-d-glucose ([18F]FDG) is widely used in oncology and other fields. In [18F]FDG PET images, increased muscle uptake is observed owing exercise load or muscle tension, in addition to malignant tumors and inflammation. Moreover, we occasionally observe non-pathological solitary or unilateral skeletal muscle uptake, which is difficult to explain the strict reason. In most cases, we can interpret them as not having pathological significance. However, it is important to recognize such muscle uptake patterns to avoid misdiagnoses with pathological ones. Therefore, the teaching point of this pictorial essay is to comprehend the patterns of solitary or asymmetrical skeletal muscle uptake seen in routine [18F]FDG-PET scans. As an educational goal, you will be able to mention muscles where intense physiological [18F]FDG uptake can be observed, differentiate between physiological muscle uptake and lesion, and discuss with any physicians or specialists about uncertain muscle uptake.
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14
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Subesinghe M, Bhuva S, Arumalla N, Cope A, D'Cruz D, Subesinghe S. FDG PET-CT in rheumatological diseases. Rheumatology (Oxford) 2021; 61:1769-1782. [PMID: 34463703 PMCID: PMC9071551 DOI: 10.1093/rheumatology/keab675] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2021] [Revised: 08/18/2021] [Accepted: 08/25/2021] [Indexed: 12/26/2022] Open
Abstract
2-deoxy-2[18F]fluoro-D-glucose (FDG) PET-CT has revolutionized oncological imaging. The cellular processes that make cancer cells visible on FDG PET-CT also occur in a number of inflammatory cells. Exploiting this phenomenon has led to a growth of evidence supporting the use of FDG PET-CT in a wide range of infective and inflammatory diseases. Rheumatological diseases can affect multiple sites within the musculoskeletal system alongside multi-organ extra-articular disease manifestations. Inflammation is central to these diseases, making FDG PET-CT a logical choice. In this review article we describe the various applications of FDG PET-CT in rheumatological diseases using illustrative examples to highlight the beneficial role of FDG PET-CT in each case.
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Affiliation(s)
- Manil Subesinghe
- King's College London & Guy's and St. Thomas' PET Centre, Guy's and St. Thomas' NHS Foundation Trust, London, UK.,Department of Cancer Imaging, School of Biomedical Engineering and Imaging Sciences, Faculty of Life Sciences and Medicine, King's College London, London, UK
| | - Shaheel Bhuva
- King's College London & Guy's and St. Thomas' PET Centre, Guy's and St. Thomas' NHS Foundation Trust, London, UK.,Department of Cancer Imaging, School of Biomedical Engineering and Imaging Sciences, Faculty of Life Sciences and Medicine, King's College London, London, UK
| | - Nikita Arumalla
- Department of Rheumatology, Guy's and St. Thomas' NHS Foundation Trust, London, UK
| | - Andrew Cope
- Department of Rheumatology, Guy's and St. Thomas' NHS Foundation Trust, London, UK.,Centre for Rheumatic Diseases, School of Immunology and Microbial Sciences, Faculty of Life Sciences and Medicine, King's College London, London, UK
| | - David D'Cruz
- Department of Rheumatology, Guy's and St. Thomas' NHS Foundation Trust, London, UK
| | - Sujith Subesinghe
- Department of Rheumatology, Guy's and St. Thomas' NHS Foundation Trust, London, UK
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Kondratyev SA, Skiteva EN, Zabrodskaya YM, Ryzhkova DV, Kondratyeva ЕА, Kondratyev AN. Structural and Metabolic Changes in Skeletal Muscles of Patients with Chronic Disorders of Consciousness—To the Issue of Critical Illness Polyneuromyopathies (a PET/CT Pathomorphological Study). J EVOL BIOCHEM PHYS+ 2021. [DOI: 10.1134/s0022093021040153] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
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Nakaya M, Kurokawa R, Kanemaru N, Sakamoto N, Nyunoya K, Joohyung Y, Kamiya K, Cho S, Fujita N, Kamio S, Koyama H, Suzuki S, Gonoi W, Abe O. Physiological 2-deoxy-2-[fluorine-18] fluoro-D-glucose accumulation in the thenar eminence in adults: a single-center retrospective study. Ann Nucl Med 2021; 35:1167-1173. [PMID: 34269978 DOI: 10.1007/s12149-021-01654-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2021] [Accepted: 07/12/2021] [Indexed: 11/28/2022]
Abstract
