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Choi J, Chae Y, Kang BT, Lee S. An evaluation of the physiological uptake range of 18F-fluoro-2-deoxy-D-glucose in normal ovaries of seven dogs using positron emission tomography/computed tomography. Front Vet Sci 2024; 11:1343695. [PMID: 38371597 PMCID: PMC10869473 DOI: 10.3389/fvets.2024.1343695] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2023] [Accepted: 01/12/2024] [Indexed: 02/20/2024] Open
Abstract
Introduction This study evaluated the physiological uptake range of 18F-fluoro-2-deoxy-D-glucose (18F-FDG) in the normal ovaries of seven dogs using positron emission tomography/computed tomography (PET/CT). Materials and methods The dogs were subjected to general anesthesia and were positioned in ventral recumbency for PET/CT scans. The dosage of 18F-FDG ranged from 0.14 to 0.17 mCi/kg and was administered intravenously followed by 0.9% NaCl flushing; PET/CT images of each dog were obtained precisely 60 min after the injection of 18F-FDG. The regions of interest were drawn manually, and standardized uptake values (SUV) were calculated to evaluate the 18F-FDG uptake in each ovary. The maximum and mean SUVs (SUV max and SUV mean) for all the ovaries of the dogs were then computed. Results The range of SUV max and SUV mean of the normal ovaries of the dogs were 1.28-1.62 and 1.07-1.31 (mean ± standard deviation), respectively. Conclusion This is the first study to investigate the normal 18F-FDG uptake baseline data of normal canine ovaries using PET/CT scans. These data will help clinicians in identifying malignant tumors before anatomical changes in the ovary through PET/CT scans.
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Affiliation(s)
- Jinyoung Choi
- Department of Veterinary Surgery, College of Veterinary Medicine, Chungbuk National University, Cheongju, Republic of Korea
| | - Yeon Chae
- Laboratory of Veterinary Internal Medicine, College of Veterinary Medicine, Chungbuk National University, Cheongju, Republic of Korea
| | - Byeong-Teck Kang
- Laboratory of Veterinary Internal Medicine, College of Veterinary Medicine, Chungbuk National University, Cheongju, Republic of Korea
| | - Sungin Lee
- Department of Veterinary Surgery, College of Veterinary Medicine, Chungbuk National University, Cheongju, Republic of Korea
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Oh SJ, Lyoo CH, Ryu YH, Choi JY. Assessing the applicability of PMOD residence times model for PET image-based radiation dosimetry. Sci Rep 2023; 13:19387. [PMID: 37938605 PMCID: PMC10632489 DOI: 10.1038/s41598-023-46822-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2023] [Accepted: 11/06/2023] [Indexed: 11/09/2023] Open
Abstract
The effective dose represents the overall internal radiation exposure to the whole body when exposed to radiation sources. This study aims to compare conventional and software-aided methods to derive the effective dose. In the present study, 8F-T807 and 18F-Mefway, specific radiotracers for the paired helical tau and serotonin 1A receptor, were administered to healthy subjects (n = 6, each radiotracer), following which whole-body positron emission tomography (PET) images were obtained for 2 h. Subsequently, time-activity curves for major organs were obtained, and the residence times were calculated using the "conventional" and "Residence Times model" tools in PMOD software. The residence times from each method was input into OLINDA/EXM software, and the effective dose was estimated. The differences in the average residence times of the brain, heart, lung, and liver were 18.4, 20.8, 10.4, and 13.3% for 18F-T807, and 17.5, 16.4, 18.1, and 17.5% for 18F-Mefway, respectively. For the mean effective dose, the error rates between the methods were 3.8 and 1.9% for 18F-T807 and 18F-Mefway, respectively. The organs that showed the greatest difference in the absorbed dose were the urinary bladder for 18F-T807 (40.4%) and the liver for 18F-Mefway (14.1%). This method of obtaining the residence time using PMOD can be easily used to derive the effective dose, and is applicable in evaluating the safety of radiotracers for clinical trials.
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Affiliation(s)
- Se Jong Oh
- Division of Applied RI, Korea Institute of Radiological and Medical Sciences, 75 Nowon-ro, Nowon-gu, Seoul, Korea
| | - Chul Hyoung Lyoo
- Department of Neurology, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Young Hoon Ryu
- Department of Nuclear Medicine, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea.
| | - Jae Yong Choi
- Division of Applied RI, Korea Institute of Radiological and Medical Sciences, 75 Nowon-ro, Nowon-gu, Seoul, Korea.
- Radiological and Medico-Oncological Sciences, University of Science and Technology (UST), Seoul, Korea.
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3
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Hu R, Zhang Y, Liu S, Lee P, Liu C, Liu A. Prognostic prediction by 18F-FDG-PET/CT parameters in patients with neuroblastoma: a systematic review and meta-analysis. Front Oncol 2023; 13:1208531. [PMID: 37519817 PMCID: PMC10375790 DOI: 10.3389/fonc.2023.1208531] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2023] [Accepted: 06/28/2023] [Indexed: 08/01/2023] Open
Abstract
Purpose Neuroblastoma is a solid malignant tumor with high malignancy and high risk for metastasis. The prognosis of neuroblastoma ranges from spontaneous regression to insensitivity to therapies and widespread metastasis. There is a non-invasive, panoramic imaging technique called 18F-fluorodeoxyglucose (18F-FDG) positron emission tomography-computed tomography (PET/CT), which can provide both complete anatomical information via CT and extent of FDG uptake value in tumors via positron emission detection. PET/CT is a powerful approach to estimating tumoral metabolic activities, and PET/CT parameters have been demonstrated to be associated with the prognosis of various tumors. However, the predictive performance of PET/CT for the prognosis of neuroblastoma remains unclear. This meta-analysis aims to assess the predictive values of maximum standardized uptake value (SUVmax), metabolic tumor volume (MTV), and total lesion glycolysis (TLG) for progression-free survival (PFS), event-free survival (EFS), and overall survival (OS) in neuroblastoma patients. Methods Literature in PubMed, Embase, Cochrane Library, and Web of Science from January 1985 to June 2023 was searched for studies evaluating predictive values of PET/CT parameters for the prognosis of neuroblastoma. Search items mainly included "Positron Emission Tomography Computed Tomography" and "Neuroblastoma". Hazard ratio (HR) was used as a pooled statistic to assess the association of SUVmax, MTV, and TLG with PFS, EFS, and OS in neuroblastoma patients. Heterogeneity test and sensitivity analysis were performed. Results There were eight studies included, with 325 participants. Meta-analysis showed that higher SUVmax was associated with shorter OS [HR = 1.27, 95% CI (1.11, 1.45), p = 0.001], while no association with PFS [HR = 1.03, 95% CI (0.99, 1.07), p = 0.222] and EFS [HR = 2.58, 95% CI (0.37, 18.24), p = 0.341] was presented. MTV showed no association with OS [HR = 2.46, 95% CI (0.34, 18.06), p = 0.376] and PFS [HR = 2.60, 95% CI (0.68, 9.88), p = 0.161]. There was a statistically significant association between TLG and OS [HR = 1.00, 95% CI (1.00, 1.00), p = 0.00], while the HR was 1, so the association could not be concluded, and TLG showed no association with PFS [HR = 1.00, 95% CI (0.99, 1.00), p = 0.974]. Conclusion High SUVmax indicates poor OS in patients with neuroblastoma. The MTV and TLG are potential prognostic predictors that need to be further validated by more well-designed studies. Systematic review registration https://www.crd.york.ac.uk/PROSPERO/, identifier 340729.
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Affiliation(s)
- Ruimin Hu
- Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Yan Zhang
- Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Siying Liu
- Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Pamela Lee
- Department of Paediatrics and Adolescent Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, Hong Kong SAR, China
| | - Chaohong Liu
- Department of Pathogen Biology, School of Basic Medicine, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Aiguo Liu
- Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
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Li Y, Chen L, Si L, Yang Y, Zhou C, Yu F, Xia G, Wang H. Triphenylamine-equipped 1,8-naphthaolactam: a versatile scaffold for the custom design of efficient subcellular imaging agents. J Mater Chem B 2023; 11:2431-2439. [PMID: 36810648 DOI: 10.1039/d2tb02528k] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/24/2023]
Abstract
Fluorescence imaging has enabled much progress in biological fields, while the evolution of commercially available dyes has lagged behind their advanced applications. Herein, we launch triphenylamine-equipped 1,8-naphthaolactam (NP-TPA) as a versatile scaffold for the custom design of an efficient subcellular imaging agent (NP-TPA-Tar), given its bright and constant emissions in various states, significant Stokes shifts, and facile modifiability. The resultant four NP-TPA-Tars maintain excellent emission behavior with targeted modifications and can map the spatial distribution of lysosomes, mitochondria, endoplasmic reticulum, and plasma membrane in Hep G2 cells. Compared to its commercial counterpart, NP-TPA-Tar has a 2.8-25.2 fold increase in Stokes shift, a 1.2-1.9 fold increase in photostability, enhanced targeting capability, and comparable imaging efficiency even at low concentrations of 50 nM. This work will help to accelerate the update of current imaging agents and super-resolution and real-time imaging in biological applications.
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Affiliation(s)
- Yingzhong Li
- Institute for Advanced Study and College of Chemistry, Nanchang University, 999 Xuefu Road, Nanchang, 330031, P. R. China.
| | - Lizhen Chen
- Institute for Advanced Study and College of Chemistry, Nanchang University, 999 Xuefu Road, Nanchang, 330031, P. R. China.
| | - Leilei Si
- Institute for Advanced Study and College of Chemistry, Nanchang University, 999 Xuefu Road, Nanchang, 330031, P. R. China.
| | - Yang Yang
- Institute for Advanced Study and College of Chemistry, Nanchang University, 999 Xuefu Road, Nanchang, 330031, P. R. China.
| | - Chunlei Zhou
- Institute for Advanced Study and College of Chemistry, Nanchang University, 999 Xuefu Road, Nanchang, 330031, P. R. China.
| | - Fuqing Yu
- Institute for Advanced Study and College of Chemistry, Nanchang University, 999 Xuefu Road, Nanchang, 330031, P. R. China.
| | - Guomin Xia
- Institute for Advanced Study and College of Chemistry, Nanchang University, 999 Xuefu Road, Nanchang, 330031, P. R. China.
| | - Hongming Wang
- Institute for Advanced Study and College of Chemistry, Nanchang University, 999 Xuefu Road, Nanchang, 330031, P. R. China.
