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Choi K, Park JS, Kwon YS, Park SH, Kim HJ, Noh H, Won KS, Song BI, Kim HW. Development of lung cancer risk prediction models based on F-18 FDG PET images. Ann Nucl Med 2023; 37:572-582. [PMID: 37458983 DOI: 10.1007/s12149-023-01858-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2023] [Accepted: 07/09/2023] [Indexed: 09/21/2023]
Abstract
OBJECTIVE We aimed to evaluate whether the degree of F-18 fluorodeoxyglucose (FDG) uptake in the lungs is associated with an increased risk of lung cancer and to develop lung cancer risk prediction models using metabolic parameters on F-18 FDG positron emission tomography (PET). METHODS We retrospectively included 795 healthy individuals who underwent F-18 FDG PET/CT scans for a health check-up. Individuals who developed lung cancer within 5 years of the PET/CT scan were classified into the lung cancer group (n = 136); those who did not were classified into the control group (n = 659). The healthy individuals were then randomly assigned to either the training (n = 585) or validation sets (n = 210). Clinical factors including age, sex, body mass index (BMI), and smoking history were collected. The standardized uptake value ratio (SUVR) and metabolic heterogeneity (MH) index were obtained for the bilateral lungs. Logistic regression models including clinical factors, SUVR, and MH index were generated to quantify the probability of lung cancer development using a training set. The prediction models were validated using a validation set. RESULTS The lung SUVR and lung MH index in the lung cancer group were significantly higher than in the control group (p < 0.001 and p < 0.001, respectively). In the combined prediction model 1, age, sex, BMI, smoking history, and lung SUVR were significantly associated with lung cancer development (age: OR 1.07, p < 0.001; male: OR 2.08, p = 0.015; BMI: OR 0.93, p = 0.057; current or past smoker: OR 5.60, p < 0.001; lung SUVR: OR 1.13, p < 0.001). In the combined prediction model 2, age, sex, BMI, smoking history, and lung MH index showed a significant association with lung cancer development (age: OR 1.06, p < 0.001; male: OR 1.87, p = 0.045; BMI: OR 0.93, p = 0.010; current or past smoker: OR 4.78, p < 0.001; lung MH index: OR 1.33, p < 0.001). In the validation data, combined prediction models 1 and 2 exhibited very good discrimination [area under the receiver operator curve (AUC): 0.867 and 0.901, respectively]. CONCLUSIONS The metabolic parameters on F-18 FDG PET are related to an increased risk of lung cancer. Metabolic parameters can be used as biomarkers to provide information independent of the clinical parameters, related to lung cancer risk.
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Affiliation(s)
- Kaeum Choi
- Department of Nuclear Medicine, Keimyung University Dongsan Hospital, 1035 Dalgubeol-daero, Sindang-dong, Dalseo-gu, Daegu, Republic of Korea
| | - Jae Seok Park
- Department of Internal Medicine, Keimyung University Dongsan Hospital, Daegu, Republic of Korea
| | - Yong Shik Kwon
- Department of Internal Medicine, Keimyung University Dongsan Hospital, Daegu, Republic of Korea
| | - Sun Hyo Park
- Department of Internal Medicine, Keimyung University Dongsan Hospital, Daegu, Republic of Korea
| | - Hyun Jung Kim
- Department of Internal Medicine, Keimyung University Dongsan Hospital, Daegu, Republic of Korea
| | - Hyunju Noh
- Department of Nursing, Cheju Halla University, Cheju, Republic of Korea
| | - Kyoung Sook Won
- Department of Nuclear Medicine, Keimyung University Dongsan Hospital, 1035 Dalgubeol-daero, Sindang-dong, Dalseo-gu, Daegu, Republic of Korea
| | - Bong-Il Song
- Department of Nuclear Medicine, Keimyung University Dongsan Hospital, 1035 Dalgubeol-daero, Sindang-dong, Dalseo-gu, Daegu, Republic of Korea
| | - Hae Won Kim
- Department of Nuclear Medicine, Keimyung University Dongsan Hospital, 1035 Dalgubeol-daero, Sindang-dong, Dalseo-gu, Daegu, Republic of Korea.
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Kim DW, Park SA, Kim MH. The utility of F-18 FDG PET/CT for diagnosis and response evaluation of hepatosplenic tuberculosis. Liver Int 2023; 43:733-734. [PMID: 36721981 DOI: 10.1111/liv.15530] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/19/2022] [Revised: 01/11/2023] [Accepted: 01/25/2023] [Indexed: 02/02/2023]
Abstract
A 77-year-old woman underwent F-18 FDG PET/CT for evaluation of fever focus. Diffuse and intense hepatosplenic uptake was noted and lymphoma or tuberculosis was proposed. Liver biopsy revealed chronic granulomatous inflammation with Langerhans-type giant cells and necrosis. A follow-up PET/CT after anti-tuberculosis treatment revealed that the hepatosplenic uptake had resolved.
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Affiliation(s)
- Dae-Weung Kim
- Department of Nuclear Medicine and Institute of Wonkwang Medical Science, Wonkwang University School of Medicine, Iksan, South Korea
| | - Soon-Ah Park
- Department of Nuclear Medicine and Institute of Wonkwang Medical Science, Wonkwang University School of Medicine, Iksan, South Korea
| | - Myoung Hyoun Kim
- Department of Nuclear Medicine and Institute of Wonkwang Medical Science, Wonkwang University School of Medicine, Iksan, South Korea
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Kumar S, Vatsa R, Shukla J, Singh G, Bal A, Mittal BR. Angiogenesis versus Metabolic Imaging in Locally Advanced Breast Cancer Patients - A Comparative Study. Indian J Nucl Med 2022; 37:54-60. [PMID: 35478676 PMCID: PMC9037866 DOI: 10.4103/ijnm.ijnm_53_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2021] [Revised: 01/05/2022] [Accepted: 01/07/2022] [Indexed: 11/24/2022] Open
Abstract
PURPOSE The comparison of angiogenesis imaging (Ga-68-DOTA-Arginine-Glycine-Aspartic Acid [RGD]) positron emission tomography/computed tomography [PET/CT]) with metabolic imaging (F-18 fluorodeoxyglucose [FDG] PET/CT) in primary staging and response assessment to neoadjuvant chemotherapy (NACT) in locally advanced breast cancer (LABC) patients. METHODS In this prospective study, 85 female patients with LABC were subjected to two PET/CT studies (Ga-68-DOTA-RGD2 and F-18 FDG) within 1 week of each other. Thirty patients had repeat studies 4 weeks after completing eight cycles of NACT. Response assessment was done by RECIST 1.1 criteria. RESULTS Ga-68-DOTA-RGD2 and F-18 FDG uptake in the primary tumor were seen in all patients. Ipsilateral axillary and internal mammary lymph nodes were detected in 77 (90.5%) versus 80 (94.1%) and 22 (25.8%) versus 27 (31.7%) patients on Ga-68-DOTA-RGD2 and F-18 FDG scans, respectively. Ipsilateral supra-clavicular lymph nodes and skeletal lesions were noted in 17 (20%) versus 21 (24.7%) patients and 23 (27.0%) versus 24 (28.2%) patients on Ga-68-DOTA-RGD2 versus F-18 FDG studies, respectively. However, the Ga-68-DOTA-RGD2 did not show uptake in F-18 FDG avid liver lesions (LLs) in 10 patients, adrenal lesion in one patient, mediastinal lymph nodes in 2 patients, lung nodules, and pleural soft-tissue deposits, each in one patient. In response assessment, 23 and 25 patients had concordance with RECIST1.1 criteria on F-18 FDG and Ga-68-DOTA-RGD2 scans, respectively. However, there were discordant results in four patients on Ga-68-DOTA-RGD2 scan and two patients on F-18 FDG scans. CONCLUSION Metabolic imaging is better in primary staging and chemotherapy response assessment than angiogenesis imaging in LABC patients. The latter may miss the metastatic soft-tissue deposits, adrenal, and LLs.
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Affiliation(s)
- Sunil Kumar
- Department of Nuclear Medicine, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Rakhee Vatsa
- Department of Nuclear Medicine, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Jaya Shukla
- Department of Nuclear Medicine, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Gurpreet Singh
- Department of General Surgery, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Amanjit Bal
- Department of Histopathology, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Bhagwant Rai Mittal
- Department of Nuclear Medicine, Post Graduate Institute of Medical Education and Research, Chandigarh, India,Address for correspondence: Dr. Bhagwant Rai Mittal, Department of Nuclear Medicine, Post Graduate Institute of Medical Education and Research, Chandigarh - 160 012, India. E-mail:
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Jeong YJ, Lim ST, Jeong HJ, Park HS, Lee SY, Han YH. Atypical sarcoid reaction mimicking recurrence on F-18 FDG PET/CT in a patient with breast malignancy. Radiol Case Rep 2021; 16:3834-3837. [PMID: 34745400 PMCID: PMC8551536 DOI: 10.1016/j.radcr.2021.09.032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2021] [Revised: 09/11/2021] [Accepted: 09/16/2021] [Indexed: 11/26/2022] Open
Abstract
Malignancy may lead to sarcoidosis, which is referred to as sarcoid reaction. This reaction is believed to be a host immune response to the release of soluble antigens from cancer cells. Studies have shown strong 2'-deoxy-2'-[F-18]fluoro-D-glucose (F-18 FDG) uptake in sarcoid reaction and in true sarcoidosis. Therefore, in patients with malignancy, sarcoid reactions can mimic metastasis or recurrence on F-18 FDG positron emission tomography/computed tomography (PET/CT). Herein, we report the case of a 58-year-old woman with a history of left breast cancer whose FDG PET/CT evaluated at 3 months after adjuvant chemotherapy presented hypermetabolic lymphadenopathy in the right supraclavicular and right mediastinal areas. We interpreted these as metastases because the involved lymph nodes were intensely hypermetabolic and appeared newly. Pathologic evaluation of the excised lymph node revealed noncaseating chronic granulomas without malignant cells, indicating a sarcoid reaction. After appropriate steroid therapy, both the size and metabolic activity of the lymphadenopathy substantially decreased. Most sarcoid reactions present as bilateral hilar and peribronchial lymphadenopathies. Our patient presents an atypical example that a sarcoid reaction can also present in a unilateral pattern, making its diagnosis challenging. When interpreting FDG PET/CT images, considering that the sarcoid reaction pattern can vary is crucial.