OBJECTIVE This study evaluated the frequency, and effect of physiological 2-deoxy-2-[fluorine-18] fluoro-D-glucose (FDG) tracer injection and its association with the penetration rates of mobile devices. METHODS This retrospective analysis included 213 patients (mean age ± standard deviation, 66.2 ± 14.1 years; range 23-93 years; 125 men) who underwent FDG-positron emission tomography examination. Elevated FDG activity in the thenar eminence with maximum standardized uptake value (SUVmax) ≥ 2.5 was considered positive. Differences according to age, sex, laterality, and tracer injection side were evaluated using Fisher's exact test. Associations were assessed using Pearson's correlation coefficient. RESULTS Twenty-three percent (49/213) of the patients had elevated FDG activity in the thenar eminence (mean SUVmax, 3.50 ± 1.04; range 2.5-6.3), including 18 with bilateral findings. No significant difference existed according to age (< 50 years vs. 50-69 years vs. ≥ 70 years), sex, laterality, or tracer injection side. No significant correlation existed between penetration rates of mobile devices and the findings (p = 0.08). CONCLUSION Elevated FDG activity in the thenar eminence occurs in adults, regardless of age, sex, laterality, or tracer injection side. This should be considered a common physiological change that does not warrant any further investigation.
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Affiliation(s)
- Moto Nakaya
- Department of Radiology, Graduate School of Medicine, University of Tokyo, 7-3-1, Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan
| | - Ryo Kurokawa
- Department of Radiology, Graduate School of Medicine, University of Tokyo, 7-3-1, Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan.
| | - Noriko Kanemaru
- Department of Radiology, Graduate School of Medicine, University of Tokyo, 7-3-1, Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan
| | - Naoya Sakamoto
- Department of Radiology, Graduate School of Medicine, University of Tokyo, 7-3-1, Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan
| | - Keisuke Nyunoya
- Department of Radiology, Graduate School of Medicine, University of Tokyo, 7-3-1, Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan
| | - Youh Joohyung
- Department of Radiology, Graduate School of Medicine, University of Tokyo, 7-3-1, Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan
| | - Kouhei Kamiya
- Department of Radiology, Graduate School of Medicine, University of Tokyo, 7-3-1, Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan.,Department of Radiology, Toho University Omori Medical Center, 6-11-1 Omori-nishi, Ota-ku, Tokyo, 143-8541, Japan
| | - Shinichi Cho
- Department of Radiology, Graduate School of Medicine, University of Tokyo, 7-3-1, Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan
| | - Nana Fujita
- Department of Radiology, Graduate School of Medicine, University of Tokyo, 7-3-1, Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan
| | - Satoru Kamio
- Department of Radiology, Graduate School of Medicine, University of Tokyo, 7-3-1, Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan
| | - Hiroaki Koyama
- Department of Radiology, Graduate School of Medicine, University of Tokyo, 7-3-1, Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan
| | - Satoshi Suzuki
- Department of Radiology, Graduate School of Medicine, University of Tokyo, 7-3-1, Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan
| | - Wataru Gonoi
- Department of Radiology, Graduate School of Medicine, University of Tokyo, 7-3-1, Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan
| | - Osamu Abe
- Department of Radiology, Graduate School of Medicine, University of Tokyo, 7-3-1, Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan
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Agrawal A, Shah S, Gnanasegaran G, Rajkotia S, Purandare N, Puranik A, Rangarajan V. PET/CT Normal Variants and Pitfalls in Pediatric disorders. Semin Nucl Med 2021; 51:572-583. [PMID: 34243902 DOI: 10.1053/j.semnuclmed.2021.06.007] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
18F- Fluoro-deoxyglucose positron emission computed tomography (18F-FDG PET CT) is an established modality used mainly in oncology. Though it has widespread oncologic indications, it is not tumor specific. Apart from the physiological distribution, uptake of FDG may be seen in many benign conditions, including infection and inflammation in children and adults. Performing and acquiring a technically adequate PET CT study may be more challenging in children. Proper preparation and an acceptable imaging protocol will help to avoid re-acquisition and in minimizing the radiation exposure. Sound knowledge of the physiological variants and benign conditions that are specific to the pediatric population will aid in correct interpretation of the PET CT study. It is important that radiologists and Nuclear Medicine physicians who report these studies are well-acquainted with these pitfalls to avoid false positive studies.