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Meng B, Sadeghipour N, Folaron MR, Strawbridge RR, Samkoe KS, Tichauer KM, Davis SC. Examining the Feasibility of Quantifying Receptor Availability Using Cross-Modality Paired-Agent Imaging. Mol Imaging Biol 2021; 24:23-30. [PMID: 34286423 PMCID: PMC8760219 DOI: 10.1007/s11307-021-01629-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2021] [Revised: 06/16/2021] [Accepted: 06/21/2021] [Indexed: 12/02/2022]
Abstract
Purpose The ability to noninvasively quantify receptor availability (RA) in solid tumors is an aspirational goal of molecular imaging, often challenged by the influence of non-specific accumulation of the contrast agent. Paired-agent imaging (PAI) techniques aim to compensate for this effect by imaging the kinetics of a targeted agent and an untargeted isotype, often simultaneously, and comparing the kinetics of the two agents to estimate RA. This is usually accomplished using two spectrally distinct fluorescent agents, limiting the technique to superficial tissues and/or preclinical applications. Applying the approach in humans using conventional imaging modalities is generally infeasible since most modalities are unable to routinely image multiple agents simultaneously. We examine the ability of PAI to be implemented in a cross-modality paradigm, in which the targeted and untargeted agent kinetics are imaged with different modalities and used to recover receptor availability. Procedures Eighteen mice bearing orthotopic brain tumors were administered a solution containing three contrast agents: (1) a fluorescent agent targeted to epidermal growth factor receptor (EGFR), (2) an untargeted fluorescent isotype, and (3) a gadolinium-based contrast agent (GBCA) for MRI imaging. The kinetics of all three agents were imaged for 1 h after administration using an MRI-coupled fluorescence tomography system. Paired-agent receptor availability was computed using (1) the conventional all-optical approach using the targeted and untargeted optical agent images and (2) the cross-modality approach using the targeted optical and untargeted MRI-GBCA images. Receptor availability estimates between the two methods were compared. Results Receptor availability values using the cross-modality approach were highly correlated to the conventional, single-modality approach (r = 0.94; p < 0.00001). Conclusion These results suggest that cross-modality paired-agent imaging for quantifying receptor availability is feasible. Ultimately, cross-modality paired-agent imaging could facilitate rapid, noninvasive receptor availability quantification in humans using hybrid clinical imaging modalities. Supplementary Information The online version contains supplementary material available at 10.1007/s11307-021-01629-6.
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Affiliation(s)
- Boyu Meng
- Thayer School of Engineering, Dartmouth College, 03755, Hanover, NH, USA
| | - Negar Sadeghipour
- Biomedical Engineering, Illinois Institute of Technology, Chicago, IL, 60616, USA
| | - Margaret R Folaron
- Thayer School of Engineering, Dartmouth College, 03755, Hanover, NH, USA
| | | | - Kimberley S Samkoe
- Thayer School of Engineering, Dartmouth College, 03755, Hanover, NH, USA.,Geisel School of Medicine, Dartmouth College, 03755, Hanover, NH, USA
| | - Kenneth M Tichauer
- Biomedical Engineering, Illinois Institute of Technology, Chicago, IL, 60616, USA
| | - Scott C Davis
- Thayer School of Engineering, Dartmouth College, 03755, Hanover, NH, USA.
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Man S, Yan J, Li J, Cao Y, Hu J, Ma W, Liu J, Zhao Q. Value of pretreatment 18F-FDG PET/CT in prognosis and the reflection of tumor burden: a study in pediatric patients with newly diagnosed neuroblastoma. Int J Med Sci 2021; 18:1857-1865. [PMID: 33746603 PMCID: PMC7976578 DOI: 10.7150/ijms.58263] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/15/2021] [Accepted: 02/11/2021] [Indexed: 11/30/2022] Open
Abstract
Fluorine-18 fluorodeoxyglucose (18F-FDG) PET/CT has been commonly used in pediatric patients with newly diagnosed neuroblastoma (NB) for diagnosis. We retrospectively reviewed 40 pediatric patients with newly diagnosed NB who underwent 18F-FDG PET/CT. Clinicopathological factors and metabolic parameters including maximum standardized uptake value (SUVmax), metabolic tumor volume (MTV), and total lesion glycolysis (TLG) on PET/CT were evaluated as predictive factors for progression-free survival (PFS) and overall survival (OS) by univariate and multivariate analysis. Spearman rank correlation analyses were used to estimate the correlations between clinical factors and PET findings. The mean follow-up after 18F-FDG-PET/CT was 32.9 months. During the follow-up period 15 (37.5%) patients experienced progression, and 9 (22.5%) died. MTV (P=0.001) and TLG (p=0.004) remained significant predictive factors for tumor progression, along with lactate dehydrogenase (LDH), neuron-specific enolase (NSE) and bone metastasis. Univariate analysis showed that bone metastasis, LDH (>1064 IU/L), NSE (>364.4 ug/L), MTV (>191 cm3) and TLG (>341.41 g) correlated with PFS, and LDH (>1064 IU/L), NSE (>364.4 ug/L) and MTV (>191 cm3) correlated with OS (p<0.05). In multivariate analysis, MTV and bone metastasis were independent prognostic factors for PFS (p=0.001 and 0.023, respectively), and MTV remained the only independent prognostic factor for OS (p= 0.004). We also found that there were correlations between semiquantitative PET/CT parameters and clinical features in NB. Our results suggested that 18F-FDG PET/CT was a useful tool to predictive progression and to reflect tumor burden for patients with NB.
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Affiliation(s)
- Shuai Man
- Department of Pediatric Oncology, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy of Tianjin, Tianjin's Clinical Research Center for Cancer, Tianjin, China
| | - Jie Yan
- Department of Pediatric Oncology, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy of Tianjin, Tianjin's Clinical Research Center for Cancer, Tianjin, China
| | - Jie Li
- Department of Pediatric Oncology, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy of Tianjin, Tianjin's Clinical Research Center for Cancer, Tianjin, China
| | - Yanna Cao
- Department of Pediatric Oncology, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy of Tianjin, Tianjin's Clinical Research Center for Cancer, Tianjin, China
| | - Jiajian Hu
- Department of Pediatric Oncology, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy of Tianjin, Tianjin's Clinical Research Center for Cancer, Tianjin, China
| | - Wenchao Ma
- Department of Molecular Imaging and Nuclear Medicine, National Clinical Research Center for Cancer, Tianjin Medical University Cancer Institute and Hospital, Tianjin, Tianjin's Clinical Research Center for Cancer, Tianjin, China
| | - Jianjing Liu
- Department of Molecular Imaging and Nuclear Medicine, National Clinical Research Center for Cancer, Tianjin Medical University Cancer Institute and Hospital, Tianjin, Tianjin's Clinical Research Center for Cancer, Tianjin, China
| | - Qiang Zhao
- Department of Pediatric Oncology, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy of Tianjin, Tianjin's Clinical Research Center for Cancer, Tianjin, China
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Identifying Musculoskeletal Pain Generators Using Molecular Imaging. Mol Imaging 2021. [DOI: 10.1016/b978-0-12-816386-3.00076-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
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Yoon D, Kogan F, Gold GE, Biswal S. Identifying Musculoskeletal Pain Generators Using Clinical PET. Semin Musculoskelet Radiol 2020; 24:441-450. [DOI: 10.1055/s-0040-1713607] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
AbstractIdentifying the source of a person's pain is a significant clinical challenge because the physical sensation of pain is believed to be subjective and difficult to quantify. The experience of pain is not only modulated by the individual's threshold to painful stimuli but also a product of the person's affective contributions, such as fear, anxiety, and previous experiences. Perhaps then to quantify pain is to examine the degree of nociception and pro-nociceptive inflammation, that is, the extent of cellular, chemical, and molecular changes that occur in pain-generating processes. Measuring changes in the local density of receptors, ion channels, mediators, and inflammatory/immune cells that are involved in the painful phenotype using targeted, highly sensitive, and specific positron emission tomography (PET) radiotracers is therefore a promising approach toward objectively identifying peripheral pain generators. Although several preclinical radiotracer candidates are being developed, a growing number of ongoing clinical PET imaging approaches can measure the degree of target concentration and thus serve as a readout for sites of pain generation. Further, when PET is combined with the spatial and contrast resolution afforded by magnetic resonance imaging, nuclear medicine physicians and radiologists can potentially identify pain drivers with greater accuracy and confidence. Clinical PET imaging approaches with fluorine-18 fluorodeoxyglucose, fluorine-18 sodium fluoride, and sigma-1 receptor PET radioligand and translocator protein radioligands to isolate the source of pain are described here.