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Affiliation(s)
- Young Jin Jeong
- Department of Nuclear Medicine, Dong-A University College of Medicine, Busan, Republic of Korea
| | - Seok Tae Lim
- Department of Nuclear Medicine, Molecular Imaging & Therapeutic Medicine Research Center, Research Institute of Clinical Medicine of Jeonbuk National University - Biomedical Research Institute of Jeonbuk National University Hospital, Jeonbuk National University Medical School and Hospital, 20, Geonjiro, Jeonju, Jeonbuk 54907, Republic of Korea
| | - Hwan-Jeong Jeong
- Department of Nuclear Medicine, Molecular Imaging & Therapeutic Medicine Research Center, Research Institute of Clinical Medicine of Jeonbuk National University - Biomedical Research Institute of Jeonbuk National University Hospital, Jeonbuk National University Medical School and Hospital, 20, Geonjiro, Jeonju, Jeonbuk 54907, Republic of Korea
| | - Ho Sung Park
- Department of Pathology, Jeonbuk National University Medical School and Hospital, Jeonju, Jeonbuk, Republic of Korea
| | - Sun Young Lee
- Department of Radiation Oncology, Jeonbuk National University Medical School and Hospital, Jeonju, Jeonbuk, Republic of Korea
| | - Yeon-Hee Han
- Department of Nuclear Medicine, Molecular Imaging & Therapeutic Medicine Research Center, Research Institute of Clinical Medicine of Jeonbuk National University - Biomedical Research Institute of Jeonbuk National University Hospital, Jeonbuk National University Medical School and Hospital, 20, Geonjiro, Jeonju, Jeonbuk 54907, Republic of Korea
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Sherzay R, Witte T, Derlin T, Hoepfner M, Bengel FM. Vessel Wall Inflammatory Activity as Determined by F-18 Fluorodeoxyglucose PET in Large Vessel Vasculitis Is Attenuated by Immunomodulatory Drugs. Diagnostics (Basel) 2021; 11:diagnostics11071132. [PMID: 34206366 PMCID: PMC8303651 DOI: 10.3390/diagnostics11071132] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2021] [Revised: 06/15/2021] [Accepted: 06/16/2021] [Indexed: 12/12/2022] Open
Abstract
F-18 fluorodeoxyglucose (F-18 FDG) PET/CT plays an increasing role in the diagnostic workup of large vessel vasculitis (LVV); however, information on the relationship between immunosuppressive drugs and vessel wall uptake is limited. In 94 patients with a confirmed diagnosis of LVV, the vessel wall-to-liver ratio (VLR) was assessed in eight vessel segments. Patients were grouped according to intake of immunomodulatory drugs (Group 1, prednisone; Group 2, prednisone + methotrexate; and Group 3, prednisone + others) and compared to treatment-naïve individuals. A total of 54/94 (57.4%) were treated with immunomodulatory drugs (Group 1, 29/49 (53.7%); Group 2, 9/54 (16.7%); Group 3, 11/54 (20.4%); and Group 4, 5/54 (9.3%)), whereas the remainder received no therapy (40/94 (42.6%)). The mean VLR of the arterial segments correlated significantly with the hematopoietic organs (r ≥ 0.22, p ≤ 0.05), c-reactive protein (r ≥ 0.25, p ≤ 0.05), and prednisone dosage (r ≥ −0.4, p ≤ 0.05). Relative to treatment-naïve patients, a significantly lower VLR was recorded in 5/8 (62.5%) of the investigated vessel segments in Group 1 (p ≤ 0.02), in 6/8 of the vessel segments in Group 2 (75.0%, p ≤ 0.006), and in 7/8 of the segments in Group 3 (87.5%, p ≤ 0.05). In LVV, the F-18 FDG uptake in vessel wall as a marker of inflammatory activity was attenuated by immunomodulatory drugs, which provides a foundation for future serial monitoring of treatment efficacy.
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Affiliation(s)
- Romilda Sherzay
- Department of Nuclear Medicine, Hannover Medical School, 30625 Hannover, Germany; (R.S.); (T.D.)
| | - Torsten Witte
- Department of Rheumatology and Immunology, Hannover Medical School, 30625 Hannover, Germany; (T.W.); (M.H.)
| | - Thorsten Derlin
- Department of Nuclear Medicine, Hannover Medical School, 30625 Hannover, Germany; (R.S.); (T.D.)
| | - Marius Hoepfner
- Department of Rheumatology and Immunology, Hannover Medical School, 30625 Hannover, Germany; (T.W.); (M.H.)
| | - Frank M. Bengel
- Department of Nuclear Medicine, Hannover Medical School, 30625 Hannover, Germany; (R.S.); (T.D.)
- Correspondence: ; Tel.: +49-(0)-511-532-2577
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Kim K, Kim SJ. Diagnostic test accuracies of F-18 FDG PET/CT for prediction of microvascular invasion of hepatocellular carcinoma: A meta-analysis. Clin Imaging 2021; 79:251-258. [PMID: 34157501 DOI: 10.1016/j.clinimag.2021.06.015] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2021] [Revised: 06/04/2021] [Accepted: 06/11/2021] [Indexed: 12/21/2022]
Abstract
PURPOSE The aim of the current meta-analysis was to evaluate diagnostic accuracies of preoperative F-18 fluorodeoxyglucose (FDG) positron emission tomography (PET) or positron emission tomography/computed tomography (PET/CT) for prediction of microvascular invasion (MVI) in hepatocellular carcinoma (HCC) patients. METHODS The scientific database such as PubMed, Cochrane, and Embase database were searched for studies evaluating diagnostic accuracies of preoperative F-18 FDG PET or PET/CT for prediction of MVI in HCC patients up to November 30, 2020. RESULTS Fourteen eligible studies (1276 patients) were enrolled. The pooled sensitivity for F-18 FDG PET or PET/CT was 0.67 (95% CI; 0.57-0.76) with heterogeneity and a pooled specificity of 0.80 (95% CI; 0.74-0.85) with heterogeneity. Likelihood ratio (LR) syntheses gave an overall positive likelihood ratio (LR+) of 3.3 (95% CI; 2.5-4.5) and negative likelihood ratio (LR-) of 0.41 (95% CI; 0.31-0.55). The pooled diagnostic odds ratio (DOR) was 8 (95% CI; 5-14). Summary receiver operating characteristic (ROC) curve indicates that the area under the curve was 0.81 (95% CI; 0.78-0.84). CONCLUSION The current meta-analysis showed a low sensitivity and moderate specificity of F-18 FDG PET or PET/CT for the prediction of MVI in HCC patients. F-18 FDG PET or PET/CT might not be useful for the preoperative prediction of MVI in HCC patients and should not be used to exclude MVI. Therefore, cautious application and interpretation should be paid to the F-18 FDG PET or PET/CT for the prediction of MVI in HCC patients preoperatively.
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Affiliation(s)
- Keunyoung Kim
- Department of Nuclear Medicine, Pusan National University Hospital, Busan 49241, Republic of Korea
| | - Seong-Jang Kim
- Department of Nuclear Medicine, Pusan National University Yangsan Hospital, Yangsan 50612, Republic of Korea; BioMedical Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Yangsan 50612, Republic of Korea; Department of Nuclear Medicine, College of Medicine, Pusan National University, Yangsan 50612, Republic of Korea.
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Lee SW, Jeong SY, Kim K, Kim SJ. Direct comparison of F-18 FDG PET/CT and MRI to predict pathologic response to neoadjuvant treatment in locally advanced rectal cancer: a meta-analysis. Ann Nucl Med 2021; 35:1038-1047. [PMID: 34109555 DOI: 10.1007/s12149-021-01639-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2020] [Accepted: 06/06/2021] [Indexed: 12/13/2022]
Abstract
OBJECTIVE The purpose of the current study was to compare the diagnostic accuracies of F-18 FDG PET/CT and MRI for prediction of pathologic responses to neoadjuvant treatment (NAT) in locally advanced rectal cancer (LARC) patients based on a systematic review and meta-analyses. METHODS The PubMed, Cochrane, and Embase databases were searched to identify studies that conducted direct comparisons of the diagnostic performance of F-18 FDG PET/CT and MRI for the prediction of pathologic response to NAT in patients with LARC from the earliest available date of indexing up to July 31, 2020. We determined the sensitivities and specificities across studies, calculated positive and negative likelihood ratios (LR + and LR -), and we constructed summary receiver operating characteristic curves. RESULTS In nine studies (427 patients), the pooled sensitivity of F-18 FDG PET/CT was 0.79 (95% CI 0.71-0.86) and the pooled specificity was 0.74 (95% CI 0.60-0.84). LR syntheses yielded an overall LR + of 3.1 (95% CI 1.9-5.0) and an LR - of 0.28 (95% CI 0.18-0.43). The pooled diagnostic odds ratio (DOR) was 11 (95% CI 5-26). The pooled sensitivity of MRI was 0.89 (95% CI 0.77-0.95) and the pooled specificity was 0.66 (95% CI 0.55-0.76). LR syntheses yielded an overall LR + of 2.6 (95% CI 1.9-3.6) and an LR - of 0.17 (95% CI 0.08-0.37). The pooled DOR was 15 (95% CI 6-42). In meta-regression analysis, no variable was identified as the source of the study heterogeneity. CONCLUSION F-18 FDG PET/CT and MRI showed similar diagnostic performances for the prediction of pathologic responses to NAT in patients with LARC. However, each modality can be a complement to other rather than being used singly.
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Affiliation(s)
- Sang-Woo Lee
- Department of Nuclear Medicine, Kyungpook National University Chilgok Hospital and School of Medicine, Daegu, 41404, Republic of Korea
| | - Shin Young Jeong
- Department of Nuclear Medicine, Kyungpook National University Chilgok Hospital and School of Medicine, Daegu, 41404, Republic of Korea
| | - Keunyoung Kim
- Department of Nuclear Medicine, Pusan National University Hospital, Busan, 49241, Republic of Korea
| | - Seong-Jang Kim
- Department of Nuclear Medicine, College of Medicine, Pusan National University Yangsan Hospital, Yangsan, 50612, Republic of Korea. .,BioMedical Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Yangsan, 50612, Republic of Korea.
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Kim K, Kim SJ. Diagnostic performance of F-18 FDG PET/CT in the detection of bone marrow involvement in paediatric hodgkin lymphoma: A meta-analysis. Leuk Res 2021; 102:106525. [PMID: 33607533 DOI: 10.1016/j.leukres.2021.106525] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2020] [Revised: 01/26/2021] [Accepted: 02/04/2021] [Indexed: 11/25/2022]
Abstract
OBJECTIVES The present study aimed to investigate the diagnostic performance of F-18 fluorodeoxyglucose (FDG) positron emission tomography/computed tomography (PET/CT) in the detection of bone marrow involvement (BMI) in paediatric Hodgkin lymphoma (HL) through a systematic review and meta-analysis. METHODS PubMed, Cochrane, and EMBASE databases were searched from the earliest available date of indexing till March 31, 2020 for studies evaluating the diagnostic performance of F-18 FDG PET/CT in the detection of BMI in paediatric HL. RESULTS Across seven studies (1265 patients), the pooled sensitivity of F-18 FDG PET or PET/CT was 0.95 (95% confidence interval [CI]: 0.87-0.98) with heterogeneity (I2 = 86.2, p < 0.001), and the pooled specificity was 0.97 (95% CI: 0.84-1.00) with heterogeneity (I2 = 97.2, p < 0.001). Likelihood ratio syntheses provided an overall positive likelihood ratio of 37.8 (95% CI: 5.2-274.9) and a negative likelihood ratio of 0.05 (95% CI: 0.02-0.14). The pooled diagnostic odds ratio was 732 (95% CI: 55-9806). The area under the summary receiver operating characteristic curve was 0.98 (95% CI: 0.97-0.99). CONCLUSIONS The present meta-analysis revealed high sensitivity and specificity of F-18 FDG PET/CT for the detection of BMI in paediatric HL. Currently, the literature regarding the use of F-18 FDG PET/CT for the detection of BMI in paediatric HL is limited. Large multicentre studies are necessary to substantiate the diagnostic accuracy of F-18 FDG PET/CT in the detection of BMI in paediatric HL. ADVANCES IN KNOWLEDGE Through a meta-analysis, this study provided a more reliable assessment of the diagnostic utility of F-18 FDG PET/CT, which exhibited good diagnostic accuracy in the detection of BMI in paediatric HL.
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Affiliation(s)
- Keunyoung Kim
- Department of Nuclear Medicine and Biomedical Research Institute, Pusan National University Hospital, Busan, Republic of Korea
| | - Seong-Jang Kim
- Department of Nuclear Medicine, College of Medicine, Pusan National University, Yangsan 50612, Republic of Korea; BioMedical Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Yangsan 50612, Republic of Korea; Department of Nuclear Medicine, Pusan National University Yangsan Hospital, Yangsan 50612, Republic of Korea.