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Affiliation(s)
- Archi Agrawal
- Department of Nuclear Medicine and Molecular Imaging, Tata Memorial Hospital, Homi Bhabha National Institute, Mumbai, MH.
| | - Sneha Shah
- Department of Nuclear Medicine and Molecular Imaging, Tata Memorial Hospital, Homi Bhabha National Institute, Mumbai, MH
| | | | - Saloni Rajkotia
- Department of Nuclear Medicine and Molecular Imaging, Tata Memorial Hospital, Homi Bhabha National Institute, Mumbai, MH
| | - Nilendu Purandare
- Department of Nuclear Medicine and Molecular Imaging, Tata Memorial Hospital, Homi Bhabha National Institute, Mumbai, MH
| | - Ameya Puranik
- Department of Nuclear Medicine and Molecular Imaging, Tata Memorial Hospital, Homi Bhabha National Institute, Mumbai, MH
| | - Venkatesh Rangarajan
- Department of Nuclear Medicine and Molecular Imaging, Tata Memorial Hospital, Homi Bhabha National Institute, Mumbai, MH
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Mihailovic J, Killeen RP, Duignan JA. PET/CT Variants and Pitfalls in Head and Neck Cancers Including Thyroid Cancer. Semin Nucl Med 2021; 51:419-440. [PMID: 33947603 DOI: 10.1053/j.semnuclmed.2021.03.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
PET/CT imaging is a dual-modality diagnostic technology that merges metabolic and structural imaging. There are several currently available radiotracers, but 18F-FDG is the most commonly utilized due to its widespread availability. 18F-FDG PET/CT is a cornerstone of head and neck squamous cell carcinoma imaging. 68Ga-DOTA-TOC is another widely used radiotracer. It allows for whole-body imaging of cellular somatostatin receptors, commonly expressed by neuroendocrine tumors and is the standard of reference for the characterization and staging of neuroendocrine tumors. The normal biodistribution of these PET radiotracers as well as the technical aspects of image acquisition and inadequate patient preparation affect the quality of PET/CT imaging. In addition, normal variants, artifacts and incidental findings may impede accurate image interpretation and can potentially lead to misdiagnosis. In order to correctly interpret PET/CT imaging, it is necessary to have a comprehensive knowledge of the normal anatomy of the head and neck and to be cognizant of potential imaging pitfalls. The interpreter must be familiar with benign conditions which may accumulate radiotracer potentially mimicking neoplastic processes and also be aware of malignancies which can demonstrate low radiotracer uptake. Appropriate use of structural imaging with either CT, MR or ultrasound can serve a complimentary role in several head and neck pathologies including local tumor staging, detection of bone marrow involvement or perineural spread, and classification of thyroid nodules. It is important to be aware of the role of these complementary modalities to maximize diagnostic accuracy and patient outcomes. The purpose of this article is to outline the basic principles of PET/CT imaging, with a focus on 18F-FDG PET/CT and 68Ga-DOTA PET/CT. Basic physiology, variant imaging appearances and potential pitfalls of image interpretation are presented within the context of common use cases of PET technology in patients with head and neck cancers and other pathologies, benign and malignant.
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Affiliation(s)
- Jasna Mihailovic
- Department of Radiology, Faculty of Medicine, University of Novi Sad, Novi Sad, Serbia; Centre of Nuclear Medicine, Oncology Institute of Vojvodina, Sremska Kamenica, Serbia.