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Affiliation(s)
- Daehyun Yoon
- Division of Musculoskeletal Radiology, Department of Radiology, Stanford University School of Medicine, Stanford, California
| | - Feliks Kogan
- Division of Musculoskeletal Radiology, Department of Radiology, Stanford University School of Medicine, Stanford, California
| | - Garry E. Gold
- Division of Musculoskeletal Radiology, Department of Radiology, Stanford University School of Medicine, Stanford, California
| | - Sandip Biswal
- Division of Musculoskeletal Radiology, Department of Radiology, Stanford University School of Medicine, Stanford, California
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Eshghi N, Garland LL, Nia E, Betancourt R, Krupinski E, Kuo PH. 18F-FDG PET/CT Can Predict Development of Thyroiditis Due to Immunotherapy for Lung Cancer. J Nucl Med Technol 2018; 46:260-264. [PMID: 29599403 DOI: 10.2967/jnmt.117.204933] [Citation(s) in RCA: 38] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2017] [Accepted: 01/04/2018] [Indexed: 12/11/2022] Open
Abstract
Our primary purpose was to determine whether increased 18F-FDG uptake in the thyroid gland predicts development of thyroiditis with subsequent hypothyroidism in patients undergoing immunotherapy with nivolumab for lung cancer. Secondarily, we determined whether 18F-FDG uptake in the thyroid gland correlates with number of administered cycles of nivolumab. Methods: Retrospective chart review over 2 y found 18 lung cancer patients treated with nivolumab who underwent 18F-FDG PET/CT before and during therapy. SUVmean, SUVmax, and total lesion glycolysis of the thyroid gland were measured. SUVs were also measured for the pituitary gland, liver, and spleen. Patients underwent monthly thyroid testing. PET/CT parameters were analyzed by unpaired t testing for differences between 2 groups (patients who developed hypothyroidism and those who did not). Correlation between development of thyroiditis and number of cycles of nivolumab was also tested. Results: Six of 18 patients developed hypothyroidism. The t test comparing the 2 groups demonstrated significant differences in SUVmean (P = 0.04), SUVmax (P = 0.04), and total lesion glycolysis (P = 0.02) of the thyroid gland. Two of 4 patients who developed thyroiditis and had increased 18F-FDG uptake in the thyroid gland had a normal TSH level at the time of follow-up 18F-FDG PET/CT. Patients who developed thyroiditis with subsequent hypothyroidism stayed longer on therapy (10.6 cycles) than patients without thyroiditis (7.6 cycles), but the trend was not statistically significant. No significant difference in PET/CT parameters was observed for pituitary gland, liver, or spleen. Conclusion:18F-FDG PET/CT can predict the development of thyroiditis with subsequent hypothyroidism before laboratory testing. Further study is required to confirm the positive trend between thyroiditis and duration of therapy.
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Affiliation(s)
| | - Linda L Garland
- Department of Medicine, Section of Hematology and Medical Oncology, Banner University Medical Center, Tucson, Arizona
| | - Emily Nia
- Breast Imaging Section, Department of Radiology, University of Texas M.D. Anderson Cancer Center, Housten, Texas
| | - Robert Betancourt
- Department of Medicine, Banner University Medical Center, Tucson, Arizona
| | - Elizabeth Krupinski
- Department of Radiology and Imaging Sciences, Emory University School of Medicine, Atlanta, Georgia; and
| | - Phillip H Kuo
- Departments of Medical Imaging and Medicine, Banner University Medical Center, and Department of Biomedical Engineering, University of Arizona, Tucson, Arizona
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Zrnc TA, Wallner J, Zemann W, Pau M, Gstettner C, Brcic L, Assaf AT, Hassanzadeh H, Feichtinger M, Schwenzer-Zimmerer K. Assessment of tumor margins in head and neck cancer using a 3D-navigation system based on PET/CT image-fusion - A pilot study. J Craniomaxillofac Surg 2018. [PMID: 29526413 DOI: 10.1016/j.jcms.2018.01.011] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
OBJECTIVES Determination of tumor margins in patients with squamous cell carcinoma of the head and neck (SCCHN) is mostly based on preoperative magnetic resonance imaging (MRI) or computed tomography scans (CT). Local recurrence of disease is often correlated with the presence of positive resection margins after surgical treatment. Positron emission tomography/computed tomography (PET/CT) imaging plays a crucial role in the assessment of patients with SCCHN. The purpose of this study was to determine whether PET/CT could predict tumor extension. METHODS In 12 patients who underwent surgical treatment of primary SCCHN (Stage III-IV) F18-FDG PET/CT image-fusion was performed on a 3D navigation-system based workstation. Image-guided needle biopsies were obtained from four different, color-coded metabolic areas within the tumor. The histopathological findings were correlated with findings on corresponding PET/CT scans. RESULTS 81.3% of biopsies from the central area were positive. Specimens taken from the outer metabolic zone were positive in 66.7% of the patients. The highest incidence of positive biopsies was found in the zone adjacent to the outermost area. There was a statistically significant difference in positive tumor histopathology when comparing the various metabolic zones (p = 0.03). CONCLUSION Exact determination of tumor is an important research topic, although results remain controversial. The results of this study suggest that in some cases PET scans may overestimate tumor extension.
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Affiliation(s)
- Tomislav A Zrnc
- Department of Oral and Maxillofacial Surgery, Medical University of Graz, Auenbruggerplatz 5, A-8036, Graz, Austria.
| | - Jürgen Wallner
- Department of Oral and Maxillofacial Surgery, Medical University of Graz, Auenbruggerplatz 5, A-8036, Graz, Austria
| | - Wolfgang Zemann
- Department of Oral and Maxillofacial Surgery, Medical University of Graz, Auenbruggerplatz 5, A-8036, Graz, Austria
| | - Mauro Pau
- Department of Oral and Maxillofacial Surgery, Medical University of Graz, Auenbruggerplatz 5, A-8036, Graz, Austria
| | - Christian Gstettner
- Department of Radiology and Division of Nuclear Medicine, Medical University of Graz, Auenbruggerplatz 9, A-8036, Graz, Austria
| | - Luka Brcic
- Institute of Pathology, Medical University of Graz, Auenbruggerplatz 25, A-8036, Graz, Austria
| | - Alexandre T Assaf
- Department of Oral and Maxillofacial Surgery, University Medical Center Hamburg Eppendorf, Martinistrasse 52, D-20246, Hamburg, Germany
| | - Hamid Hassanzadeh
- Department of Orthopaedic Surgery, University of Virginia Health System, Charlottesville, VA, USA
| | - Matthias Feichtinger
- Department of Oral and Maxillofacial Surgery, Medical University of Graz, Auenbruggerplatz 5, A-8036, Graz, Austria
| | - Katja Schwenzer-Zimmerer
- Department of Oral and Maxillofacial Surgery, Medical University of Graz, Auenbruggerplatz 5, A-8036, Graz, Austria
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Detection of nociceptive-related metabolic activity in the spinal cord of low back pain patients using 18F-FDG PET/CT. Scand J Pain 2017; 15:53-57. [DOI: 10.1016/j.sjpain.2016.11.017] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2016] [Revised: 11/17/2016] [Accepted: 11/26/2016] [Indexed: 11/18/2022]
Abstract
Abstract
Background
Over the past couple of decades, a number of centers in the brain have been identified as important sites of nociceptive processing and are collectively known as the ‘pain matrix.’ Imaging tools such as functional magnetic resonance imaging (MRI) and 18F-fluorodeoxyglucose (18F-FDG) positron emission tomography (PET) have played roles in defining these pain-relevant, physiologically active brain regions. Similarly, certain segments of the spinal cord are likely more metabolically active in the setting of pain conditions, the location of which is dependent upon location of symptoms. However, little is known about the physiologic changes in the spinal cord in the context of pain. This study aimed to determine whether uptake of 18F-FDG in the spinal cord on positron emission tomography/computed tomography (PET/CT) of patients with low back pain (LBP) differs from that of patients without LBP.
Methods
We conducted a retrospective review of 18F-FDG PET/CT scans of 26 patients with non-central nervous system cancers, 13 of whom had reported LBP and 13 of whom were free of LBP (controls). No patients had spinal stenosis or significant 18F-FDG contribution of degenerative changes of the spine into the spinal canal. Circular regions of interests were drawn within the spinal canal on transaxial images, excluding bony or discal elements of the spine, and the maximum standardized uptake value (SUVmax) of every slice from spinal nerves C1 to S1 was obtained. SUVmax were normalized by subtracting the SUVmax of spinal nerve L5, as minimal neural tissue is present at this level. Normalized SUVmax of LBP patients were compared to those of LBP-free patients at each vertebral level.
Results
We found the normalized SUVmax of patients with LBP to be significantly greater than those of control patients when jointly tested at spinal nerves of T7, T8, T9 and T10 (p < 0.001). No significant difference was found between the two groups at other levels of the spinal cord. Within the two groups, normalized SUVmax generally decreased cephalocaudally.
Conclusions
Patients with LBP show increased uptake of 18F-FDG in the caudal aspect of the thoracic spinal cord, compared to patients without LBP.
Implications
This paper demonstrates the potential of 18F-FDG PET/CT as a biomarker of increased metabolic activity in the spinal cord related to LBP. As such, it could potentially aid in the treatment of LBP by localizing physiologically active spinal cord regions and guiding minimally invasive delivery of analgesics or stimulators to relevant levels of the spinal cord.
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Lee HJ, Park JY, Lee JJ, Kim MH, Kim DY, Suh DS, Kim JH, Kim YM, Kim YT, Nam JH. Comparison of MRI and 18F-FDG PET/CT in the preoperative evaluation of uterine carcinosarcoma. Gynecol Oncol 2016; 140:409-14. [PMID: 26777990 DOI: 10.1016/j.ygyno.2016.01.009] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2015] [Revised: 01/06/2016] [Accepted: 01/07/2016] [Indexed: 11/28/2022]
Abstract
OBJECTIVE To compare the validities of magnetic resonance imaging (MRI) and (18)F-fluoro-deoxyglucose positron emission tomography/computed tomography ((18)F-FDG PET/CT) in preoperative evaluation of uterine carcinosarcoma. METHODS Pathologic results of primary tumor lesions and paraaortic and pelvic lymph node (LN) areas were compared with the preoperative image findings. Differences in the validity parameters of both images were compared using McNemar test. RESULTS For detecting primary tumor lesions (n=56), the sensitivity, specificity, accuracy, positive predictive value, and negative predictive value for (18)F-FDG PET/CT versus MRI were 98.1% versus 98.1% (P=1.000), 33.3% versus 100% (P=0.157), 94.6% versus 98.2% (P=0.500), 96.3% versus 100%, and 50% versus 75%, respectively. For paraaortic LN areas, the values were 77.8% versus 51.9% (P=0.016), 90.2% versus 100% (P=0.025), 85.9% versus 83.3% (P=0.774), 80.8% versus 100%, and 88.5% versus 79.7%, respectively. For pelvic LN areas, the values were 61.1% versus 50% (P=0.125), 86.8% versus 89.5% (P=0.727), 78.6% versus 76.8% (P=0.774), 68.8% versus 69.2%, and 82.5% versus 79.1%, respectively. For extrauterine disease, the patient-based values for (18)F-FDG PET/CT were 100%, 78.9%, 85.7%, 69.2%, and 100%, respectively. CONCLUSION In patients with uterine carcinosarcoma, (18)F-FDG PET/CT is comparable to MRI in detecting primary uterine lesions. For predicting LN metastases, though (18)F-FDG PET/CT might be insufficient for replacing lymphadenectomy or MRI, it might allow lymphadenectomy to be omitted in poor surgical candidates. For detecting extrauterine metastases, it could also be useful to identify unsuspected disease.