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Kim SJ, Pak K, Kim K. Diagnostic performance of F-18 FDG PET for detection of cardiac sarcoidosis; A systematic review and meta-analysis. J Nucl Cardiol 2020; 27:2103-2115. [PMID: 30603894 DOI: 10.1007/s12350-018-01582-y] [Citation(s) in RCA: 41] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2018] [Accepted: 12/17/2018] [Indexed: 11/29/2022]
Abstract
OBJECTIVE The purpose of the current study was to investigate the diagnostic performance of F-18 fluorodeoxyglucose (FDG) positron emission tomography/computed tomography (PET/CT) for diagnosis of cardiac sarcoidosis (CS) through a systematic review and meta-analysis. METHODS The PubMed and EMBASE database, from the earliest available date of indexing through 31 March 31, 2018, were searched for studies evaluating the diagnostic performance of F-18 FDG PET or PET/CT for CS. We determined the sensitivities and specificities across studies, calculated positive and negative likelihood ratios (LR+ and LR-), and constructed summary receiver operating characteristic (SROC) curves. RESULTS Across 17 studies (891 patients), the pooled sensitivity was 0.84 [95% confidence interval (95% CI) 0.71-0.91] with heterogeneity (I2 = 77.5) and a pooled specificity of 0.83 (95% CI 0.74-0.89) with heterogeneity (I2 = 80.0). Likelihood ratio (LR) syntheses gave an overall LR+ of 4.9 (95% CI 3.3-7.3) and LR- of 0.2 (95% CI 0.11-0.35). The pooled diagnostic odds ratio was 27 (95% CI 14-55). Hierarchical SROC curve indicates that the area under the curve was 0.90 (95% CI 0.87-0.92). Meta-regression showed that combined myocardial perfusion imaging was the source of heterogeneity. CONCLUSION The current meta-analysis showed the moderate sensitivity and specificity of F-18 FDG PET or PET/CT for diagnosis of CS. The presence of combined myocardial perfusion imaging could improve diagnostic accuracy of F-18 FDG PET or PET/CT for diagnosis of CS. At present, the literature regarding the use of F-18 FDG PET for detection of CS remains limited; thus, further large multicenter studies would be necessary to substantiate the diagnostic accuracy of F-18 FDG PET for diagnosis of CS.
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Affiliation(s)
- Seong-Jang Kim
- Department of Nuclear Medicine, Pusan National University Yangsan Hospital, Yangsan, 50612, Korea.
- BioMedical Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Yangsan, 50612, Korea.
- Department of Nuclear Medicine, College of Medicine, Pusan National University, Yangsan, 50612, Korea.
| | - Kyoungjune Pak
- Department of Nuclear Medicine, Pusan National University Hospital, Pusan, Korea
| | - Keunyoung Kim
- Department of Nuclear Medicine, Pusan National University Hospital, Pusan, Korea
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Kim K, Kim SJ. Direct comparison of diagnostic accuracies of F-18 FDG PET and MRI for detection of bone marrow involvement in lymphoma patients; A meta-analysis. Leuk Res 2020; 99:106475. [PMID: 33189988 DOI: 10.1016/j.leukres.2020.106475] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2020] [Revised: 10/26/2020] [Accepted: 11/01/2020] [Indexed: 11/23/2022]
Abstract
BACKGROUND The purpose of the current study was to compare the diagnostic accuracies of F-18 FDG PET or PET/CT and MRI for detection of bone marrow involvement (BMI) in lymphoma patients through a systematic review and meta-analysis. METHODS AND MATERIALS The PubMed, Cochrane database, and EMBASE database, from the earliest available date of indexing through July 31, 2020, were searched for studies evaluating direct comparison of diagnostic performance of F-18 FDG PET or PET/CT and MRI for BMI in lymphoma patients. We determined the sensitivities and specificities across studies, calculated positive and negative likelihood ratios (LR + and LR-), and constructed summary receiver operating characteristic curves. RESULTS Across 5 studies (212 patients), the pooled sensitivity of F-18 FDG PET or PET/CT was 0.65 (95 % CI; 0.42-0.82) a pooled specificity of 0.90 (95 % CI; 0.85-0.94). Likelihood ratio (LR) syntheses gave an overall positive likelihood ratio (LR+) of 6.4 (95 % CI; 3.3-12.4) and negative likelihood ratio (LR-) of 0.39 (95 % CI; 0.21-0.73). The pooled DOR was 16 (95 % CI; 5-56). The pooled sensitivity of MRI was 0.78 (95 % CI; 0.55-0.91) and a pooled specificity of 0.86 (95 % CI; 0.67-0.95). Likelihood ratio (LR) syntheses gave an overall positive likelihood ratio (LR+) of 5.6 (95 % CI; 1.8-17.0) and negative likelihood ratio (LR-) of 0.26 (95 % CI; 0.1-0.65). The pooled DOR was 22 (95 % CI; 3-149). In meta-regression analysis, no variable was the source of the study heterogeneity. CONCLUSION F-18 FDG PET or PET/CT and MRI showed similar diagnostic performances for the detection of BMI in lymphoma patients. Further large multicenter studies would be necessary to substantiate the diagnostic accuracy of F-18 FDG PET or PET/CT and MRI for the diagnosis of BMI in lymphoma patients.
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Tripathi M, Tripathi M, Parida GK, Kumar R, Dwivedi S, Nehra A, Bal C. Biomarker-Based Prediction of Progression to Dementia: F-18 FDG-PET in Amnestic MCI. Neurol India 2020; 67:1310-1317. [PMID: 31744965 DOI: 10.4103/0028-3886.271245] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Background Metabolic patterns on brain F-18 fluorodeoxyglucose (FDG) positron emission tomography (PET) can predict the decline in amnestic mild cognitive impairment (aMCI) to Alzheimer's disease dementia (AD) or other dementias. Objective This study was undertaken to evaluate the diagnostic accuracy of baseline F-18 FDG-PET in aMCI for predicting conversion to AD or other dementias on follow-up. Patients and Methods A total of 87 patients with aMCI were enrolled in the study. Each patient underwent a detailed clinical and neuropsychological examination and FDG-PET at baseline. Each PET scan was visually classified based on predefined dementia patterns. Automated analysis of FDG PET was performed using Cortex ID (GE Healthcare). The mean follow-up duration was 30.4 ± 9.3 months (range: 18-48 months). Diagnosis of dementia at follow-up (obtained using clinical diagnostic criteria) constituted the reference standard, and all the included aMCI patients were divided into two groups: the aMCI converters (MCI-C) and MCI nonconverters (MCI-NC). Diagnostic accuracy of FDG PET was calculated using this reference standard. Results There were 23 MCI-C and 64 MCI-NC. Of the 23 MCI-C, 19 were diagnosed as probable AD, 1 as frontotemporal demetia (FTD), and 3 as vascular dementia (VD). Of the 64 MCI-NC, 9 had subjective improvement in cognition, and 55 remained stable. The conversion rate for all types of dementia in our series was 26.4% (23/87) and for Alzheimer's type dementia was 21.8% (19/87). The of PET-based visual interpretation was 91.9%. Sensitivity, specificity, positive predictive value, and negative predictive value for FDG-PET-based prediction of dementia conversion were 86.9% [confidence interval (CI) 66.4%-97.2%)], 93.7% (CI 84.7%-98.2%), 83.3% (CI 65.6%-92.9%), and 95.2% (CI 87.4%-98.9%), respectively. Kappa for agreement between visual and Cortex ID was 0.94 indicating excellent agreement. In the three aMCI patients progressing to VD, no specific abnormality in metabolic pattern was noted; however, there was marked cortical atrophy on computed tomography. Conclusion FDG-PET-based visual and cortex ID classification has a good accuracy in predicting progression to dementia including AD in the prodromal aMCI phase. Absence of typical metabolic patterns on FDG-PET can play an important exclusionary role for progression to dementia. Vascular cognitive impairment with cerebral atrophy needs further studies to confirm and uncover potential mechanisms.
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Affiliation(s)
- Madhavi Tripathi
- Department of Nuclear Medicine, All India Institute of Medical Sciences, New Delhi, India
| | - Manjari Tripathi
- Department of Neurology, Cardiothoracic and Neurosciences Centre, All India Institute of Medical Sciences, New Delhi, India
| | - Girish Kumar Parida
- Department of Nuclear Medicine, All India Institute of Medical Sciences, New Delhi, India
| | - Rajeev Kumar
- Department of Nuclear Medicine, All India Institute of Medical Sciences, New Delhi, India
| | - Sadanand Dwivedi
- Department of Biostatistics, All India Institute of Medical Sciences, New Delhi, India
| | - Ashima Nehra
- Department of Neurology, Cardiothoracic and Neurosciences Centre, All India Institute of Medical Sciences, New Delhi, India
| | - Chandrasekhar Bal
- Department of Nuclear Medicine, All India Institute of Medical Sciences, New Delhi, India
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Kim SJ, Lee JS. Diagnostic Performance of F-18 Fluorodeoxyglucose Positron Emission Tomography or Positron Emission Tomography/Computed Tomography for Differentiation of Benign and Malignant Vertebral Compression Fractures: A Meta-Analysis. World Neurosurg 2020; 137:e626-e633. [PMID: 32105873 DOI: 10.1016/j.wneu.2020.02.085] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2020] [Revised: 02/13/2020] [Accepted: 02/14/2020] [Indexed: 11/29/2022]
Abstract
OBJECTIVE The purpose of the present study was to investigate the diagnostic performance of F-18 fluorodeoxyglucose (FDG) positron emission tomography/computed tomography (PET/CT) for the differentiation of benign and malignant vertebral compression fractures (VCFxs) through a systematic review and meta-analysis. METHODS MEDLINE via PubMed, Cochrane, Scopus, and Embase database, from the earliest available date of indexing through September 30, 2019, were searched for studies evaluating the diagnostic performance of F-18 FDG PET or PET/CT for the differentiation of malignant VCFxs. We determined the sensitivities and specificities across the studies, calculated the positive and negative likelihood ratios (LR+ and LR-, respectively), and constructed summary receiver operating characteristic curves. RESULTS For the 5 studies (274 patients), the pooled sensitivity was 0.96 (95% confidence interval [CI], 0.82-0.99) without heterogeneity (I2, 50.6) and 0.77 (95% CI, 0.56-0.89) with heterogeneity (I2, 76.1). LR syntheses gave an overall LR+ of 4.1 (95% CI, 2.1-8.0) and LR- of 0.05 (95% CI, 0.01-0.23). The pooled diagnostic odds ratio (DOR) was 78 (95% CI, 19-316). The hierarchical summary receiver operating characteristic curve indicates that the areas under the curve was 0.94 (95% CI, 0.92-0.96). CONCLUSIONS The results of the present meta-analysis have shown high sensitivity and moderate specificity for F-18 FDG PET and PET/CT for differentiation of malignant VCFxs. At present, the reported data regarding the use of F-18 FDG PET for differentiation of malignant VCFxs remain limited; thus, further large multicenter studies are necessary to substantiate the diagnostic accuracy of F-18 FDG PET for the differentiation of malignant VCFxs.
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Affiliation(s)
- Seong-Jang Kim
- Department of Nuclear Medicine, BioMedical Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, and Department of Nuclear Medicine, College of Medicine, Pusan National University, Yangsan, Republic of Korea
| | - Jung Sub Lee
- Department of Orthopaedic Surgery, BioMedical Research Institute, Pusan National University Hospital, Pusan National University, Busan, Republic of Korea.
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Jeong J, Jeong YJ, Park KW, Kang DY. Correlation of Early-Phase F-18 Florapronal PET with F-18 FDG PET in Alzheimer's Disease and Normal Brain. Nucl Med Mol Imaging 2019; 53:328-33. [PMID: 31723362 DOI: 10.1007/s13139-019-00612-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2019] [Revised: 08/26/2019] [Accepted: 09/04/2019] [Indexed: 10/26/2022] Open
Abstract
Purpose F-18 florapronol (FPN) is the commercially recognized beta-amyloid positron emission tomography (PET) radiotracer in Korea. This study compared the early F-18 florapronol PET with F-18 fluorodeoxyglucose (FDG) PET between healthy controls (HC) and Alzheimer's dementia (AD) patients. Methods A total of 29 subjects (15 HC and 14 AD subjects) underwent F-18 FPN PET and F-18 FDG PET. F-18 FDG PET image was acquired from 30 to 60 min and F-18 FPN PET for 0 to 10 min. F-18 FPN and F-18 FDG images were spatially normalized with transformation matrices obtained from individual CT images and standardized uptake value ration (SUVR) from cerebellum area, and the global mean was calculated using PMOD 3.6. Pearson's correlation coefficients between F-18 FDG and early F-18 FPN for predefined cortical brain regions were calculated. Results We compared the F-18 FDG and F-18 FPN for SUVR of a specific region in global mean normalization and cerebellum normalization, and most of the correlation coefficient was higher in global mean normalization. In global mean normalization, the correlation coefficient for SUVR of HC was higher than that of AD in all brain regions. Conclusions Early F-18 FPN study can be used as a proxy marker for the F-18 FDG PET.