| | - Ronan P Killeen
- Department of Radiology, St Vincent's University Hospital, Elm Park, Dublin 4, Ireland; UCD - SVUH PET CT Research Centre, St Vincent's University Hospital, Elm Park, Dublin 4, Ireland
| | - John A Duignan
- Department of Radiology, St Vincent's University Hospital, Elm Park, Dublin 4, Ireland; UCD - SVUH PET CT Research Centre, St Vincent's University Hospital, Elm Park, Dublin 4, Ireland
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Woodford J, Gillman A, Jenvey P, Roberts J, Woolley S, Barber BE, Fernandez M, Rose S, Thomas P, Anstey NM, McCarthy JS. Positron emission tomography and magnetic resonance imaging in experimental human malaria to identify organ-specific changes in morphology and glucose metabolism: A prospective cohort study. PLoS Med 2021; 18:e1003567. [PMID: 34038421 PMCID: PMC8154100 DOI: 10.1371/journal.pmed.1003567] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/19/2020] [Accepted: 02/17/2021] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Plasmodium vivax has been proposed to infect and replicate in the human spleen and bone marrow. Compared to Plasmodium falciparum, which is known to undergo microvascular tissue sequestration, little is known about the behavior of P. vivax outside of the circulating compartment. This may be due in part to difficulties in studying parasite location and activity in life. METHODS AND FINDINGS To identify organ-specific changes during the early stages of P. vivax infection, we performed 18-F fluorodeoxyglucose (FDG) positron emission tomography/magnetic resonance imaging (PET/MRI) at baseline and just prior to onset of clinical illness in P. vivax experimentally induced blood-stage malaria (IBSM) and compared findings to P. falciparum IBSM. Seven healthy, malaria-naive participants were enrolled from 3 IBSM trials: NCT02867059, ACTRN12616000174482, and ACTRN12619001085167. Imaging took place between 2016 and 2019 at the Herston Imaging Research Facility, Australia. Postinoculation imaging was performed after a median of 9 days in both species (n = 3 P. vivax; n = 4 P. falciparum). All participants were aged between 19 and 23 years, and 6/7 were male. Splenic volume (P. vivax: +28.8% [confidence interval (CI) +10.3% to +57.3%], P. falciparum: +22.9 [CI -15.3% to +61.1%]) and radiotracer uptake (P. vivax: +15.5% [CI -0.7% to +31.7%], P. falciparum: +5.5% [CI +1.4% to +9.6%]) increased following infection with each species, but more so in P. vivax infection (volume: p = 0.72, radiotracer uptake: p = 0.036). There was no change in FDG uptake in the bone marrow (P. vivax: +4.6% [CI -15.9% to +25.0%], P. falciparum: +3.2% [CI -3.2% to +9.6%]) or liver (P. vivax: +6.2% [CI -8.7% to +21.1%], P. falciparum: -1.4% [CI -4.6% to +1.8%]) following infection with either species. In participants with P. vivax, hemoglobin, hematocrit, and platelet count decreased from baseline at the time of postinoculation imaging. Decrements in hemoglobin and hematocrit were significantly greater in participants with P. vivax infection compared to P. falciparum. The main limitations of this study are the small sample size and the inability of this tracer to differentiate between host and parasite metabolic activity. CONCLUSIONS PET/MRI indicated greater splenic tropism and metabolic activity in early P. vivax infection compared to P. falciparum, supporting the hypothesis of splenic accumulation of P. vivax very early in infection. The absence of uptake in the bone marrow and liver suggests that, at least in early infection, these tissues do not harbor a large parasite biomass or do not provoke a prominent metabolic response. PET/MRI is a safe and noninvasive method to evaluate infection-associated organ changes in morphology and glucose metabolism.