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Affiliation(s)
- Hyun Ju Lee
- Department of Obstetrics and Gynecology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Republic of Korea
| | - Jeong-Yeol Park
- Department of Obstetrics and Gynecology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Republic of Korea
| | - Jong Jin Lee
- Department of Nuclear Medicine, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Republic of Korea
| | - Mi Hyun Kim
- Department of Radiology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Republic of Korea
| | - Dae-Yeon Kim
- Department of Obstetrics and Gynecology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Republic of Korea
| | - Dae-Shik Suh
- Department of Obstetrics and Gynecology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Republic of Korea
| | - Jong-Hyeok Kim
- Department of Obstetrics and Gynecology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Republic of Korea
| | - Yong-Man Kim
- Department of Obstetrics and Gynecology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Republic of Korea
| | - Young-Tak Kim
- Department of Obstetrics and Gynecology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Republic of Korea
| | - Joo-Hyun Nam
- Department of Obstetrics and Gynecology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Republic of Korea
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18F-FDG PET/CT lung 'focalities' without coregistered CT findings: an interpretative clinical dilemma. Nucl Med Commun 2015; 36:334-9. [PMID: 25658717 DOI: 10.1097/mnm.0000000000000261] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
AIM The aim of the study was to assess the prevalence of focal fluorine-18 fluorodeoxyglucose (18F-FDG) activity in the lungs using 18F-FDG PET/computed tomography (CT) without matching CT findings. MATERIALS AND METHODS A total of 10,500 consecutive 18F-FDG PET/CT records over 4 years were reviewed for focal incongruence between PET and CT, potentially indicating an artifact 18F-FDG (2.2 MBq/kg) was injected through a butterfly needle, followed by a 10 ml saline flush. Non-contrast-enhanced low-dose CT (140 kV and 40-80 mA) was coregistrated with PET. RESULTS Sixteen patients (12 men and four women; mean age 63 years, range 44-83) had focal pulmonary areas of high 18F-FDG activity [mean maximum standardized uptake value (SUV max) 15.8; range 3.5-81.0], typically peripheral, with a mean maximum diameter of 1.3 cm (range 0.5-2.2 cm) on PET. 18F-FDG focality was singular in 14 patients, whereas two patients had two foci each. None had corresponding CT abnormalities. Identification of these 'focalities' during the acquisition phase led to late respiratory gated thoracic PET acquisitions in eight patients at 2 h with no significant changes in the location or size of the 'focalities'. Five PET/CTs repeated at 48 h did not confirm the 'focalities'. Five had negative follow-up contrast-enhanced CT. 18F-FDG-positive 'focalities' at PET/CT without anatomical correlation findings were considered as 'artefactual accumulation' of the tracer. CONCLUSION In the absence of morphological abnormality, focal pulmonary 18F-FDG activity is very rare (1.5 cases/1000 PET scans) but potentially very 'dangerous'. Artefact identification during acquisition can lead to late respiratory gated images for more confident interpretation, avoiding erroneous reports or further imaging procedures.
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Li YQ, Liao XX, Lu JH, Liu R, Hu CL, Dai G, Zhang XS, Shi XC, Li X. Assessing the early changes of cerebral glucose metabolism via dynamic (18)FDG-PET/CT during cardiac arrest. Metab Brain Dis 2015; 30:969-77. [PMID: 25703241 DOI: 10.1007/s11011-015-9658-0] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/22/2014] [Accepted: 02/10/2015] [Indexed: 12/31/2022]
Abstract
To study the changes of cerebral glucose metabolism (CGM) during the phase of return of spontaneous circulation (ROSC) after cardiac arrest (CA), we used 18-fluorodeoxyglucose-positron emission tomography/computed tomography ((18)FDG-PET/CT) to measure the CGM changes in six beagle canine models. After the baseline (18)FDG-PET/CT was recorded, ventricular fibrillation (VF) was induced for 6 min, followed by close-chest cardiopulmonary resuscitation (CPR) in conjunction with intravenous (IV) administration of epinephrine and external defibrillator shocks until ROSC was achieved, within 30 min. The (18)FDG was recorded prior to intravenous administration at 0 h (baseline), and at 4, 24, and 48 h after CA with ROSC. We evaluated the expression of two key control factors in canine CGM, hexokinase I (HXK I) and HXK II, by immunohistochemistry at the four above mentioned time points. Electrically induced VF of 6 min duration was successfully induced in the dogs. Resuscitation was then performed to maintain blood pressure stability. Serial (18)FDG-PET/CT scans found that the CGM decreased at 4 h after ROSC and remained lower than the baseline even at 48 h. The expression of HXK I and II levels were consistent with the changes in CGM. These data from our present work showed that (18)FDG-PET/CT imaging can be used to detect decreased CGM during CA and was consistent with the results of CMRgl. Furthermore, there were also concomitant changes in the expression of HXK I and HXK II. The decrease in CGM may be an early sign of hyperacute global cerebral ischemia.
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Affiliation(s)
- Ying-Qing Li
- Emergency Department of Guangzhou First People's Hospital, Guangzhou Medical University, Panfu Road 1, Guangzhou, People's Republic of China
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Validation of the CT iterative reconstruction technique for low-dose CT attenuation correction for improving the quality of PET images in an obesity-simulating body phantom and clinical study. Nucl Med Commun 2015; 36:839-47. [DOI: 10.1097/mnm.0000000000000326] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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17
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Yang J, Wang H, Zhang Y, Yin Y. Evaluation of GMI and PMI diffeomorphic-based demons algorithms for aligning PET and CT Images. J Appl Clin Med Phys 2015. [PMID: 26218993 PMCID: PMC5690013 DOI: 10.1120/jacmp.v16i4.5148] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Fusion of anatomic information in computed tomography (CT) and functional information in F18‐FDG positron emission tomography (PET) is crucial for accurate differentiation of tumor from benign masses, designing radiotherapy treatment plan and staging of cancer. Although current PET and CT images can be acquired from combined F18‐FDG PET/CT scanner, the two acquisitions are scanned separately and take a long time, which may induce potential positional errors in global and local caused by respiratory motion or organ peristalsis. So registration (alignment) of whole‐body PET and CT images is a prerequisite for their meaningful fusion. The purpose of this study was to assess the performance of two multimodal registration algorithms for aligning PET and CT images. The proposed gradient of mutual information (GMI)‐based demons algorithm, which incorporated the GMI between two images as an external force to facilitate the alignment, was compared with the point‐wise mutual information (PMI) diffeomorphic‐based demons algorithm whose external force was modified by replacing the image intensity difference in diffeomorphic demons algorithm with the PMI to make it appropriate for multimodal image registration. Eight patients with esophageal cancer(s) were enrolled in this IRB‐approved study. Whole‐body PET and CT images were acquired from a combined F18‐FDG PET/CT scanner for each patient. The modified Hausdorff distance (dMH) was used to evaluate the registration accuracy of the two algorithms. Of all patients, the mean values and standard deviations (SDs) of dMH were 6.65 (± 1.90) voxels and 6.01 (± 1.90) after the GMI‐based demons and the PMI diffeomorphic‐based demons registration algorithms respectively. Preliminary results on oncological patients showed that the respiratory motion and organ peristalsis in PET/CT esophageal images could not be neglected, although a combined F18‐FDG PET/CT scanner was used for image acquisition. The PMI diffeomorphic‐based demons algorithm was more accurate than the GMI‐based demons algorithm in registering PET/CT esophageal images. PACS numbers: 87.57.nj, 87.57. Q‐, 87.57.uk
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Gallamini A, Hutchings M, Borra A. Functional Imaging in Hodgkin Lymphoma. HODGKIN LYMPHOMA 2015. [DOI: 10.1007/978-3-319-12505-3_7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
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Muzic RF, DiFilippo FP. Positron emission tomography-magnetic resonance imaging: technical review. Semin Roentgenol 2014; 49:242-54. [PMID: 25497909 DOI: 10.1053/j.ro.2014.10.001] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Affiliation(s)
- Raymond F Muzic
- Department of Radiology, University Hospitals Case Medical Center & Case Center for Imaging Research, Case Western Reserve University, Cleveland, OH.
| | - Frank P DiFilippo
- Department of Nuclear Medicine, Cleveland Clinic, Cleveland, OH; Cleveland Clinic Lerner College of Medicine, Case Western Reserve University, Cleveland, OH
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Kundu-Raychaudhuri S, Mitra A, Datta-Mitra A, Chaudhari AJ, Raychaudhuri SP. In vivo quantification of mouse autoimmune arthritis by PET/CT. Int J Rheum Dis 2014; 19:452-8. [PMID: 24965561 DOI: 10.1111/1756-185x.12410] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
AIM To quantify the progression and severity of mouse collagen-induced arthritis (CIA) using an in vivo imaging tool, (18) F-fluorodeoxyglucose ((18) F-FDG) PET/CT and validate it against gold standard 'histopathological' evaluation. METHOD The PET radiotracer (18) F-FDG, a marker for glucose metabolism, was injected in mice at different stages of CIA and the radiotracer distribution was imaged using a PET scanner. A sequential CT scan provided correlated anatomy. Radiotracer concentration was derived from PET/CT images for individual limb joints and on a per-limb basis at different stages of the disease. The imaging outcomes were subjected to correlation analysis with concurrently measured clinical and histological score. RESULTS Clinical and histological score, and hence disease severity, showed a strong linear correlation (r(2) = 0.71, P = 0.001 and r(2) = 0.87, P < 0.001, respectively) with radiotracer concentration measured from PET/CT during the progression of CIA. CONCLUSIONS The strong positive correlation of the (18) F-FDG PET/CT findings with the histopathological evaluation at different stages of the disease suggest the potential of this imaging tool for the non-invasive assessment of progression and severity in mouse autoimmune arthritis. Thus, in preclinical studies, (18) F-FDG PET/CT can be considered as a non-invasive tool to develop novel therapies of inflammatory arthritis.