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Kim SJ, Pak K, Kim K. Diagnostic performance of F-18 FDG PET/CT for prediction of KRAS mutation in colorectal cancer patients: a systematic review and meta-analysis. Abdom Radiol (NY) 2019; 44:1703-1711. [PMID: 30603881 DOI: 10.1007/s00261-018-01891-3] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
OBJECTIVE The purpose of the current study was to investigate the diagnostic performance of F-18 fluorodeoxyglucose (FDG) positron emission tomography/computed tomography (PET/CT) for the prediction of v-Ki-ras-2 Kirsten rat sarcoma viral oncogene homolog (KRAS) mutation in colorectal cancer (CRC) patients through a systematic review and meta-analysis. METHODS The PubMed and EMBASE database, from the earliest available date of indexing through April 30, 2018, were searched for studies evaluating the diagnostic performance of F-18 FDG PET/CT for prediction of KRAS mutation in CRC patients. RESULTS Across 9 studies (804 patients), the pooled sensitivity for F-18 FDG PET/CT was 0.66 (95% CI 0.60-0.73) without heterogeneity (I2 = 34.1, p = 0.14) and a pooled specificity of 0.67 (95% CI 0.62-0.72) without heterogeneity (I2 = 1.63, p = 0.42). Likelihood ratio (LR) syntheses gave an overall positive likelihood ratio (LR+) of 2.0 (95% CI 1.7-2.4) and negative likelihood ratio (LR-) of 0.5 (95% CI 0.41-0.61). The pooled diagnostic odds ratio (DOR) was 4 (95% CI 3-6). Hierarchical summary receiver operating characteristic (ROC) curve indicates that the areas under the curve were 0.69 (95% CI 0.65-0.73). CONCLUSION The current meta-analysis showed the low sensitivity and specificity of F-18 FDG PET/CT for prediction of KRAS mutation in CRC patients. The DOR was very low and the likelihood ratio scatter-gram indicated that F-18 FDG PET/CT might not be useful for prediction of KRAS mutation and not for its exclusion. Therefore, cautious application and interpretation should be paid to the F-18 FDG PET/CT for prediction of KRAS mutation in CRC patients.
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Kim SJ, Pak K, Kim K. Diagnostic accuracy of F-18 FDG PET or PET/CT for detection of lymph node metastasis in clinically node negative head and neck cancer patients; A systematic review and meta-analysis. Am J Otolaryngol 2019; 40:297-305. [PMID: 30473166 DOI: 10.1016/j.amjoto.2018.10.013] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2018] [Revised: 10/18/2018] [Accepted: 10/23/2018] [Indexed: 12/29/2022]
Abstract
OBJECTIVE The purpose of the current study was to investigate the diagnostic performance of F-18 fluorodeoxyglucose (FDG) positron emission tomography (PET) or positron emission tomography/computed tomography (PET/CT) for the detection of cervical lymph node (LN) metastasis in clinically node negative head and neck squamous cell cancer (cN0 HNSCC) patients through a systematic review and meta-analysis. METHODS The PubMed and EMBASE database, from the earliest available date of indexing through April 30, 2018, were searched for studies evaluating the diagnostic performance of F-18 FDG PET or PET/CT for the detection of LN metastasis in cN0 HNSCC patients. We determined the sensitivities and specificities across studies, calculated positive and negative likelihood ratios (LR+ and LR-), and constructed summary receiver operating characteristic (SROC) curves. RESULTS Across 18 studies (1044 patients), the pooled sensitivity for F-18 FDG PET or PET/CT for the detection of LN metastasis was 0.58 and a pooled specificity of 0.87 for patient based analysis. Neck side based analysis showed the pooled sensitivity of 0.67 and a pooled specificity of 0.85. Level based study demonstrated the pooled sensitivity of 0.53 and a pooled specificity of 0.97 (95% CI; 0.95-0.98). In meta-regression analysis, no definite variable was the source of the study heterogeneity. CONCLUSION The current meta-analysis showed the low sensitivity and moderate specificity of F-18 FDG PET/CT for the detection of cervical LN metastasis in cN0 HNSCC patients. Level based analysis of F-18 FDG PET or PET/CT has a high specificity and NPV for the detection of cervical metastatic LN detection.
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Bae SU, Won KS, Song BI, Jeong WK, Baek SK, Kim HW. Accuracy of F-18 FDG PET/CT with optimal cut-offs of maximum standardized uptake value according to size for diagnosis of regional lymph node metastasis in patients with rectal cancer. Cancer Imaging 2018; 18:32. [PMID: 30217167 PMCID: PMC6137872 DOI: 10.1186/s40644-018-0165-5] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2018] [Accepted: 08/30/2018] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND The low sensitivity of F-18 fluorodeoxyglucose (FDG) positron emission tomography/computed tomography (PET/CT) for the evaluation of metastatic lymph nodes (LNs) is mainly due to the partial volume effect in patients with rectal cancer. This retrospective study evaluated the diagnostic accuracy of F-18 FDG PET/CT with optimal cut-off values of the maximum standardized uptake value (SUVmax), according to LN size, for the evaluation of regional LN in rectal cancer patients. METHODS This study included 176 patients with rectal cancer who underwent F-18 FDG PET/CT for initial staging. Patients were classified based on the long-axis diameter of the regional LN on CT images as small (≤ 7 mm; n = 118) and large (> 7 mm; n = 58) LN groups. The optimal cut-off value of SUVmax was determined for each group, using receiver operating characteristic curve analysis. Areas under the curve (AUC) were compared by C-statistics using two methods: the cut-off value of SUVmax optimized according to LN size, and a fixed SUVmax cut-off value of 2.5. RESULTS The optimal cut-off values of SUVmax for the small and large LN groups were 1.1, and 2.1, respectively. The sensitivity, specificity, and accuracy of F-18 FDG PET/CT using the optimal cut-off values were 90.6, 70.9, and 76.3% in the small LN group, and 68.6, 78.3, and 72.4% in the large LN group. The sensitivity, specificity, and accuracy of F-18 FDG PET/CT using the fixed cut-off value were 18.8, 100, and 78.0% in the small LN group, and 51.4, 87.0, and 65.5% in the large LN group. The AUC was significantly higher using the optimal cut-off values than the fixed cut-off value (0.808 vs. 0.594, p = 0.005) in the small LN group, but not in the large LN group (0.734 vs. 0.692, p = 0.429). CONCLUSIONS Application of the lower cut-off value of SUVmax improves the diagnostic performance of F-18 FDG PET/CT for the evaluation of small regional LNs in patients with rectal cancer.
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Affiliation(s)
- Sung Uk Bae
- Department of Surgery, Keimyung University Dongsan Medical Center, Daegu, Republic of Korea
| | - Kyoung Sook Won
- Department of Nuclear Medicine, Keimyung University Dongsan Medical Center, 56 Dalseong-ro, Jung-gu, Daegu, 41931, Republic of Korea
| | - Bong-Il Song
- Department of Nuclear Medicine, Keimyung University Dongsan Medical Center, 56 Dalseong-ro, Jung-gu, Daegu, 41931, Republic of Korea
| | - Woon Kyung Jeong
- Department of Surgery, Keimyung University Dongsan Medical Center, Daegu, Republic of Korea
| | - Seong Kyu Baek
- Department of Surgery, Keimyung University Dongsan Medical Center, Daegu, Republic of Korea
| | - Hae Won Kim
- Department of Nuclear Medicine, Keimyung University Dongsan Medical Center, 56 Dalseong-ro, Jung-gu, Daegu, 41931, Republic of Korea.
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Saad Aldin E, Sekar P, Saad Eddin Z, Keller J, Pollard J. Incidental diagnosis of sternoclavicular septic arthritis with Moraxella nonliquefaciens. IDCases 2018; 12:44-46. [PMID: 29942746 PMCID: PMC6010954 DOI: 10.1016/j.idcr.2018.03.011] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2018] [Revised: 03/12/2018] [Accepted: 03/12/2018] [Indexed: 11/30/2022] Open
Abstract
An 83-year old man presented acutely to the emergency department with generalized weakness and subjective fevers. A month earlier he had undergone resection of a large intramuscular sarcoma from his thigh. The cancer staging work-up was still underway and a decision about adjuvant therapy was still pending. Although initial laboratory assessment showed leukocytosis, this normalized soon after admission without the use of antimicrobials. No fevers were documented. During the admission an 18F-FDG PET/CT was performed in continuation of his sarcoma staging workup. This revealed unexpected abnormal radiotracer uptake in the left sternoclavicular joint with fluid collections extending into the sternocleidomastoid muscle and the mediastinum. Imaging findings were consistent with septic arthritis and abscess formation, despite lack of fever or localizing symptoms. Ultrasound-guided aspiration revealed purulent fluid that grew Moraxella nonliquefaciens. Given the unusual presentation, ongoing clinical uncertainty about the true cause of the septic joint, and concern for an occult sarcoma metastasis, surgical debridement and resection of the joint was carried out. Pathology and microbiology evaluation confirmed septic arthritis with osteomyelitis and abscess extension into the mediastinum. No tumor cells were identified. Postoperative course was complicated by hematoma, but otherwise the patient responded well to antimicrobial therapy.
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Affiliation(s)
- Ehab Saad Aldin
- Department of Diagnostic Radiology, University of Iowa Hospitals and Clinics, Iowa City, IA 52242, United States
| | - Poorani Sekar
- Department of Internal Medicine, University of Iowa Hospitals and Clinics, Iowa City, IA 52242, United States
| | - Zein Saad Eddin
- Department of Vascular Surgery, University of Pittsburgh Medical Center, Pittsburgh, PA 15213, United States
| | - Jaclyn Keller
- Department of Diagnostic Radiology, University of Iowa Hospitals and Clinics, Iowa City, IA 52242, United States
| | - Janet Pollard
- Department of Diagnostic Radiology, University of Iowa Hospitals and Clinics, Iowa City, IA 52242, United States
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O'Connor MK, Tran TD, Swanson TN, Ellingson LR, Hunt KN, Whaley DH. Improved visualization of breast tissue on a dedicated breast PET system through ergonomic redesign of the imaging table. EJNMMI Res 2017; 7:100. [PMID: 29260333 PMCID: PMC5736520 DOI: 10.1186/s13550-017-0351-7] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2017] [Accepted: 12/06/2017] [Indexed: 12/30/2022] Open
Abstract
Background Breast lesions closer than 2 cm to the chest wall are difficult to position in the field of view of dedicated breast PET (db-PET) systems. This inability to detect such lesions is a significant limitation of these systems. The primary objective of this study was to determine if modifications to the design of the imaging table and detector used for a db-PET system would enable improved visualization of breast tissue close to the chest wall. All studies were performed on a commercially available db-PET system (Mammi-PET). A central square section of the imaging table, containing the standard 180-mm circular aperture, was modified such that it could be removed and replaced by thinner sections with a larger aperture. Additional changes were made to the cover plate of the detector array and the patient mattress. A total of 60 patients were studied. After administration of F-18 FDG, 30 patients were imaged with a 220-mm-diameter aperture and the standard aperture, and 30 patients with a 200-mm aperture and the standard aperture. On all scans, the length of breast tissue in the field of view was measured as the greatest extent of tissue from the nipple back to the posterior edge of the breast. Image quality and patient comfort were recorded. Results Averaged over both breasts, relative to the standard aperture, the increase in breast length was 12.5 + 7.7 mm with the 220-mm aperture, and 12.3 + 6.5 mm with the 200-mm aperture (p < 0.05 for both apertures). In ~ 5% of cases, the larger apertures resulted in some degradation in image quality due to closer proximity to cardiac/hepatic activity. In 10–20% of cases, movement of the breast tissue was observed as the detector ring was moved to scan the anterior region of the breast. The patient survey indicated no significant difference in the comfort level between the standard aperture and either of the prototype apertures. Conclusions Modifications to the image table and system resulted in a significant gain in the volume of breast tissue that could be imaged on the db-PET system and should allow better visualization of lesions close to the chest wall.