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Affiliation(s)
- John Woodford
- Clinical Tropical Medicine Laboratory, QIMR-Berghofer Medical Research Institute, Brisbane, Australia
- University of Queensland, Brisbane, Australia
| | - Ashley Gillman
- Commonwealth Scientific and Industrial Research Organisation, Brisbane, Australia
| | - Peter Jenvey
- Department of Radiology, Royal Brisbane and Women’s Hospital, Brisbane, Australia
| | - Jennie Roberts
- Department of Radiology, Royal Brisbane and Women’s Hospital, Brisbane, Australia
| | - Stephen Woolley
- Clinical Tropical Medicine Laboratory, QIMR-Berghofer Medical Research Institute, Brisbane, Australia
- Centre for Defence Pathology, Royal Centre for Defence Medicine, Birmingham, United Kingdom
| | - Bridget E. Barber
- Clinical Tropical Medicine Laboratory, QIMR-Berghofer Medical Research Institute, Brisbane, Australia
- Global and Tropical Health Division, Menzies School of Health Research and Charles Darwin University, Darwin, Australia
| | - Melissa Fernandez
- Clinical Tropical Medicine Laboratory, QIMR-Berghofer Medical Research Institute, Brisbane, Australia
| | - Stephen Rose
- Commonwealth Scientific and Industrial Research Organisation, Brisbane, Australia
| | - Paul Thomas
- Herston Imaging Research Facility, Brisbane, Australia
| | - Nicholas M. Anstey
- Global and Tropical Health Division, Menzies School of Health Research and Charles Darwin University, Darwin, Australia
| | - James S. McCarthy
- Clinical Tropical Medicine Laboratory, QIMR-Berghofer Medical Research Institute, Brisbane, Australia
- University of Queensland, Brisbane, Australia
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Xu T, Zhang X, Zhang S, Liu C, Fu W, Zeng C, Chen Y. Imaging features and prognostic value of 18F-FDG PET/CT detection of soft-tissue metastasis from lung cancer: a retrospective study. BMC Cancer 2020; 20:596. [PMID: 32586285 PMCID: PMC7318454 DOI: 10.1186/s12885-020-07080-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2020] [Accepted: 06/16/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Soft-tissue metastasis (STM) is a relatively rare, but not exceptional, manifestation of lung cancer. The purpose of this study was to evaluate the imaging features of STM from lung cancer using fluorine-18 fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG PET/CT), and assess the impact of STM detected at baseline PET/CT on patient survival. METHODS Out of 4543 patients with lung cancer who underwent 18F-FDG PET/CT in our hospital between January 2013 and September 2018, 85 were diagnosed with STM (78 at baseline PET/CT and 7 at restaging PET/CT) and included in the imaging study. We conducted a comparative survival analysis between patients with stage 4 lung cancer with and without STM at baseline PET/CT (n = 78 in each group) and performed univariate and multivariate analyses to investigate the factors affecting the prognosis of lung cancer. RESULTS A total of 219 lesions were identified by 18F-FDG PET/CT: 215 were detected by PET and 139 by CT. Muscle STM were primarily found in the hip and upper limb muscle, whereas subcutaneous STM were mainly distributed in the chest, abdomen, and back. In 68 patients, STM were found incidentally during routine 18F-FDG PET/CT staging. Isolated STM were detected in 6 patients, whose tumor staging and treatment were affected by PET/CT findings. There were no significant differences in the 1-, 3-, and 5-year survival rates between patients with and without STM at baseline PET/CT. Brain and adrenal metastases, but not STM, were associated with poor prognosis of stage 4 lung cancer. CONCLUSIONS We described the PET/CT imaging characteristics of STM from lung cancer, and confirmed that PET/CT can detect unsuspected STM to change the staging and treatment of some patients. Our analysis indicates that STM is not a useful prognostic indicator for patients with advanced lung cancer, while brain and adrenal metastases portend a poor prognosis.
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Affiliation(s)
- Tingting Xu
- Department of Nuclear Medicine, the Affiliated Hospital of Southwest Medical University, Luzhou, Sichuan, PR China, 646000.,Nuclear Medicine and Molecular Imaging Key Laboratory of Sichuan Province, No 25 TaiPing St, Jiangyang District, Luzhou, Sichuan, 646000, PR China
| | - Xinyi Zhang
- Department of Nuclear Medicine, the Affiliated Hospital of Southwest Medical University, Luzhou, Sichuan, PR China, 646000.,Nuclear Medicine and Molecular Imaging Key Laboratory of Sichuan Province, No 25 TaiPing St, Jiangyang District, Luzhou, Sichuan, 646000, PR China
| | - Shumao Zhang
- Department of Nuclear Medicine, the Affiliated Hospital of Southwest Medical University, Luzhou, Sichuan, PR China, 646000.,Nuclear Medicine and Molecular Imaging Key Laboratory of Sichuan Province, No 25 TaiPing St, Jiangyang District, Luzhou, Sichuan, 646000, PR China
| | - Chunfeng Liu
- Department of Respiratory Medicine, the Affiliated Hospital of Southwest Medical University, Luzhou, Sichuan, PR China, 646000
| | - Wenhui Fu
- Department of Nuclear Medicine, the Affiliated Hospital of Southwest Medical University, Luzhou, Sichuan, PR China, 646000.,Nuclear Medicine and Molecular Imaging Key Laboratory of Sichuan Province, No 25 TaiPing St, Jiangyang District, Luzhou, Sichuan, 646000, PR China
| | - Chengrun Zeng
- Department of Nuclear Medicine, the Affiliated Hospital of Southwest Medical University, Luzhou, Sichuan, PR China, 646000.,Nuclear Medicine and Molecular Imaging Key Laboratory of Sichuan Province, No 25 TaiPing St, Jiangyang District, Luzhou, Sichuan, 646000, PR China
| | - Yue Chen
- Department of Nuclear Medicine, the Affiliated Hospital of Southwest Medical University, Luzhou, Sichuan, PR China, 646000. .,Nuclear Medicine and Molecular Imaging Key Laboratory of Sichuan Province, No 25 TaiPing St, Jiangyang District, Luzhou, Sichuan, 646000, PR China.