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Affiliation(s)
- Smriti Kundu-Raychaudhuri
- Division of Rheumatology, Allergy and Clinical Immunology, School of Medicine, University of California Davis, Davis, California, USA.,VA Northern California Health Care System, Sacramento, California, USA
| | - Anupam Mitra
- VA Northern California Health Care System, Sacramento, California, USA.,Division of Dermatology, School of Medicine, University of California Davis, Sacramento, California, USA
| | - Ananya Datta-Mitra
- Division of Rheumatology, Allergy and Clinical Immunology, School of Medicine, University of California Davis, Davis, California, USA.,VA Northern California Health Care System, Sacramento, California, USA
| | - Abhijit J Chaudhari
- Department of Radiology, School of Medicine, University of California Davis, Sacramento, California, USA
| | - Siba P Raychaudhuri
- Division of Rheumatology, Allergy and Clinical Immunology, School of Medicine, University of California Davis, Davis, California, USA.,VA Northern California Health Care System, Sacramento, California, USA
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Respiratory-induced errors in tumor quantification and delineation in CT attenuation-corrected PET images: effects of tumor size, tumor location, and respiratory trace: a simulation study using the 4D XCAT phantom. Mol Imaging Biol 2014; 15:655-65. [PMID: 23780352 DOI: 10.1007/s11307-013-0656-5] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
PURPOSE We investigated the magnitude of respiratory-induced errors in tumor maximum standardized uptake value (SUVmax), localization, and volume for different respiratory motion traces and various lesion sizes in different locations of the thorax and abdomen in positron emission tomography (PET) images. PROCEDURES Respiratory motion traces were simulated based on the common patient breathing cycle and three diaphragm motions used to drive the 4D XCAT phantom. Lesions with different diameters were simulated in different locations of lungs and liver. The generated PET sinograms were subsequently corrected using computed tomography attenuation correction involving the end exhalation, end inhalation, and average of the respiratory cycle. By considering respiration-averaged computed tomography as a true value, the lesion volume, displacement, and SUVmax were measured and analyzed for different respiratory motions. RESULTS Respiration with 35-mm diaphragm motion results in a mean lesion SUVmax error of 24 %, a mean superior inferior displacement of 7.6 mm and a mean lesion volume overestimation of 129 % for a 9-mm lesion in the liver. Respiratory motion results in lesion volume overestimation of 50 % for a 9-mm lower lung lesion near the liver with just 15-mm diaphragm motion. Although there are larger errors in lesion SUVmax and volume for 35-mm motion amplitudes, respiration-averaged computed tomography results in smaller errors than the other two phases, except for the lower lung region. CONCLUSIONS The respiratory motion-induced errors in tumor quantification and delineation are highly dependent upon the motion amplitude, tumor location, tumor size, and choice of the attenuation map for PET image attenuation correction.
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Williams LM, Morandi F, Osborne DR, Narak J, LeBlanc AK. Kinetic analysis of 2-([(18)F]fluoro)-2-deoxy-d-glucose uptake in brains of anesthetized healthy dogs. Am J Vet Res 2014; 75:588-94. [PMID: 24866515 DOI: 10.2460/ajvr.75.6.588] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To assess kinetic 2-([(18)F]fluoro)-2-deoxy-d-glucose ((18)FDG) uptake in the brain of anesthetized healthy adult dogs by use of positron emission tomography (PET) and to determine whether (18)FDG uptake differs among anatomic regions of the brain. ANIMALS 5 healthy Beagles. PROCEDURES Each isoflurane-anesthetized dog was administered (18)FDG IV (dose range, 3.0 to 5.2 mCi), and PET data were acquired for 2 hours. A CT scan (without contrast agent administration) was performed to allow more precise neuroanatomic localization. Defined regions of interest within the brain were drawn on reconstructed image data. Standard uptake values (SUVs) for (18)FDG were calculated to generate time-activity curves and determine time to peak uptake. RESULTS Time-activity curve analysis identified 4 regional uptake patterns: olfactory, gray matter, white matter, and other (brainstem, cerebellum, and occipital and frontal regions). The highest maximum SUVs were identified in the olfactory bulbs and cerebral gray matter, and the lowest maximum SUV was identified in cerebral white matter. Mean time to peak uptake ranged from 37.8 minutes in white matter to 82.7 minutes in the olfactory bulbs. CONCLUSIONS AND CLINICAL RELEVANCE Kinetic analysis of (18)FDG uptake revealed differences in uptake values among anatomic areas of the brain in dogs. These data provide a baseline for further investigation of (18)FDG uptake in dogs with immune-mediated inflammatory brain disease and suggest that (18)FDG-PET scanning has potential use for antemortem diagnosis without histologic analysis and for monitoring response to treatment. In clinical cases, a 1-hour period of PET scanning should provide sufficient pertinent data.
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Affiliation(s)
- Lindsay M Williams
- Department of Small Animal Clinical Sciences, College of Veterinary Medicine, University of Tennessee, Knoxville, TN 37996
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Mankoff DA, Pryma DA. The contribution of physics to Nuclear Medicine: physicians' perspective on future directions. EJNMMI Phys 2014; 1:5. [PMID: 26501447 PMCID: PMC4545216 DOI: 10.1186/2197-7364-1-5] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2014] [Accepted: 02/22/2014] [Indexed: 02/07/2023] Open
Abstract
Background Advances in Nuclear Medicine physics enabled the specialty of Nuclear Medicine and directed research in other aspects of radiotracer imaging, ultimately leading to Nuclear Medicine’s emergence as an important component of current medical practice. Discussion Nuclear Medicine’s unique ability to characterize in vivo biology without perturbing it will assure its ongoing role in a practice of medicine increasingly driven by molecular biology. However, in the future, it is likely that advances in molecular biology and radiopharmaceutical chemistry will increasingly direct future developments in Nuclear Medicine physics, rather than relying on physics as the primary driver of advances in Nuclear Medicine. Summary Working hand-in-hand with clinicians, chemists, and biologists, Nuclear Medicine physicists can greatly enhance the specialty by creating more sensitive and robust imaging devices, by enabling more facile and sophisticated image analysis to yield quantitative measures of regional in vivo biology, and by combining the strengths of radiotracer imaging with other imaging modalities in hybrid devices, with the overall goal to enhance Nuclear Medicine’s ability to characterize regional in vivo biology.
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Affiliation(s)
- David A Mankoff
- Division of Nuclear Medicine, Hospital of the University of Pennsylvania, University of Pennsylvania, 116 Donner Building, 3400 Spruce Street, Philadelphia, PA, 19104-4283, USA.
| | - Daniel A Pryma
- Division of Nuclear Medicine, Hospital of the University of Pennsylvania, University of Pennsylvania, 116 Donner Building, 3400 Spruce Street, Philadelphia, PA, 19104-4283, USA.
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Glide-Hurst CK, Chetty IJ. Improving radiotherapy planning, delivery accuracy, and normal tissue sparing using cutting edge technologies. J Thorac Dis 2014; 6:303-18. [PMID: 24688775 PMCID: PMC3968554 DOI: 10.3978/j.issn.2072-1439.2013.11.10] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2013] [Accepted: 11/07/2013] [Indexed: 12/25/2022]
Abstract
In the United States, more than half of all new invasive cancers diagnosed are non-small cell lung cancer, with a significant number of these cases presenting at locally advanced stages, resulting in about one-third of all cancer deaths. While the advent of stereotactic ablative radiation therapy (SABR, also known as stereotactic body radiotherapy, or SBRT) for early-staged patients has improved local tumor control to >90%, survival results for locally advanced stage lung cancer remain grim. Significant challenges exist in lung cancer radiation therapy including tumor motion, accurate dose calculation in low density media, limiting dose to nearby organs at risk, and changing anatomy over the treatment course. However, many recent technological advancements have been introduced that can meet these challenges, including four-dimensional computed tomography (4DCT) and volumetric cone-beam computed tomography (CBCT) to enable more accurate target definition and precise tumor localization during radiation, respectively. In addition, advances in dose calculation algorithms have allowed for more accurate dosimetry in heterogeneous media, and intensity modulated and arc delivery techniques can help spare organs at risk. New delivery approaches, such as tumor tracking and gating, offer additional potential for further reducing target margins. Image-guided adaptive radiation therapy (IGART) introduces the potential for individualized plan adaptation based on imaging feedback, including bulky residual disease, tumor progression, and physiological changes that occur during the treatment course. This review provides an overview of the current state of the art technology for lung cancer volume definition, treatment planning, localization, and treatment plan adaptation.
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Liu Y. Fluorodeoxyglucose uptake in absence of CT abnormality on PET-CT: What is it? World J Radiol 2013; 5:460-467. [PMID: 24379932 PMCID: PMC3874502 DOI: 10.4329/wjr.v5.i12.460] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/16/2013] [Revised: 10/29/2013] [Accepted: 11/19/2013] [Indexed: 02/06/2023] Open
Abstract
The purpose of this article is to provide a pictorial review of the findings and interpretative pitfalls about focal fluorodeoxyglucose (FDG) uptake in the absence of corresponding computer tomography (CT) lesion or abnormality on an integrated positron emission tomography (PET)-CT. The integrated CT images in the PET-CT scanner allow correct co-registration and fused imaging of anatomical and functional data. On FDG PET-CT imaging, a real pathologic process often demonstrates abnormal uptake associated with a visible corresponding CT lesion or abnormality. When focal uptake is seen on PET imaging but no corresponding anatomic abnormality is visualized on the integrated CT, one should always be aware of possible mis-registration or mismatch of the PET and CT images due to the patient’s respiratory or body motion. While most of the hot spots in the absence of corresponding anatomic abnormalities are artefactual or secondary to benign etiologies, some may represent small sized or early staged neoplasm or metastases, especially in the gastrointestinal tract and skeletons. Caution should be exercised to simply diagnose a pathology based on the presence of the uptake only, or exclude the disease based on the absence of anatomic abnormality.