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Affiliation(s)
- Michael K O'Connor
- Department of Radiology, Charlton 1-225, Mayo Clinic, 200 First Street SW, Rochester, MN, 55905, USA.
| | - Thuy D Tran
- Department of Radiology, Charlton 1-225, Mayo Clinic, 200 First Street SW, Rochester, MN, 55905, USA
| | - Tiffinee N Swanson
- Department of Radiology, Charlton 1-225, Mayo Clinic, 200 First Street SW, Rochester, MN, 55905, USA
| | - Lacey R Ellingson
- Department of Radiology, Charlton 1-225, Mayo Clinic, 200 First Street SW, Rochester, MN, 55905, USA
| | - Katie N Hunt
- Department of Radiology, Charlton 1-225, Mayo Clinic, 200 First Street SW, Rochester, MN, 55905, USA
| | - Dana H Whaley
- Department of Radiology, Charlton 1-225, Mayo Clinic, 200 First Street SW, Rochester, MN, 55905, USA
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Kim JS. F-18 FDG PET/CT Imaging of Eccrine Sweat Gland Carcinoma of the Scrotum with Extensive Regional and Distant Metastases. Asia Ocean J Nucl Med Biol 2017; 5:104-108. [PMID: 28660220 PMCID: PMC5482914 DOI: 10.22038/aojnmb.2017.19550.1145] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Eccrine carcinoma is an extremely rare malignant skin cancer arising from eccrine sweat glands with a high metastatic potential. It mainly occurs in the elderly, with equal incidence in both sexes. It usually spreads to regional lymph nodes, with liver, lungs, and bones being the most common sites of distant metastasis. Because of tumor rarity, little is known about the value of F-18 FDG PET/CT in evaluating this disease. Our case report aims to increase current knowledge of F-18 FDG PET/CT in eccrine sweat gland carcinoma as a noninvasive imaging tool for assessing the extension of the disease and detecting distant metastases. We reported a 96-year-old man who presented with as lowly progressive, ill-margined erythematous papules and nodules with a crusted and eroded involving multiple sites of groin, scrotum, penis, left pelvic wall, left hip and left thigh for >3 years, which became extensive in the past 2 months. The histologic investigation confirmed the diagnosis of an eccrine carcinoma. He was performed F-18 FDG PET/CT to further evaluate the lesions. FDG PET/CT imaging revealed FDG uptake at the extensive skin lesion, involvement of lymph nodes, and multiple FDG-avid of liver, skeletal and lung metastases.
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Affiliation(s)
- Jin-Suk Kim
- Department of Nuclear Medicine, Konyang University Hospital, Daejeon, Republic of Korea,Corresponding author: Jin-Suk Kim, Department of Nuclear Medicine, Konyang University Hospital, 685 Gasuwon-dong, Seo-gu, Daejeon 302-718, Korea. Tel: 82426009474; Fax: 82426009499;
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Kim MH, Kim DW, Park SA, Kim CG. Transiently Altered Distribution of F-18 FDG in a Patient with Subacute Thyroiditis. Nucl Med Mol Imaging 2016; 52:82-84. [PMID: 29391918 DOI: 10.1007/s13139-016-0454-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2016] [Revised: 09/19/2016] [Accepted: 09/26/2016] [Indexed: 11/25/2022] Open
Abstract
F-18 fluorodeoxyglucose (FDG) is a highly influential radiotracer that provides valuable information in many cancer types. However, the normal biodistribution of F-18 FDG is often variable and can be altered by intrinsic or iatrogenic factors. We report a case of diffuse symmetrically increased skeletal muscle uptake and relatively decreased hepatic uptake on F-18 FDG PET/CT in a 57-year-old female with pulmonary adenocarcinoma. Detailed clinical evaluation and retrospective radiologic evaluation revealed that she had been diagnosed with subacute thyroiditis 2 weeks ago. After 6 weeks, F-18 FDG distribution was normalized at the follow-up PET/CT study.
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Affiliation(s)
- Myoung Hyoun Kim
- Department of Nuclear Medicine, Wonkwang University School of Medicine and Institute of Wonkwang Medical Science, 895, Muwang-ro, Iksan, 54538 Republic of Korea
| | - Dae-Weung Kim
- Department of Nuclear Medicine, Wonkwang University School of Medicine and Institute of Wonkwang Medical Science, 895, Muwang-ro, Iksan, 54538 Republic of Korea
| | - Soon-Ah Park
- Department of Nuclear Medicine, Wonkwang University School of Medicine and Institute of Wonkwang Medical Science, 895, Muwang-ro, Iksan, 54538 Republic of Korea
| | - Chang Guhn Kim
- Department of Nuclear Medicine, Wonkwang University School of Medicine and Institute of Wonkwang Medical Science, 895, Muwang-ro, Iksan, 54538 Republic of Korea
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Chang CA, Pattison DA, Tothill RW, Kong G, Akhurst TJ, Hicks RJ, Hofman MS. (68)Ga-DOTATATE and (18)F-FDG PET/CT in Paraganglioma and Pheochromocytoma: utility, patterns and heterogeneity. Cancer Imaging 2016; 16:22. [PMID: 27535829 PMCID: PMC4989291 DOI: 10.1186/s40644-016-0084-2] [Citation(s) in RCA: 111] [Impact Index Per Article: 13.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2016] [Accepted: 08/12/2016] [Indexed: 12/24/2022] Open
Abstract
Background Pheochromocytomas (PCC) and paragangliomas (PGL) are neuroendocrine tumours arising from pluripotent neural crest stem cells and are associated with neurons of the autonomic nervous system. PCCs/PGLs are often hereditary and multifocal, and their biologic behaviour and metabolic activity vary making imaging of these tumours challenging. The imaging gold standard has been I-123 MIBG complemented by CT or MRI. PGLs being neuroendocrine tumours express somatostatin receptors enabling imaging with Ga-68 DOTA-coupled peptides such as DOTATATE. Imaging with F-18 FDG also provides additional information regarding metabolic activity and biologic aggressiveness of these tumours, or, in some situations, reflecting metabolic reprogramming of these tumours. We report our experience using both Ga-68 DOTATATE and F-18 FDG PET/CT imaging in patients with PGLs and PCCs. Methods This was a retrospective review of 23 patients with proven PGL/PCC who underwent both DOTATATE and FDG PET/CT. Seven patients also had I-123 MIBG SPECT/CT and 1 patient had I-124 MIBG PET/CT. Lesional intensity and patterns of uptake were analysed. Results DOTATATE and FDG were positive at most sites of disease (96.2 % vs 91.4 %), although uptake intensity was significantly higher on DOTATATE with a median SUV of 21 compared to 12.5 for FDG (p < 0.001). SUVmax on F-18 FDG was significantly higher (p < 0.001) in clinically aggressive cases. I-123/I-124 MIBG detected fewer lesions (30.4 %). Conclusion Overall, Ga-68 DOTATATE PET/CT detected similar number but has significantly greater lesion-to-background contrast compared to F-18 FDG PET/CT. Combined with high specificity, patient convenience and relatively low cost, DOTATATE PET/CT should be considered the ideal first line investigation for imaging PGL/PCC. Depending on DOTATATE findings and the clinical question, FDG and MIBG remain useful and, in selected cases, may provide more accurate staging, disease characterisation and guide treatment choices.
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Affiliation(s)
- Chian A Chang
- Cancer Imaging, Peter MacCallum Cancer Centre, 305 Grattan Street, Melbourne, VIC, 3000, Australia
| | - David A Pattison
- Cancer Imaging, Peter MacCallum Cancer Centre, 305 Grattan Street, Melbourne, VIC, 3000, Australia.,Endocrinology Service, Peter MacCallum Cancer Centre, Melbourne, Australia
| | - Richard W Tothill
- Sir Peter MacCallum Department of Oncology, University of Melbourne, Melbourne, Australia
| | - Grace Kong
- Cancer Imaging, Peter MacCallum Cancer Centre, 305 Grattan Street, Melbourne, VIC, 3000, Australia
| | - Tim J Akhurst
- Cancer Imaging, Peter MacCallum Cancer Centre, 305 Grattan Street, Melbourne, VIC, 3000, Australia.,Sir Peter MacCallum Department of Oncology, University of Melbourne, Melbourne, Australia
| | - Rodney J Hicks
- Cancer Imaging, Peter MacCallum Cancer Centre, 305 Grattan Street, Melbourne, VIC, 3000, Australia.,Sir Peter MacCallum Department of Oncology, University of Melbourne, Melbourne, Australia
| | - Michael S Hofman
- Cancer Imaging, Peter MacCallum Cancer Centre, 305 Grattan Street, Melbourne, VIC, 3000, Australia. .,Sir Peter MacCallum Department of Oncology, University of Melbourne, Melbourne, Australia.
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Kim JS, Cha EJ. A Rare Case of Multilocular Thymic Cyst with Follicular Lymphoid Hyperplasia: Radiologic and Histopathologic Features. Nucl Med Mol Imaging 2016; 50:161-3. [PMID: 27275366 DOI: 10.1007/s13139-016-0404-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2015] [Revised: 01/26/2016] [Accepted: 02/03/2016] [Indexed: 11/25/2022] Open
Abstract
Multilocular thymic cysts are rare and acquired lesions induced by an inflammatory arising within the thymus. We report a rare case of multilocular thymic cyst with follicular lymphoid hyperplasia in a 59-year-old female. Chest CT and MRI revealed a large multilocular cystic mass, which contains thick septa and nodules in the thymus. F-18 FDG PET/CT showed almost no FDG uptake of the multilocular cystic mass but moderate FDG uptake of the solid nodules. Extended total thymectomy was performed. Histopathological findings revealed follicular lymphoid hyperplasia of thymic tissue but no neoplastic lesion. Based on these findings, diagnosis of multilocular thymic cyst with follicular lymphoid hyperplasia was made. This is a rare case that preoperatively was difficult to diagnose.
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Affiliation(s)
- Jin-Suk Kim
- Department of Nuclear Medicine, Konyang University Hospital, 685 Gasuwon-dong, Seo-gu, Daejeon, 302-718 Republic of Korea
| | - Eun Jung Cha
- Department of pathology, Konyang University Hospital, Daejeon, Republic of Korea
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Han YH, Lim ST, Jeong HJ, Sohn MH. Clinical Value of a One-Stop-Shop Low-Dose Lung Screening Combined with (18)F-FDG PET/CT for the Detection of Metastatic Lung Nodules from Colorectal Cancer. Nucl Med Mol Imaging 2016; 50:144-9. [PMID: 27275363 DOI: 10.1007/s13139-015-0387-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2015] [Revised: 11/17/2015] [Accepted: 12/01/2015] [Indexed: 02/07/2023] Open
Abstract
PURPOSE The aim of this study was to evaluate the clinical usefulness of additional low-dose high-resolution lung computed tomography (LD-HRCT) combined with (18)F-fluoro-2-deoxyglucose positron emission tomography with CT ((18)F-FDG PET/CT) compared with conventional lung setting image of (18)F-FDG PET/CT for the detection of metastatic lung nodules from colorectal cancer. METHODS From January 2011 to September 2011, 649 patients with colorectal cancer underwent additional LD-HRCT at maximum inspiration combined with (18)F-FDG PET/CT. Forty-five patients were finally diagnosed to have lung metastasis based on histopathologic study or clinical follow-up. Twenty-five of the 45 patients had ≤5 metastatic lung nodules and the other 20 patients had >5 metastatic nodules. One hundred and twenty nodules in the 25 patients with ≤5 nodules were evaluated by conventional lung setting image of (18)F-FDG PET/CT and by additional LD-HRCT respectively. Sensitivities, specificities, diagnostic accuracies, positive predictive values (PPVs), and negative predictive values (NPVs) of conventional lung setting image of (18)F-FDG PET/CT and additional LD-HRCT were calculated using standard formulae. The McNemar test and receiver-operating characteristic (ROC) analysis were performed. RESULTS Of the 120 nodules in the 25 patients with ≤5 metastatic lung nodules, 66 nodules were diagnosed as metastatic. Eleven of the 66 nodules were confirmed histopathologically and the others were diagnosed by clinical follow-up. Conventional lung setting image of (18)F-FDG PET/CT detected 40 of the 66 nodules and additional LD-HRCT detected 55 nodules. All 15 nodules missed by conventional lung setting imaging but detected by additional LD-HRCT were <1 cm in size. The sensitivity, specificity, and diagnostic accuracy of the modalities were 60.6 %, 85.2 %, and 71.1 % for conventional lung setting image and 83.3 %, 88.9 %, and 85.8 % for additional LD-HRCT. By ROC analysis, the area under the ROC curve (AUC) of conventional lung setting image and additional LD-HRCT were 0.712 and 0.827 respectively. CONCLUSION Additional LD-HRCT with maximum inspiration was superior to conventional lung setting image of (18)F-FDG PET/CT for the detection of metastatic lung nodules from colorectal cancer (P < 0.05).