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Beheshti M, Manafi-Farid R, Rezaee A, Langsteger W. PET/CT and PET/MRI, Normal Variations, and Artifacts. Clin Nucl Med 2020. [DOI: 10.1007/978-3-030-39457-8_17] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
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18F-FDG-PET/CT in measuring volume and global metabolic activity of thigh muscles. Nucl Med Commun 2020; 41:162-168. [DOI: 10.1097/mnm.0000000000001127] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
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Gray BR, Koontz NA. Normal Patterns and Pitfalls of FDG Uptake in the Head and Neck. Semin Ultrasound CT MR 2019; 40:367-375. [DOI: 10.1053/j.sult.2019.07.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Frank I, Mann K, Duerr F. Fluorine-18-fluoro-2-deoxy-d-glucose PET-CT aids in detection of soft-tissue injuries for dogs with thoracic or pelvic limb lameness. Vet Radiol Ultrasound 2019; 60:575-585. [PMID: 31357247 DOI: 10.1111/vru.12790] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2019] [Revised: 04/20/2019] [Accepted: 05/28/2019] [Indexed: 12/13/2022] Open
Abstract
Fluorine-18-fluoro-2-deoxy-d-glucose positron emission tomography (FDG PET) provides physiologic images of tissues based on their glucose metabolism. The combination of FDG PET and CT (FDG PET-CT) has been utilized in human musculoskeletal imaging to localize soft tissue lesions, however, this modality has not been thoroughly investigated for the diagnosis of canine lameness. This prospective, descriptive study evaluated FDG PET-CT findings in 25 client-owned dogs with inconclusive origin of thoracic or pelvic limb lameness (thoracic limb n = 15/25, 60%; pelvic limb n = 6/25, 24%; and combination of both limbs n = 4/25, 16%). We hypothesized that FDG PET-CT would aid the detection of soft tissue lesions not visible with other imaging modalities. Combined FDG PET-CT detected soft tissue lesions in 40% (n = 10/25) and osteoarthritis in 64% (n = 16/25) of the patients. FDG PET detected more soft tissue lesions than contrast-enhanced CT (n = 15/15, 100% and n = 12/15, 80%, respectively), while CT identified more osteoarthritis lesions than FDG PET (n = 26/26, 100% and n = 18/26, 69%, respectively). The three imaging-diagnoses based on the FDG PET component included the following: flexor carpi ulnaris muscle tear, psoas major myopathy, and tarsal desmopathy. No diagnosis for the lameness was obtained in three dogs. Findings supported FDG PET-CT as a useful adjunct imaging modality for detection of certain soft tissue injuries of the musculoskeletal system. Combined FDG PET-CT should be considered for cases where the cause of lameness is thought to be of soft tissue origin and cannot be diagnosed by conventional means.