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Dolovich MB, Bailey DL. Positron emission tomography (PET) for assessing aerosol deposition of orally inhaled drug products. J Aerosol Med Pulm Drug Deliv 2013; 25 Suppl 1:S52-71. [PMID: 23215847 DOI: 10.1089/jamp.2012.1su6] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
The topical distribution of inhaled therapies in the lung can be viewed using radionuclides and imaging. Positron emission tomography (PET) is a three-dimensional functional imaging technique providing quantitatively accurate localization of the quantity and distribution of an inhaled or injected PET radiotracer in the lung. A series of transaxial slices through the lungs are obtained, comparable to an X-ray computed tomography (CT) scan. Subsequent reformatting allows coronal and sagittal images of the distribution of radioactivity to be viewed. This article describes procedures for administering [(18)F]-fluorodeoxyglucose aerosol to human subjects for the purpose of determining dose and distribution following inhalation from an aerosol drug delivery device (ADDD). The advantages of using direct-labeled PET drugs in the ADDD are discussed with reference to the literature. The methods for designing the inhalation system, determining proper radiation shielding, calibration, and validation of administered radioactivity, scanner setup, and data handling procedures are described. Obtaining an X-ray CT or radionuclide transmission scan to provide accurate geometry of the lung and also correct for tissue attenuation of the PET radiotracer is discussed. Protocols for producing accurate images, including factors that need to be incorporated into the data calibration, are described, as well as a proposed standard method for partitioning the lung into regions of interest. Alternate methods are described for more detailed assessments. Radiation dosimetry/risk calculations for the procedures are appended, as well as a sample data collection form and spreadsheet for calculations. This article should provide guidance for those interested in using PET to determine quantity and distribution of inhaled therapeutics.
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Affiliation(s)
- Myrna B Dolovich
- Faculty of Health Sciences, Michael de Groote School of Medicine, McMaster University, Hamilton, Ontario, Canada.
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Abstract
Over the past years, computer-assisted surgery has gained more importance in craniomaxillofacial surgery, especially in primary and secondary treatment of head and neck malignancies. The basis for oncologic treatment of the head and neck region requires detailed planning using computed tomography, cone-beam computed tomography, or magnetic resonance imaging in combination with computer-assisted, infrared-based navigation system. These techniques allow a preplanned image-guided path to the tumor region for taking biopsies, resection, or reconstruction. The aim of this work was to show the advances and technical benefits for tumor surgery in a daily clinical routine from the view of the craniomaxillofacial surgeon. The target of our working group was to develop and clinically evaluate a novel three-dimensional planning and navigation software solution for treatment of craniofacial tumors. This work was carried out on 5 categories for oncologic surgical procedures in which computer-assisted surgery was applied from 2005 to 2011: preplanned trajectorial-guided tumor biopsy, intraoperative image-controlled tumor resection, tumor mapping, reconstruction after tumor surgery (true to original), and oral rehabilitation (backward planning). Successful preoperative planning, import of image data suitable for navigation, and intraoperative precise infrared-based navigation were obtained for all 5 categories without any complications. Image-guided navigation technique for head and neck oncologic surgery provides a precise, safe surgical method with real-time excellent anatomic orientation. Regarding the advantages of computer-assisted surgery, this technique will play a major part in craniofacial reconstructive surgery and will address widespread general methodologic solutions that are of great interest in multidisciplinary oncologic treatment.
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Wu LM, Hu JN, Hua J, Liu MJ, Chen J, Xu JR. Diagnostic value of diffusion-weighted magnetic resonance imaging compared with fluorodeoxyglucose positron emission tomography/computed tomography for pancreatic malignancy: a meta-analysis using a hierarchical regression model. J Gastroenterol Hepatol 2012; 27:1027-35. [PMID: 22414092 DOI: 10.1111/j.1440-1746.2012.07112.x] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
BACKGROUND AND AIM To obtain diagnostic performance of diffusion-weighted magnetic resonance imaging (DWI) and fluorine 18 fluorodeoxyglucose (FDG) positron emission tomography/computed tomography (PET/CT) in the detection of pancreatic malignancy. METHODS We performed a meta-analysis of all available studies of the diagnostic performance of DWI and PET/CT for pancreatic malignancy. MEDLINE, EMBASE, Cochrane library and some other databases were searched for initial studies. We determined sensitivities and specificities across studies, calculated positive and negative likelihood ratios (LR+ and LR-), and constructed summary receiver operating characteristic curves (SROC) using hierarchical regression models. RESULTS Across 16 studies with 804 patients, PET/CT sensitivity was 0.87 (95% confidence interval [CI], 0.82, 0.81) and specificity was 0.83 (95% CI, 0.71, 0.91). Overall, LR+ was 5.84 (95% CI, 4.59, 7.42) and LR- was 0.24 (95% CI, 0.17, 0.33). DWI sensitivity was 0.85 (95% CI, 0.74, 0.92) and specificity was 0.91 (95% CI, 0.71, 0.98). LR+ was 9.53 (95% CI, 2.41, 37.65) and LR- was 0.17 (95% CI, 0.09, 0.32). In subgroup analysis, the sensitivity of enhanced versus unenhanced PET/CT in the detection of pancreatic cancer was 0.91 (95% CI, 0.86, 0.96) versus 0.84 (95% CI, 0.78, 0.90) (P > 0.05), the specificity 0.88 (95% CI, 0.73, 1.00) versus 0.81 (95% CI, 0.69, 0.94) (P > 0.05). CONCLUSION Positron emission tomography/computed tomography (PET/CT) was highly sensitive and DWI was a highly specific modality in diagnosing patients with pancreatic malignancy. PET/CT and DWI could play different roles in diagnosing pancreatic carcinoma. Enhanced PET/CT seems to be superior to unenhanced PET/CT. Further larger prospective studies are needed to establish its value for diagnosis in pancreatic cancer.
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Affiliation(s)
- Lian-Ming Wu
- Department of Radiology, Renji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
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CT tube current for attenuation map in a combined PET/CT system: obese patient simulated phantom study. Ann Nucl Med 2012; 26:359-64. [PMID: 22359224 DOI: 10.1007/s12149-012-0584-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2011] [Accepted: 01/30/2012] [Indexed: 10/28/2022]
Abstract
OBJECTIVE The CT portion of PET/CT provides attenuation correction of the PET emission scan. This study was performed to evaluate how much the CT tube current can be lowered while still providing attenuation maps on PET images. METHODS Two body phantoms (outside diameters of 300 and 500 mm) were used to investigate, and PET/CT acquisitions were performed with an Aquiduo PCA-7000B (Toshiba Medical Systems, Otawara, Japan). The CT scan was performed with the following parameters (120 kVp; 0.5-s rotation; 10, 20, 40, 80, 160, 200, 320, 460 mA). After the CT scan, PET images for (18)F-FDG (5.3 kBq/mL) were obtained for 4 min/bed position. The linear attenuation coefficients for (18)F-FDG in 300- and 500-mm phantoms, pixel values and SD of CT images, radioactivity concentration values and hot- and cold-sphere contrast on PET images in the 500-mm phantom were evaluated. RESULTS In the 300-mm phantom, all eight tube currents gave average linear attenuation coefficients of approximately 0.095 cm(-1). In contrast, the average linear attenuation coefficients of the 500-mm phantom at 10, 20, and 40 mA were significantly decreased (0.081, 0.087, and 0.092 cm(-1), respectively; p < 0.05) as compared to 0.096 cm(-1) of the other tube currents. Further, CT pixel values decreased 10 and 20 mA. Thus, the background radioactivity concentration values at 10 and 20 mA were substantially underestimated to be 57 and 80%, respectively (p < 0.05); the hot-sphere contrast values at 10 and 20 mA were 0.26 and 0.29; the cold-sphere contrast values at 10, 20, and 40 mA were -0.33, -0.16, and 0.08. CONCLUSIONS Although the linear attenuation coefficients in the 300-mm phantom remained the same with varying CT tube currents, the 500-mm phantom yielded significant differences in the range 10-40 mA. Therefore, the CT tube currents for attenuation correction should be adjusted over 40 mA in obese patients.
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Terezakis SA, Heron DE, Lavigne RF, Diehn M, Loo BW. What the Diagnostic Radiologist Needs to Know about Radiation Oncology. Radiology 2011; 261:30-44. [DOI: 10.1148/radiol.11101688] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
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Mohammed N, Kestin L, Grills I, Shah C, Glide-Hurst C, Yan D, Ionascu D. Comparison of IGRT registration strategies for optimal coverage of primary lung tumors and involved nodes based on multiple four-dimensional CT scans obtained throughout the radiotherapy course. Int J Radiat Oncol Biol Phys 2011; 82:1541-8. [PMID: 21664070 DOI: 10.1016/j.ijrobp.2011.04.025] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2010] [Revised: 03/16/2011] [Accepted: 04/11/2011] [Indexed: 11/29/2022]
Abstract
PURPOSE To investigate the impact of primary tumor and involved lymph node (LN) geometry (centroid, shape, volume) on internal target volume (ITV) throughout treatment for locally advanced non-small cell lung cancer using weekly four-dimensional computed tomography (4DCT). METHODS AND MATERIALS Eleven patients with advanced non-small cell lung cancer were treated using image-guided radiotherapy with acquisition of weekly 10-Phase 4DCTs (n = 51). Initial ITV was based on planning 4DCT. Master-ITV incorporated target geometry across the entire treatment (all 4DCTs). Geographic miss was defined as the % Master-ITV positioned outside of the initial planning ITV after registration is complete. Registration strategies considered were bony (B), primary tumor soft tissue alone (T), and registration based on primary tumor and involved LNs (T_LN). RESULTS The % geographic miss for the primary tumor, mediastinal, and hilar lymph nodes based on each registration strategy were (1) B: 30%, 30%, 30%; (2) T: 21%, 40%, 36%; and (3) T_LN: 26%, 26%, 27%. Mean geographic expansions to encompass 100% of the primary tumor and involved LNs were 1.2 ± 0.7 cm and 0.8 ± 0.3 cm, respectively, for B and T_LN. Primary and involved LN expansions were 0.7 ± 0.5 cm and 1.1 ± 0.5 cm for T. CONCLUSION T is best for solitary targets. When treatments include primary tumor and LNs, B and T_LN provide more comprehensive geographic coverage. We have identified high % geographic miss when considering multiple registration strategies. The dosimetric implications are the subject of future study.