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Affiliation(s)
- Yeon-Hee Han
- Department of Nuclear Medicine, Research Institute of Clinical Medicine, Chonbuk National University-Biomedical Research Institute, Chonbuk National University Hospital, Cyclotron Research Center, Molecular Imaging and Therapeutic Medicine Research Center, Chonbuk National University Medical School and Hospital, Jeonju, Jeonbuk Republic of Korea
| | - Seok Tae Lim
- Department of Nuclear Medicine, Research Institute of Clinical Medicine, Chonbuk National University-Biomedical Research Institute, Chonbuk National University Hospital, Cyclotron Research Center, Molecular Imaging and Therapeutic Medicine Research Center, Chonbuk National University Medical School and Hospital, Jeonju, Jeonbuk Republic of Korea
| | - Hwan-Jeong Jeong
- Department of Nuclear Medicine, Research Institute of Clinical Medicine, Chonbuk National University-Biomedical Research Institute, Chonbuk National University Hospital, Cyclotron Research Center, Molecular Imaging and Therapeutic Medicine Research Center, Chonbuk National University Medical School and Hospital, Jeonju, Jeonbuk Republic of Korea
| | - Myung-Hee Sohn
- Department of Nuclear Medicine, Research Institute of Clinical Medicine, Chonbuk National University-Biomedical Research Institute, Chonbuk National University Hospital, Cyclotron Research Center, Molecular Imaging and Therapeutic Medicine Research Center, Chonbuk National University Medical School and Hospital, Jeonju, Jeonbuk Republic of Korea
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24
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Duncan JR, Carr D, Kaffenberger BH. The utility of positron emission tomography with and without computed tomography in patients with nonmelanoma skin cancer. J Am Acad Dermatol 2016; 75:186-96. [PMID: 26992283 DOI: 10.1016/j.jaad.2016.01.045] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2015] [Revised: 01/16/2016] [Accepted: 01/20/2016] [Indexed: 10/22/2022]
Abstract
Combined positron emission tomography (PET) and computed tomography (CT) scans are widely used in the staging and monitoring of most malignancies. The differential for PET-positive cutaneous lesions includes primary skin cancers, infections, cutaneous metastases from distant malignancies, and benign neoplasms. In dermatology, PET/CT scans have been most widely studied in patients with melanoma and Merkel cell carcinoma. The role of PET/CT scans in the management of other cutaneous malignancies is less clear, but it has shown great promise in the management of patients with squamous cell carcinoma and cutaneous lymphoma. This review seeks to address the usefulness of PET/CT scans in nonmelanoma skin cancer and to provide guidance regarding the management of patients with incidental PET-positive nodules. Currently, there is limited experience with PET/CT scans for staging and monitoring of non-head and neck metastatic basal cell and squamous cell carcinomas, and results show limited sensitivity and specificity. We also address the evidence for management of an incidental PET-positive cutaneous nodule and recommend obtaining a biopsy specimen in patients with a known noncutaneous malignancy, a history of primary skin cancer, or a high risk of either cutaneous or noncutaneous malignancy.
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Affiliation(s)
| | - David Carr
- Division of Dermatology, Wexner Medical Center at Ohio State University, Ghanna, Ohio
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Wang LJ, Wu HB, Wang M, Han YJ, Li HS, Zhou WL, Wang QS. Utility of F-18 FDG PET/CT on the evaluation of primary bone lymphoma. Eur J Radiol 2015; 84:2275-9. [PMID: 26388466 DOI: 10.1016/j.ejrad.2015.09.011] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2015] [Revised: 08/21/2015] [Accepted: 09/08/2015] [Indexed: 10/23/2022]
Abstract
PURPOSE Primary bone lymphoma (PBL) is a rare type of malignant lymphoma. Few data have been reported regarding the utility of F-18 FDG PET/CT in this disease. The aim of this study was to assess the role of F-18 FDG PET/CT in the diagnosis and therapeutic effect evaluation of PBL. MATERIALS AND METHODS A total of 19 consecutive patients with PBL were enrolled. Whole-body PET/CT scan was performed for all patients. The diagnosis of PBL was established by histopathology and immunohistochemistry. RESULTS F-18 FDG PET/CT was positive in 94.7% (18/19) of patients. Uptake of FDG in lesions was intense with SUVmax of 15.14 ± 11.82. Multiple involved lesions were found in 47.4% (9/19) patients, while 52.6% presented with a single involved lesion. Based on the lesions, PET detected 98.9% (87/88) lesions. Among them, 71.6% (63/88) lesions were found to be located in axial skeleton and 28.4% (25/88) in the extremity skeleton. FDG PET/CT also found the lesions infiltrate to the surrounding soft tissue in 84.2% (16/19) patients. On the syn-modality CT, the bone destruction was noted in 43.2% (38/88) of the lesions, of which 50.0% lesions presented as slight change in bone density and 50.0% as severe change. The diagnostic sensitivity of PET was much higher than that of CT (98.9% vs. 43.2%, P=0.000). PET/CT was performed for evaluation of treatment response in 13 patients. In 12 patients with complete response(CR), PET/CT found the 25 lesions were F-18 FDG fully resoluted after treatment, however, bone destruction was still presented in 72.0% (18/25) lesions. CONCLUSIONS The present study suggests that F-18 FDG PET/CT was a sensitive imaging modality for diagnosis and treatment response evaluation of PBL.
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Affiliation(s)
- Li-Juan Wang
- NanFang PET/CT Center, Nanfang Hospital, Southern Medical University, 1838 Guangzhou Avenue North, Guangzhou, Guangdong Province 510515, China.
| | - Hu-Bing Wu
- NanFang PET/CT Center, Nanfang Hospital, Southern Medical University, 1838 Guangzhou Avenue North, Guangzhou, Guangdong Province 510515, China.
| | - Meng Wang
- NanFang PET/CT Center, Nanfang Hospital, Southern Medical University, 1838 Guangzhou Avenue North, Guangzhou, Guangdong Province 510515, China.
| | - Yan-Jiang Han
- NanFang PET/CT Center, Nanfang Hospital, Southern Medical University, 1838 Guangzhou Avenue North, Guangzhou, Guangdong Province 510515, China.
| | - Hong-Sheng Li
- NanFang PET/CT Center, Nanfang Hospital, Southern Medical University, 1838 Guangzhou Avenue North, Guangzhou, Guangdong Province 510515, China.
| | - Wen-Lan Zhou
- NanFang PET/CT Center, Nanfang Hospital, Southern Medical University, 1838 Guangzhou Avenue North, Guangzhou, Guangdong Province 510515, China.
| | - Quan-Shi Wang
- NanFang PET/CT Center, Nanfang Hospital, Southern Medical University, 1838 Guangzhou Avenue North, Guangzhou, Guangdong Province 510515, China.
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Jo I, Zeon SK, Kim SH, Kim HW, Kang SH, Kwon SY, Kim SJ. Correlation of Primary Tumor FDG Uptake with Clinicopathologic Prognostic Factors in Invasive Ductal Carcinoma of the Breast. Nucl Med Mol Imaging 2014; 49:19-25. [PMID: 25774234 DOI: 10.1007/s13139-014-0296-y] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2014] [Revised: 08/24/2014] [Accepted: 08/25/2014] [Indexed: 12/14/2022] Open
Abstract
PURPOSE The purpose of this study was to investigate the correlation of primary tumor FDG uptake to clinicopathological prognostic factors in invasive ductal carcinoma of the breast. METHODS We retrospectively reviewed 136 of 215 female patients with pathologically proven invasive ductal breast cancer from January 2008 to December 2011 who underwent F-18 FDG PET/CT for initial staging and follow-up after curative treatment with analysis of estrogen receptor (ER), progesterone receptor (PR) and human epithelial growth factor receptor 2 (HER2). The maximum standardized uptake value (SUVmax) of the primary breast tumor was measured and compared with hormonal receptor and HER2 overexpression status. RESULTS The high SUVmax of primary breast tumors is significantly correlated with the clinicopathological factors: tumor size, histologic grade, TNM stage, negativity of ER, negativity of PR, HER2 overexpression and triple negativity. The recurrent group with non-triple negative cancer had a higher SUVmax compared with the non-recurrent group, though no significant difference in FDG uptake was noted between the recurrence and non-recurrent groups in subjects with triple-negative cancer. Lymph node involvement was the independent risk factor for cancer recurrence in the multivariate analysis. CONCLUSIONS In conclusion, high FDG uptake in primary breast tumors is significantly correlated with clinicopathological factors, such as tumor size, histologic grade, TNM stage, negativity of the hormonal receptor, HER2 overexpression and triple negativity. Therefore, FDG PET/CT is a helpful prognostic tool to direct the further management of patients with breast cancer.
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Affiliation(s)
- I Jo
- Department of Nuclear Medicine, Keimyung University, School of Medicine, Daegu, Republic of Korea
| | - Seok Kil Zeon
- Department of Nuclear Medicine, Bundang Jesaeng General Hospital, Seohyeon-dong 255-2, Seongnam, Republic of Korea
| | - Sung Hoon Kim
- Department of Nuclear Medicine, Keimyung University, School of Medicine, Daegu, Republic of Korea
| | - Hae Won Kim
- Department of Nuclear Medicine, Keimyung University, School of Medicine, Daegu, Republic of Korea
| | - Sun Hee Kang
- Department of Surgery, Keimyung University, School of Medicine, Daegu, Republic of Korea
| | - Sun Young Kwon
- Department of Pathology, Keimyung University, School of Medicine, Daegu, Republic of Korea
| | - Su Jin Kim
- Department of Anesthesiology and Pain Medicine, Dongguk University, School of Medicine, Gyeongju, Republic of Korea
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Lee AY, Choi SJ, Jung KP, Park JS, Lee SM, Bae SK. Characteristics of Metastatic Mediastinal Lymph Nodes of Non-Small Cell Lung Cancer on Preoperative F-18 FDG PET/CT. Nucl Med Mol Imaging 2014; 48:41-6. [PMID: 24900137 DOI: 10.1007/s13139-013-0244-2] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2013] [Revised: 10/04/2013] [Accepted: 10/08/2013] [Indexed: 10/26/2022] Open
Abstract
PURPOSE The aim of this study was to evaluate the characteristics of PET and CT features of mediastinal metastatic lymph nodes on F-18 FDG PET/CT and to determine the diagnostic criteria in nodal staging of non-small cell lung cancer. METHODS One hundred four non-small cell lung cancer patients who had preoperative F-18 FDG PET/CT were included. For quantitative analysis, the maximum SUV of the primary tumor, maximum SUV of the lymph nodes (SUVmax), size of the lymph nodes, and average Hounsfield units (aHUs) and maximum Hounsfield units (mHUs) of the lymph nodes were measured. The SUVmax, SUV ratio of the lymph node to blood pool (LN SUV/blood pool SUV), SUV ratio of the lymph node to primary tumor (LN SUV/primary tumor SUV), size, aHU, and mHU were compared between the benign and malignant lymph nodes. RESULTS Among 372 dissected lymph node stations that were pathologically diagnosed after surgery, 49 node stations were malignant and 323 node stations benign. SUVmax, LN SUV/blood pool SUV, and size were significantly different between the malignant and benign lymph node stations (P < 0.0001). However, there was no significant difference in LN SUV/primary tumor SUV (P = 0.18), mHU (P = 0.42), and aHU (P = 0.98). Using receiver-operating characteristic curve analyses, there was no significant difference among these three variables (SUVmax, LN SUV/blood pool SUV, and size). The optimal cutoff values were 2.9 for SUVmax, 1.4 for LN SUV/blood pool SUV, and 5 mm for size. When the cutoff value of SUVmax ≥2.9 and size ≥5 mm were used in combination, the positive predictive value was 44.2 %, and the negative predictive value was 90.9 %. When we evaluated the results based on the histology of the primary tumor, the negative predictive value was 92.3 % in adenocarcinoma (cutoff values of SUVmax ≥2.3 and size ≥5 mm) and 97.2 % in squamous cell carcinoma (cutoff values of SUVmax ≥3.6 and size ≥8 mm), separately. CONCLUSIONS In the lymph node staging of non-small cell lung cancer, SUVmax, LN SUV/blood pool SUV, and size show statistically significant differences between malignant and benign lymph nodes. These variables can be used to differentiate malignant from benign lymph nodes. The combination of the SUVmax and size of lymph node might have a good negative predictive value.