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Affiliation(s)
- Ilan Frank
- Department of Clinical Sciences, Colorado State University, Fort Collins, Colorado
| | - Kelly Mann
- Department of Environmental and Radiological Health Sciences, Colorado State University, Fort Collins, Colorado
| | - Felix Duerr
- Department of Clinical Sciences, Colorado State University, Fort Collins, Colorado
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Adenocarcinoma of the Stomach Leading to Recurrent Regurgitation and Muscular Hypermetabolism on 18F-FDG PET/CT. Clin Nucl Med 2019; 44:901-902. [PMID: 31274559 DOI: 10.1097/rlu.0000000000002681] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Skeletal muscle uptake of F-FDG can result from a variety of physiologic and pathologic conditions. It is important for the physician to interpret these uptake patterns in the correct context to avoid a misdiagnosis. We present a case of a 36-year-old man with progressive, repeated episodes of regurgitation who was diagnosed with adenocarcinoma of the stomach. F-FDG PET/CT showed increased tracer uptake in the primary tumor and in the intercostal and sternocleidomastoid muscles. The pattern of tracer uptake along with the clinical history and examination of the patient helped differentiate a physiologic variant from a pathologic cause.
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Tsai HY, Lee MH, Wan CH, Yang LY, Yen TC, Tseng JR. C-reactive protein levels can predict positive 18F-FDG PET/CT findings that lead to management changes in patients with bacteremia. JOURNAL OF MICROBIOLOGY, IMMUNOLOGY, AND INFECTION = WEI MIAN YU GAN RAN ZA ZHI 2018; 51:839-846. [PMID: 30190232 DOI: 10.1016/j.jmii.2018.08.003] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/26/2018] [Revised: 07/31/2018] [Accepted: 08/02/2018] [Indexed: 02/05/2023]
Abstract
BACKGROUND/PURPOSE Bacteremia portends high rates of morbidity and mortality. Although 18F-fluorodeoxyglucose positron emission tomography and computed tomography (18F-FDG PET/CT) imaging has clinical value in assessing fever of unknown origin, its usefulness in bacteremia has not been entirely elucidated. We therefore designed the current single-center retrospective study to investigate 1) the clinical value of 18F-FDG PET/CT imaging in assessing bacteremia and 2) the association between laboratory data and imaging findings. METHODS We examined 102 patients with bacteremia who had undergone 18F-FDG PET/CT imaging. The patients' clinical and laboratory data were reviewed and analyzed in relation to 18F-FDG PET/CT findings. Patients showing positive results underwent quantitative measurements of 18F-FDG uptake. RESULTS Positive 18F-FDG PET/CT findings were identified in 74 (72.5%) patients, and 40 (54.1%) underwent modified treatment or management because of the imaging results (p = 0.003). Positive 18F-FDG PET/CT findings were significantly associated with higher white blood cell (WBC) counts and C-reactive protein (CRP) levels (p = 0.012 and < 0.001, respectively). Notably, CRP levels accurately predicted (area under curve = 0.752; p < 0.001) positive 18F-FDG PET/CT findings (optimal cut-off point: 54.025 mg/L). CONCLUSION A majority (54.1%, n = 40) of the patients with positive 18F-FDG PET/CT results underwent treatment modifications; they accounted for most cases (87%) of management changes in our cohort. Leukocytosis and increased CRP levels are significantly associated with positive 18F-FDG PET/CT findings in patients with bacteremia. CRP levels >54.025 mg/L were accurate predictors of positive 18F-FDG PET/CT results.
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Affiliation(s)
- Han-Yu Tsai
- Division of Infectious Diseases, Department of Internal Medicine, Chang Gung Memorial Hospital at Linkou, Taoyuan, Taiwan
| | - Ming-Hsun Lee
- Division of Infectious Diseases, Department of Internal Medicine, Chang Gung Memorial Hospital at Linkou, Taoyuan, Taiwan
| | - Chih-Hsing Wan
- Department of Nuclear Medicine, Mackay Memorial Hospital, Taipei, Taiwan
| | - Lan-Yan Yang
- Biostatistics Unit, Clinical Trial Center, Chang Gung Memorial Hospital at Linkou, Taoyuan, Taiwan
| | - Tzu-Chen Yen
- Department of Nuclear Medicine and Center for Advanced Molecular Imaging and Translation, Chang Gung Memorial Hospital at Linkou, Taoyuan, Taiwan; Department of Medical Imaging and Radiological Sciences, College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Jing-Ren Tseng
- Department of Nuclear Medicine and Center for Advanced Molecular Imaging and Translation, Chang Gung Memorial Hospital at Linkou, Taoyuan, Taiwan; Department of Medical Imaging and Radiological Sciences, College of Medicine, Chang Gung University, Taoyuan, Taiwan.
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