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Affiliation(s)
- Nasiruddin Mohammed
- Department of Radiation Oncology, William Beaumont Hospital, Royal Oak, MI 48073, USA
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Blodgett TM, Mehta AS, Mehta AS, Laymon CM, Carney J, Townsend DW. PET/CT artifacts. Clin Imaging 2011; 35:49-63. [PMID: 21237418 DOI: 10.1016/j.clinimag.2010.03.001] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2009] [Accepted: 02/21/2010] [Indexed: 11/28/2022]
Abstract
There are several artifacts encountered in positron emission tomography/computed tomographic (PET/CT) imaging, including attenuation correction (AC) artifacts associated with using CT for AC. Several artifacts can mimic a 2-deoxy-2-[18F] fluoro-d-glucose (FDG) avid malignant lesions and therefore recognition of these artifacts is clinically relevant. Our goal was to identify and characterize these artifacts and also discuss some protocol variables that may affect image quality in PET/CT.
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Terezakis SA, Yahalom J. PET–Computed Tomography for Radiation Treatment Planning of Lymphoma and Hematologic Malignancies. PET Clin 2011; 6:165-75. [DOI: 10.1016/j.cpet.2011.03.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Feichtinger M, Pau M, Zemann W, Aigner RM, Kärcher H. Intraoperative control of resection margins in advanced head and neck cancer using a 3D-navigation system based on PET/CT image fusion. J Craniomaxillofac Surg 2010; 38:589-94. [DOI: 10.1016/j.jcms.2010.02.004] [Citation(s) in RCA: 45] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2009] [Revised: 11/10/2009] [Accepted: 02/05/2010] [Indexed: 10/19/2022] Open
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LEE MINSU, LEE AHRA, JUNG MIAE, LEE INHYE, CHOI JIHYE, CHUNG HYUNWOO, JEONG SOONWUK, NAHM SANGSOEP, EOM KIDONG. CHARACTERIZATION OF PHYSIOLOGIC 18F-FDG UPTAKE WITH PET-CT IN DOGS. Vet Radiol Ultrasound 2010; 51:670-3. [DOI: 10.1111/j.1740-8261.2010.01727.x] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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Lee MS, Ko J, Lee AR, Lee IH, Jung MA, Austin B, Chung H, Nahm S, Eom K. Effects of anesthetic protocol on normal canine brain uptake of 18F-FDG assessed by PET/CT. Vet Radiol Ultrasound 2010; 51:130-5. [PMID: 20402395 DOI: 10.1111/j.1740-8261.2009.01636.x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
Abstract
The purpose of this study was to assess the effects of four anesthetic protocols on normal canine brain uptake of 2-deoxy-2-[18F]fluoro-D-glucose (FDG) using positron emission tomography/computed tomography (PET/CT). Five clinically normal beagle dogs were anesthetized with (1) propofol/isoflurane, (2) medetomidine/pentobarbital, (3) xylazine/ketamine, and (4) medetomidine/tiletamine-zolazepam in a randomized cross-over design. The standard uptake value (SUV) of FDG was obtained in the frontal, parietal, temporal and occipital lobes, cerebellum, brainstem and whole brain, and compared within and between anesthetic protocols using the Friedman test with significance set at P < 0.05. Significant differences in SUVs were observed in various part of the brain associated with each anesthetic protocol. The SUV for the frontal and occipital lobes was significantly higher than in the brainstem in all dogs. Dogs receiving medetomidine/tiletamine-zolazepam also had significantly higher whole brain SUVs than the propofol/isoflurane group. We concluded that each anesthetic protocol exerted a different regional brain glucose uptake pattern. As a result, when comparing brain glucose uptake using PET/CT, one should consider the effects of anesthetic protocols on different regions of the glucose uptake in the dog's brain.
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Affiliation(s)
- Min Su Lee
- Department of Veterinary Diagnostic Imaging, the College of Veterinary Medicine, Konkuk University, Seoul, Korea
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Kitajima K, Suzuki K, Nakamoto Y, Onishi Y, Sakamoto S, Senda M, Kita M, Sugimura K. Low-dose non-enhanced CT versus full-dose contrast-enhanced CT in integrated PET/CT studies for the diagnosis of uterine cancer recurrence. Eur J Nucl Med Mol Imaging 2010; 37:1490-8. [PMID: 20386901 DOI: 10.1007/s00259-010-1440-2] [Citation(s) in RCA: 41] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2009] [Accepted: 03/05/2010] [Indexed: 11/27/2022]
Abstract
PURPOSE To evaluate low-dose non-enhanced CT (ldCT) and full-dose contrast-enhanced CT (ceCT) in integrated (18)F-fluorodeoxyglucose (FDG) PET/CT studies for restaging of uterine cancer. METHODS A group of 100 women who had undergone treatment for uterine cervical (n=55) or endometrial cancer (n=45) underwent a conventional PET/CT scans with ldCT, and then a ceCT scan. Two observers retrospectively reviewed and interpreted the PET/ldCT and PET/ceCT images in consensus using a three-point grading scale (negative, equivocal, or positive) per patient and per lesion. Final diagnoses were obtained by histopathological examination, or clinical follow-up for at least 6 months. RESULTS Patient-based analysis showed that the sensitivity, specificity and accuracy of PET/ceCT were 90% (27/30), 97% (68/70) and 95% (95/100), respectively, whereas those of PET/ldCT were 83% (25/30), 94% (66/70) and 91% (91/100), respectively. Sensitivity, specificity and accuracy did not significantly differ between two methods (McNemar test, p=0.48, p=0.48, and p=0.13, respectively). There were 52 sites of lesion recurrence: 12 pelvic lymph node (LN), 11 local recurrence, 8 peritoneum, 7 abdominal LN, 5 lung, 3 supraclavicular LN, 3 liver, 2 mediastinal LN, and 1 muscle and bone. The grading results for the 52 sites of recurrence were: negative 5, equivocal 0 and positive 47 for PET/ceCT, and negative 5, equivocal 4 and positive 43 for PET/ldCT, respectively. Four equivocal regions by PET/ldCT (local recurrence, pelvic LN metastasis, liver metastasis and muscle metastasis) were correctly interpreted as positive by PET/ceCT. CONCLUSION PET/ceCT is an accurate imaging modality for the assessment of uterine cancer recurrence. Its use reduces the frequency of equivocal interpretations.
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Affiliation(s)
- Kazuhiro Kitajima
- Department of PET Diagnosis, Institute of Biomedical Research and Innovation, 2-2 Minatojima-Nakamachi, Chuo-ku, Kobe 650-0047, Japan.