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Vamsy M, Dattatreya P, Parakh M, Dayal M, Rao VP. F18 FDG positron emission tomography revelation of primary testicular lymphoma with concurrent multiple extra nodal involvement. Indian J Nucl Med 2013; 28:36-8. [PMID: 24019676 PMCID: PMC3764692 DOI: 10.4103/0972-3919.116816] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
Primary testicular lymphoma (PTL) a relatively rare disease of non-Hodgkin's lymphomas occurring with a lesser incidence of 1-2% has a propensity to occur at later ages above 50 years. PTL spreads to extra nodal sites due to deficiency of extra cellular adhesion molecules. We present detection of multiple sites of extra nodal involvement of PTL by F-18 positron emission tomography/computed tomography study aiding early detection of the dissemination thus aiding in staging and management.
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Affiliation(s)
- Mohana Vamsy
- Deparment of Surgical Oncology, Omega Hospitals, A Unit of Hyderabad Institute of Oncology, Banjara Hills, Hyderabad, Andhra Pradesh, India
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Abstract
Fluorine-18 fluoro-deoxy-glucose positron emission tomography (F-18 FDG PET) is not sensitive modality for the diagnosis of primary hepatocellular carcinoma (HCC). However, FDG-PET imaging may be useful in the identification of extrahepatic metastases. We report an interesting image of HCC with solitary metastasis to sternum detected by F-18 FDG PET/CT.
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Abstract
Detection of recurrence of tumors with conventional imaging like computed tomography (CT) and magnetic resonance imaging (MRI) can be difficult because of distorted anatomy and implants in situ. Fluorine-18 fluorodeoxyglucose positron emission tomography/computed tomography (F-18 FDG PET/CT has been shown to be very useful in detection of recurrent tumors with higher accuracy than conventional imaging method. Giant cell tumors of foot though rare have high recurrence potential after initial curative treatment. However, currently there is no literature addressing the role of F-18 FDG PET/CT in evaluation of these tumors. We report a case of post excisional recurrent giant cell tumor of foot diagnosed on F-18 FDG PET/CT. In addition, to detection of recurrence F-18 FDG PET/CT also aided in accurate management of the patient.
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Affiliation(s)
- Kuruva Manohar
- Department of Nuclear Medicine and PET, Postgraduate Institute of Medical Education and Research, Chandigarh, India
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Lee HJ, Ahn BC, Hwang SW, Cho SK, Kim HW, Lee SW, Hwang JH, Lee J. F-18 fluorodeoxyglucose PET/CT and post hoc PET/MRI in a case of primary meningeal melanomatosis. Korean J Radiol 2013; 14:343-9. [PMID: 23483049 PMCID: PMC3590351 DOI: 10.3348/kjr.2013.14.2.343] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2012] [Accepted: 06/11/2012] [Indexed: 11/15/2022] Open
Abstract
Primary meningeal melanomatosis is a rare, aggressive variant of primary malignant melanoma of the central nervous system, which arises from melanocytes within the leptomeninges and carries a poor prognosis. We report a case of primary meningeal melanomatosis in a 17-year-old man, which was diagnosed with (18)F-fluorodeoxyglucose (F-18 FDG) PET/CT, and post hoc F-18 FDG PET/MRI fusion images. Whole-body F-18 FDG PET/CT was helpful in ruling out the extracranial origin of melanoma lesions, and in assessing the therapeutic response. Post hoc PET/MRI fusion images facilitated the correlation between PET and MRI images and demonstrated the hypermetabolic lesions more accurately than the unenhanced PET/CT images. Whole body F-18 FDG PET/CT and post hoc PET/MRI images might help clinicians determine the best therapeutic strategy for patients with primary meningeal melanomatosis.
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Affiliation(s)
- Hong Je Lee
- Department of Nuclear Medicine, Dongnam Institute of Radiological & Medical Sciences, Busan 619-953, Korea
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Hwang JP, Lim SM. Uterine Epithelioid Angiosarcoma on F-18 FDG PET/CT. Nucl Med Mol Imaging 2013; 47:134-7. [PMID: 24900095 DOI: 10.1007/s13139-013-0191-y] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2012] [Revised: 01/07/2013] [Accepted: 01/10/2013] [Indexed: 12/12/2022] Open
Abstract
Uterine epithelioid angiosarcoma can have conventional imaging characteristics similar to those of other uterine tumors, such as leiomyoma, leiomyosarcomas or hemangioendothelioma. Uterine epithelioid angiosarcoma exhibiting increased fluorine-18 fluorodeoxyglucose (F-18 FDG) activity can be misdiagnosed. A 61-year-old woman who was diagnosed with uterine epithelioid angiosarcoma underwent F-18 FDG positron emission tomography/computed tomography (PET/CT) as a part of the pretreatment work up for surgery. F-18 FDG PET/CT showed an intense F-18 FDG uptake in the uterus in addition to increased F-18 FDG uptake at the paraaortic and aortocaval lymph nodes. To our knowledge, this is the first case report of intense F-18 FDG uptake in uterine epithelioid angiosarcoma in Korea.
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Affiliation(s)
- Jae Pil Hwang
- Department of Nuclear Medicine, Korea Institute of Radiological and Medical Sciences, Nowon-Gil 75, Gongneung-Dong, , Nowon-Gu Seoul, 139-706 Korea
| | - Sang Moo Lim
- Department of Nuclear Medicine, Korea Institute of Radiological and Medical Sciences, Nowon-Gil 75, Gongneung-Dong, , Nowon-Gu Seoul, 139-706 Korea ; Department of Molecular Imaging Research Center, Korea Institute of Radiological and Medical Sciences, Seoul, Korea
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Kim JS, Jeong YJ, Sohn MH, Jeong HJ, Lim ST, Kim DW, Kwak JY, Yim CY. Usefulness of F-18 FDG PET/CT in subcutaneous panniculitis-like T cell lymphoma: disease extent and treatment response evaluation. Radiol Oncol 2012; 46:279-83. [PMID: 23412422 PMCID: PMC3572891 DOI: 10.2478/v10019-012-0017-z] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2011] [Accepted: 01/21/2012] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND.: Subcutaneous panniculitis-like T-cell lymphoma (SPTCL) is a rare form of cutaneous lymphomas, accounting for less than 1% of cases of non-Hodgkin's lymphoma. Fluorine-18 fluorodeoxyglucose (F-18 FDG) positron-emission tomography/computed tomography (PET/CT) findings of SPTCL before and after treatment were rarely reported. CASE REPORT.: We report a case of SPTCL in which F-18 FDG PET/CT showed increased FDG accumulations in numerous subcutaneous nodules without extracutaneous disease. Contrast-enhanced CT during F-18 FDG PET/CT showed multiple minimally enhancing nodules with an infiltrative pattern in the subcutaneous layer throughout the body. Follow-up F-18 FDG PET/CT after three cycles of CHOP chemotherapy showed a complete metabolic remission of the lesions. CONCLUSIONS.: F-18 FDG PET/CT is suggested to be useful in assessing the disease activity, extent and treatment response in SPTCL.
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Affiliation(s)
- Jin-Suk Kim
- Department of Nuclear Medicine, Konyang University Hospital, Daejeon, South Korea
| | - Young Jin Jeong
- Department of Nuclear Medicine, Dong-A University Medical Center, Busan, South Korea
| | - Myung-Hee Sohn
- Department of Nuclear Medicine
- Research Institute of Clinical Medicine, Chonbuk National University Medical School and Hospital, Jeonju, Jeonbuk, South Korea
- Correspondence to: Myung-Hee Sohn, M.D., Department of Nuclear Medicine, Chonbuk National University Medical School and Hospital, San 2-20 Geumam-dong, Deokjin-gu, Jeonju, Jeonbuk, 561-180, South Korea. Phone: +82-63-250-1174; Fax: +82-63-255-1172; E-mail:
| | - Hwan-Jeong Jeong
- Department of Nuclear Medicine
- Research Institute of Clinical Medicine, Chonbuk National University Medical School and Hospital, Jeonju, Jeonbuk, South Korea
| | - Seok Tae Lim
- Department of Nuclear Medicine
- Research Institute of Clinical Medicine, Chonbuk National University Medical School and Hospital, Jeonju, Jeonbuk, South Korea
| | - Dong Wook Kim
- Department of Nuclear Medicine
- Research Institute of Clinical Medicine, Chonbuk National University Medical School and Hospital, Jeonju, Jeonbuk, South Korea
| | - Jae-Yong Kwak
- Department of Internal Medicine and
- Research Institute of Clinical Medicine, Chonbuk National University Medical School and Hospital, Jeonju, Jeonbuk, South Korea
| | - Chang-Yeol Yim
- Department of Internal Medicine and
- Research Institute of Clinical Medicine, Chonbuk National University Medical School and Hospital, Jeonju, Jeonbuk, South Korea
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Tripathi M, Jaimini A, D'Souza MM, Sharma R, Jain J, Garg G, Singh D, Kumar N, Mishra AK, Grover RK, Mondal A. Spectrum of brain abnormalities detected on whole body F-18 FDG PET/CT in patients undergoing evaluation for non-CNS malignancies. Indian J Nucl Med 2012; 26:123-9. [PMID: 22174526 PMCID: PMC3237218 DOI: 10.4103/0972-3919.90271] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Abstract
We present the pattern of metabolic brain abnormalities detected in patients undergoing whole body (WB) F-18 flurodeoxyglucose (FDG) positron emission tomography/computed tomography (PET/CT) examination for non-central nervous system (CNS) malignancies. Knowledge of the PET/CT appearance of various intracranial metabolic abnormalities enables correct interpretation of PET scans in oncological patients where differentiation of metastasis from benign intracranial pathologies is important and improves specificity of the PET study. A complete clinical history and correlation with CT and MRI greatly helps in arriving at a correct imaging diagnosis.
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Affiliation(s)
- Madhavi Tripathi
- Division of PET Imaging, Molecular Imaging and Research Centre, MIRC, Institute of Nuclear Medicine and Allied Sciences, Lucknow Road, Delhi, India
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Harisankar CNB, Kashyap R, Bhattacharya A, Mittal BR. Fluoro-deoxy-glucose Positron Emission Tomography/Computed Tomography Pattern in a Patient with Linitis Plastica of the Stomach Caused by Primary Signet Cell Adenocarcinoma. World J Nucl Med 2012; 11:26-7. [PMID: 22942780 PMCID: PMC3425226 DOI: 10.4103/1450-1147.98743] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
We report the findings of [18F] fluoro-deoxy-glucose (FDG) positron emission tomography (PET) performed in a 67-year-old female with suspicion of gastric carcinoma. Intense FDG uptake was noted in the thickened gastric wall. Subsequent laparotomy showed diffuse involvement of the gastric wall by signet ring cell adenocarcinoma. This report highlights FDG PET/CT pattern in linitis plastica of the stomach caused by primary signet cell adenocarcinoma.
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36
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Jeong YJ, Yoon HJ, Kang DY. Growing Cardiac Hemangioma on Serial F-18 FDG PET/CT. Nucl Med Mol Imaging 2012; 46:223-6. [PMID: 24900065 DOI: 10.1007/s13139-012-0155-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/29/2012] [Revised: 06/12/2012] [Accepted: 06/21/2012] [Indexed: 11/30/2022] Open
Abstract
Cardiac hemangiomas are extremely rare, benign tumors, which can occur anywhere in the heart. Symptoms are variable according to the size, extension and tumor location, but most cases are asymptomatic and are detected incidentally. They may grow, remain stable and regress; therefore, the natural course of the tumors is unpredictable. Diagnosis mainly depends upon echocardiography, CT, MRI and angiography. Reports of detection by F-18 FDG PET/CT are very limited. We report a case of cardiac hemangioma attached to the right ventricle, compressing the ventricle. It was revealed incidentally on F-18 FDG PET/CT for routine evaluation of thyroid cancer. During two serial F-18 FDG PET/CTs, it grew from 2.8 cm to 4.0 cm with mild FDG uptake. After surgery, the patient remained stable without any complications.
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Affiliation(s)
- Young Jin Jeong
- Department of Nuclear Medicine, Dong-A University Medical Center, 3ga 1, Dongdaesin-dong, Seo-gu, Busan 602-715 South Korea
| | - Hyun Jin Yoon
- Department of Nuclear Medicine, Dong-A University Medical Center, 3ga 1, Dongdaesin-dong, Seo-gu, Busan 602-715 South Korea
| | - Do-Young Kang
- Department of Nuclear Medicine, Dong-A University Medical Center, 3ga 1, Dongdaesin-dong, Seo-gu, Busan 602-715 South Korea
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37
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Kim SH, Won KS, Choi BW, Jo I, Zeon SK, Chung WJ, Kwon JH. Usefulness of F-18 FDG PET/CT in the Evaluation of Early Treatment Response After Interventional Therapy for Hepatocellular Carcinoma. Nucl Med Mol Imaging 2012; 46:102-10. [PMID: 24900042 DOI: 10.1007/s13139-012-0138-8] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2011] [Accepted: 04/01/2012] [Indexed: 01/02/2023] Open
Abstract
PURPOSE This retrospective study investigated the usefulness of F-18 fluorodeoxyglucose (FDG) positron emission tomography/computed tomography (PET/CT) after interventional therapy for hepatocellular carcinoma (HCC). METHODS Between March 2007 and November 2010, 31 patients (24 men, 7 women; mean age, 61.8 ± 11.0 years) with 45 lesions underwent PET/CT within 1 month after interventional therapy for HCC. Twenty-six patients with 40 lesions underwent transcatheter arterial chemoembolization (TACE), two patients with 2 lesions underwent radiofrequency ablation (RFA), and three patients with 3 lesions underwent percutaneous ethanol injection therapy (PEIT). Patients with a history of previous interventional therapy were excluded. Visual analysis was graded as positive when FDG was observed as an eccentric, nodular, or infiltrative pattern, and negative in case of isometabolic, hypometabolic, or rim-shaped uptake. For quantitative analysis, the standardized uptake value (SUV) was measured by region of interest technique. Maximum SUV (SUVmax) was assessed, and the ratio of SUVmax of tumor to mean SUV of normal liver (TNR) was calculated. The patients were divided into two groups, with and without residual tumor, based on 6-month clinical follow-up with serum alpha-fetoprotein and contrast-enhanced abdominal CT. RESULTS Of the 45 lesions, 24 were classified in the residual tumor group and the other 21 lesions in the no residual tumor group. No residual tumor was detected after RFA or PEIT. By visual analysis, the respective values for sensitivity, specificity, positive predictive value, negative predictive value, and accuracy were 87.5, 71.4, 77.8, 83.3, and 80.0 %. However, there were no significant differences in the SUVmax and TNR between the two groups. CONCLUSIONS It is suggested that FDG PET/CT may play a role in the evaluation of early treatment response after interventional therapy for HCC. The results indicate that FDG PET/CT visual analysis may be more useful than quantitative analysis. Further prospective studies with a large number of patients and established protocol are needed to substantiate our results.
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Affiliation(s)
- Sung Hoon Kim
- Department of Nuclear Medicine, Keimyung University, School of Medicine, 56 Dalseong-ro, Jung-gu, Daegu 700-712 Republic of Korea
| | - Kyoung Sook Won
- Department of Nuclear Medicine, Keimyung University, School of Medicine, 56 Dalseong-ro, Jung-gu, Daegu 700-712 Republic of Korea
| | - Byung Wook Choi
- Department of Nuclear Medicine, Keimyung University, School of Medicine, 56 Dalseong-ro, Jung-gu, Daegu 700-712 Republic of Korea
| | - Il Jo
- Department of Nuclear Medicine, Keimyung University, School of Medicine, 56 Dalseong-ro, Jung-gu, Daegu 700-712 Republic of Korea
| | - Seok Kil Zeon
- Department of Nuclear Medicine, Keimyung University, School of Medicine, 56 Dalseong-ro, Jung-gu, Daegu 700-712 Republic of Korea
| | - Woo Jin Chung
- Department of Internal Medicine, Keimyung University, School of Medicine, Daegu, Korea
| | - Jung Hyeok Kwon
- Department of Radiology, Keimyung University, School of Medicine, Daegu, Korea
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Sağer S, Yılmaz S, Ozhan M, Halaç M, Ergül N, Ciftci H, Cermik TF. F-18 Fdg PET/CT Findings of a Patient with Takayasu Arteritis Before and After Therapy. Mol Imaging Radionucl Ther 2012; 21:32-4. [PMID: 23486556 PMCID: PMC3590965 DOI: 10.4274/mirt.021896] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2011] [Accepted: 12/20/2011] [Indexed: 12/01/2022] Open
Abstract
Vasculitis is defined as inflammation and necrosis with leukocytic infiltration of the blood vessel wall. Takayasu arteritis is a chronic inflammatory arteritis that primarily involves the aorta and its main branches. A 64-year-old female patient with a 2-month history of fever of unknown origin was presented to our clinic for F-18 FDG PET/CT imaging. Baseline PET/CT images demonstrated intense F-18 FDG uptake in the aorta, bilateral subclavian and brachiocephalic arteries consistent with Takayasu arteritis. After 2 months of immunosuppressive therapy, she was asymptomatic and follow-up FDG PET/CT scan showed almost complete disappearance of large vessels’ F-18 FDG uptake. FDG PET/CT is a sensitive technique for assessing presence of large-vessel vasculitis such as Takayasu arteritis, extent of large-vessel inflammation and disease activity after therapy. Conflict of interest:None declared.
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Affiliation(s)
- Sait Sağer
- Istanbul University Cerrahpaşa Medical Faculty, Department of Nuclear Medicine, Istanbul, Turkey
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Manohar K, Mittal BR, Kashyap R, Bhattacharya A, Kakkar N, Mete UK. F-18 fluorodeoxy glucose positron emission tomography/computed tomography findings in a rare case of penile leiomyosarcoma. J Clin Imaging Sci 2011; 1:58. [PMID: 22267993 PMCID: PMC3261598 DOI: 10.4103/2156-7514.90955] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2011] [Accepted: 11/22/2011] [Indexed: 12/24/2022] Open
Abstract
Penile cancer is a rare entity accounting for only 0.4% all male malignancies. Penile leiomyosarcomas are even rarer with only around 35 cases reported in literature. We report a rare case of penile leiomyosarcoma illustrating F-18 Fluorodeoxy glucose (FDG) positron emission tomography/computed tomography (PET/CT) features and histopathology correlation.
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Affiliation(s)
- Kuruva Manohar
- Department of Nuclear Medicine and PET, Postgraduate Institute of Medical Education and Research, Chandigarh, India
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40
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Harisankar CNB, Mittal BR, Agrawal KL, Abrar ML, Bhattacharya A, Singh B, Modi M. FDG-PET findings in fronto-temporal dementia: A case report and review of literature. Indian J Nucl Med 2011; 26:96-8. [PMID: 22174516 PMCID: PMC3237227 DOI: 10.4103/0972-3919.90261] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Fronto-temporal lobar degeneration (FTLD) is a clinically and pathologically heterogeneous syndrome, characterized by progressive decline in behavior or language associated with degeneration of the frontal and anterior temporal lobes. Three distinct clinical variants of FTLD have been described. Despite the difficulties, accurate diagnosis is critical because the clinical management differs for Alzheimer's disease (AD) and FTLD. Positron emission tomography with fluro-deoxy-glucose (FDG-PET) typically shows sufficient abnormalities that can be used to improve the accuracy of distinguishing AD from FTLD in individual cases. Though temporo-parietal hypometabolism is sensitive in diagnosis of AD, it is less specific. The importance of evaluating the cingulate and anterior temporal cortices for arriving at a diagnosis of FTLD is stressed.
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Tripathi M, D'Souza M, Bal J, Guliani S, Jain J, Santosh, Sharma R, Mondal A. Comparision of F-18 FDG and C-11 Methionine PET/CT for demonstration of subependymal deposit in a treated case of glioblastoma multiforme. Indian J Nucl Med 2011; 26:91-3. [PMID: 22174514 PMCID: PMC3237225 DOI: 10.4103/0972-3919.90259] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/04/2022] Open
Abstract
A 10-year-boy post-operative, post-radiotherapy case of left temporal glioblastoma multiforme (GBM) was referred for F-18 Flurodeoxyglucose (FDG) Positron emission tomography/Computed Tomography (PET/CT) to rule out residual/recurrent disease 6 months following completion of therapy. The FDG scan 3 months following therapy had not shown evidence of viable residual or metastatic disease. The present scan showed a tiny focus of abnormal FDG accumulation in the region of the trigone of the left lateral ventricle which was best appreciated on the plain PET image. A correlative C-11 methionine study showed a well defined focus of abnormal tracer accumulation in the region of the left trigone. CECT and MRI done subsequently proved it to be a subependymal deposit. This case therefore demonstrates the possibility of subependymal deposits in GBM and the need for this possibility to be entertained during interpretation of the FDG study. It also highlights the advantage of labelled amino acids like C-11 methionine for clearly delineating subependymal deposits apart from the advantage for unequivocal interpretation of the PET study in recurrent brain tumors.
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Affiliation(s)
- Madhavi Tripathi
- Division of PET Imaging, Molecular Imaging and Research Centre, Institute of Nuclear Medicine and Allied Sciences, Delhi, India
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42
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Santhosh S, Mittal BR, Kashyap R, Bhattacharya A, Singh B. Symmetric increased skeletal muscular uptake of F-18 fluoro-deoxyglucose: A clue for the diagnosis of Graves' disease. Indian J Nucl Med 2011; 26:155-6. [PMID: 23326069 PMCID: PMC3543583 DOI: 10.4103/0972-3919.104000] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
F-18 fluoro-deoxyglucose (FDG) uptake in the thyroid and thymus is well reported in patients with Graves’ disease. Incidental skeletal muscle uptake has also been reported in other non-musculoskeletal (benign and malignant) pathologies. We report a patient of Graves’ disease showing symmetrical skeletal muscle uptake but no thyroidal or thymus uptake of FDG.
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Affiliation(s)
- Sampath Santhosh
- Department of Nuclear Medicine and PET, Postgraduate Institute of Medical Education and Research, Chandigarh, India
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43
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Kashyap R, Mittal BR, Chakraborty D, Bhattacharya A, Singh B. Multiple Skeletal Muscle Metastases in a Case of Transitional Cell Carcinoma of Bladder Detected by F-18 FDG PET/CT. Nucl Med Mol Imaging 2010; 44:297-9. [PMID: 24899968 DOI: 10.1007/s13139-010-0052-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2010] [Accepted: 09/01/2010] [Indexed: 01/26/2023] Open
Abstract
We present a case of poorly differentiated muscle invasive transitional cell carcinoma in a 64-year-old male diagnosed with FDG-avid mass in the urinary bladder wall and multiple skeletal muscles visualised on F-18 FDG PET/CT.
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Affiliation(s)
- Raghava Kashyap
- Dept. of Nuclear Medicine & PET, Postgraduate Institute of Medical Education and Research, Chandigarh, 160 012 India
| | - Bhagwant Rai Mittal
- Dept. of Nuclear Medicine & PET, Postgraduate Institute of Medical Education and Research, Chandigarh, 160 012 India
| | - Dhritiman Chakraborty
- Dept. of Nuclear Medicine & PET, Postgraduate Institute of Medical Education and Research, Chandigarh, 160 012 India
| | - Anish Bhattacharya
- Dept. of Nuclear Medicine & PET, Postgraduate Institute of Medical Education and Research, Chandigarh, 160 012 India
| | - Baljinder Singh
- Dept. of Nuclear Medicine & PET, Postgraduate Institute of Medical Education and Research, Chandigarh, 160 012 India
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