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Tewarie RDN, Yu J, Seidel J, Rahiem ST, Hurtado A, Tsui BM, Grotenhuis JA, Pomper MG, Oudega M. Positron Emission Tomography for Serial Imaging of the Contused Adult Rat Spinal Cord. Mol Imaging 2010; 9:7290.2010.00011. [DOI: 10.2310/7290.2010.00011] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/30/2023] Open
Affiliation(s)
- Rishi D.S. Nandoe Tewarie
- From the International Center for Spinal Cord Injury, Hugo W. Moser Research Institute at Kennedy Krieger, Baltimore, MD; Departments of Radiology and Neurology, Johns Hopkins University School of Medicine, Baltimore, MD; Department of Neurosurgery, Radboud University Nijmegen Medical Center, Nijmegen, the Netherlands; and Departments of Physical Medicine and Rehabilitation and Neurobiology, University of Pittsburgh School of Medicine, Pittsburgh, PA
| | - Jianhua Yu
- From the International Center for Spinal Cord Injury, Hugo W. Moser Research Institute at Kennedy Krieger, Baltimore, MD; Departments of Radiology and Neurology, Johns Hopkins University School of Medicine, Baltimore, MD; Department of Neurosurgery, Radboud University Nijmegen Medical Center, Nijmegen, the Netherlands; and Departments of Physical Medicine and Rehabilitation and Neurobiology, University of Pittsburgh School of Medicine, Pittsburgh, PA
| | - Jurgen Seidel
- From the International Center for Spinal Cord Injury, Hugo W. Moser Research Institute at Kennedy Krieger, Baltimore, MD; Departments of Radiology and Neurology, Johns Hopkins University School of Medicine, Baltimore, MD; Department of Neurosurgery, Radboud University Nijmegen Medical Center, Nijmegen, the Netherlands; and Departments of Physical Medicine and Rehabilitation and Neurobiology, University of Pittsburgh School of Medicine, Pittsburgh, PA
| | - Sahar T. Rahiem
- From the International Center for Spinal Cord Injury, Hugo W. Moser Research Institute at Kennedy Krieger, Baltimore, MD; Departments of Radiology and Neurology, Johns Hopkins University School of Medicine, Baltimore, MD; Department of Neurosurgery, Radboud University Nijmegen Medical Center, Nijmegen, the Netherlands; and Departments of Physical Medicine and Rehabilitation and Neurobiology, University of Pittsburgh School of Medicine, Pittsburgh, PA
| | - Andres Hurtado
- From the International Center for Spinal Cord Injury, Hugo W. Moser Research Institute at Kennedy Krieger, Baltimore, MD; Departments of Radiology and Neurology, Johns Hopkins University School of Medicine, Baltimore, MD; Department of Neurosurgery, Radboud University Nijmegen Medical Center, Nijmegen, the Netherlands; and Departments of Physical Medicine and Rehabilitation and Neurobiology, University of Pittsburgh School of Medicine, Pittsburgh, PA
| | - Benjamin M.W. Tsui
- From the International Center for Spinal Cord Injury, Hugo W. Moser Research Institute at Kennedy Krieger, Baltimore, MD; Departments of Radiology and Neurology, Johns Hopkins University School of Medicine, Baltimore, MD; Department of Neurosurgery, Radboud University Nijmegen Medical Center, Nijmegen, the Netherlands; and Departments of Physical Medicine and Rehabilitation and Neurobiology, University of Pittsburgh School of Medicine, Pittsburgh, PA
| | - J. Andre Grotenhuis
- From the International Center for Spinal Cord Injury, Hugo W. Moser Research Institute at Kennedy Krieger, Baltimore, MD; Departments of Radiology and Neurology, Johns Hopkins University School of Medicine, Baltimore, MD; Department of Neurosurgery, Radboud University Nijmegen Medical Center, Nijmegen, the Netherlands; and Departments of Physical Medicine and Rehabilitation and Neurobiology, University of Pittsburgh School of Medicine, Pittsburgh, PA
| | - Martin G. Pomper
- From the International Center for Spinal Cord Injury, Hugo W. Moser Research Institute at Kennedy Krieger, Baltimore, MD; Departments of Radiology and Neurology, Johns Hopkins University School of Medicine, Baltimore, MD; Department of Neurosurgery, Radboud University Nijmegen Medical Center, Nijmegen, the Netherlands; and Departments of Physical Medicine and Rehabilitation and Neurobiology, University of Pittsburgh School of Medicine, Pittsburgh, PA
| | - Martin Oudega
- From the International Center for Spinal Cord Injury, Hugo W. Moser Research Institute at Kennedy Krieger, Baltimore, MD; Departments of Radiology and Neurology, Johns Hopkins University School of Medicine, Baltimore, MD; Department of Neurosurgery, Radboud University Nijmegen Medical Center, Nijmegen, the Netherlands; and Departments of Physical Medicine and Rehabilitation and Neurobiology, University of Pittsburgh School of Medicine, Pittsburgh, PA
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Circulating tumor cells and bone metastases as detected by FDG–PET/CT in patients with metastatic breast cancer. Ann Oncol 2010; 21:33-9. [DOI: 10.1093/annonc/mdp262] [Citation(s) in RCA: 71] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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Performance of integrated FDG-PET/contrast-enhanced CT in the diagnosis of recurrent pancreatic cancer: comparison with integrated FDG-PET/non-contrast-enhanced CT and enhanced CT. Mol Imaging Biol 2009; 12:452-9. [PMID: 19949988 DOI: 10.1007/s11307-009-0271-7] [Citation(s) in RCA: 42] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2009] [Revised: 07/30/2009] [Accepted: 10/09/2009] [Indexed: 12/14/2022]
Abstract
PURPOSE The purpose of this study is to evaluate the accuracy of 2-deoxy-2-[F-18]fluoro-D: -glucose-positron emission tomography (FDG-PET)/computed tomography (CT) with intravenous contrast for depiction of recurrent pancreatic cancer, compared with PET/non-enhanced CT and CT. PROCEDURE Forty-five patients previously treated for pancreatic cancer underwent PET/CT for suspected recurrence. Lesion status was determined on the basis of histopathology and radiological imaging follow-up. RESULTS Patient-based analysis showed that sensitivity, specificity, and accuracy of PET/contrast-enhanced CT were 91.7%, 95.2%, and 93.3%, respectively, whereas those of PET/non-enhanced CT were 83.3%, 90.5%, and 86.7%, respectively, and those of enhanced CT were 66.7%, 85.7%, and 75.6%, respectively. In 21 patients whom the final diagnosis was obtained from the histopathologic examination, those figures of PET/contrast-enhanced CT were 94.7%, 50.0%, and 90.4%, respectively. The sensitivity of PET/contrast-enhanced CT in detecting local recurrence, abdominal lymph node metastasis, and peritoneal dissemination were 83.3%, 87.5%, and 83.3%, respectively. CONCLUSION PET/contrast-enhanced CT is an accurate modality for assessing recurrence of pancreatic cancer.
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Zaidi H, Vees H, Wissmeyer M. Molecular PET/CT imaging-guided radiation therapy treatment planning. Acad Radiol 2009; 16:1108-33. [PMID: 19427800 DOI: 10.1016/j.acra.2009.02.014] [Citation(s) in RCA: 50] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2008] [Revised: 02/11/2009] [Accepted: 02/19/2009] [Indexed: 01/01/2023]
Abstract
The role of positron emission tomography (PET) during the past decade has evolved rapidly from that of a pure research tool to a methodology of enormous clinical potential. (18)F-fluorodeoxyglucose (FDG)-PET is currently the most widely used probe in the diagnosis, staging, assessment of tumor response to treatment, and radiation therapy planning because metabolic changes generally precede the more conventionally measured parameter of change in tumor size. Data accumulated rapidly during the last decade, thus validating the efficacy of FDG imaging and many other tracers in a wide variety of malignant tumors with sensitivities and specificities often in the high 90 percentile range. As a result, PET/computed tomography (CT) had a significant impact on the management of patients because it obviated the need for further evaluation, guided further diagnostic procedures, and assisted in planning therapy for a considerable number of patients. On the other hand, the progress in radiation therapy technology has been enormous during the last two decades, now offering the possibility to plan highly conformal radiation dose distributions through the use of sophisticated beam targeting techniques such as intensity-modulated radiation therapy (IMRT) using tomotherapy, volumetric modulated arc therapy, and many other promising technologies for sculpted three-dimensional (3D) dose distribution. The foundation of molecular imaging-guided radiation therapy lies in the use of advanced imaging technology for improved definition of tumor target volumes, thus relating the absorbed dose information to image-based patient representations. This review documents technological advancements in the field concentrating on the conceptual role of molecular PET/CT imaging in radiation therapy treatment planning and related image processing issues with special emphasis on segmentation of medical images for the purpose of defining target volumes. There is still much more work to be done and many of the techniques reviewed are themselves not yet widely implemented in clinical settings.
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Fluorine-18-Fluorodeoxyglucose Positron Emission Tomography/Computed Tomography Imaging in Pyogenic and Tuberculous Spondylitis. J Comput Assist Tomogr 2009; 33:587-92. [DOI: 10.1097/rct.0b013e318187fef8] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Wang X, Koch S. Positron emission tomography/computed tomography potential pitfalls and artifacts. Curr Probl Diagn Radiol 2009; 38:156-69. [PMID: 19464586 DOI: 10.1067/j.cpradiol.2008.01.001] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
With the recent use of 18-fluoro-2-deoxyglucose (FDG) positron emission tomography (PET) for tumor staging and treatment response, it is important to recognize many pitfalls, artifacts, and benign uptakes that are commonly encountered. Normal physiology can explain many regions of increased FDG activity, as well as incidental benign tumors and benign metabolic conditions. Recognition of characterization of benign causes and physiologic variants for FDG uptake are discussed to avoid improper characterization as a malignancy. A basic understanding of PET/computed tomographic physics is also discussed, in relation to attenuation correction artifacts caused by metallic implants and contrast agents in the gastrointestinal tract, as well as artifacts caused in fused images due to patient motion. Also presented is the rationale for expected, benign uptake in various metabolic diseases, as well as pharmacologic methods for decreasing the artifacts caused by metabolic diseases. PET/computed tomographic evaluation of the thyroid, thymus, adrenal adenomas, uterus and ovaries, infection/inflammatory changes, and postradiation/chemotherapy changes are also discussed, with expected normal changes, as well as pitfalls and artifacts.
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Affiliation(s)
- Xia Wang
- Department of Radiology, Henry Ford Health System, Detroit, MI 48202-2689, USA
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Abstract
PET has become a cornerstone procedure in modern lymphoma management. This paper reviews, from a clinical point of view, the evidence for using PET in the different subtypes of lymphoma and the different steps of their management. The reader is given an overview of the current PET-based interventional lymphoma trials and an insight into possible future developments in the field, including new PET tracers.
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Affiliation(s)
- Martin Hutchings
- Departments of Oncology and Haematology, Rigshospitalet, The Finsen Centre-Copenhagen University Hospital, 9 Blegdamsvej, Copenhagen Ø, Denmark.
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Incidental focal F-18 FDG accumulation in lung parenchyma without abnormal CT findings. Ann Nucl Med 2009; 23:599-603. [PMID: 19452248 DOI: 10.1007/s12149-009-0262-4] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2009] [Accepted: 03/19/2009] [Indexed: 12/26/2022]
Abstract
F-18 fluorodeoxyglucose (FDG) PET/CT that simultaneously offers anatomic and metabolic information is widely used and has become an effective modality in many clinical fields, especially oncology. For accurate interpretation, it is necessary to understand false-positive findings in the F-18 FDG PET image, such as physiologic conditions, findings related to patients' medical and surgical histories, normal variants, and artificial conditions. We report three cases of incidental focal F-18 FDG accumulation in lung parenchyma without abnormal CT findings in the PET/CT images. In the primary PET/CT studies, two cases showed single and one case showed multiple FDG foci in the lung without any CT abnormalities. All FDG accumulations disappeared in PET/CT studies repeated 1-3 days after the primary scannings. These artifacts are probably related to microembolisms attributable to the intravenous injection of F-18 FDG. Therefore, a cautious interpretation of the correspondence between anatomic and metabolic images is required and repeated PET/CT is helpful.
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De Giorgi U, Valero V, Rohren E, Dawood S, Ueno NT, Miller MC, Doyle GV, Jackson S, Andreopoulou E, Handy BC, Reuben JM, Fritsche HA, Macapinlac HA, Hortobagyi GN, Cristofanilli M. Circulating tumor cells and [18F]fluorodeoxyglucose positron emission tomography/computed tomography for outcome prediction in metastatic breast cancer. J Clin Oncol 2009; 27:3303-11. [PMID: 19451443 DOI: 10.1200/jco.2008.19.4423] [Citation(s) in RCA: 119] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023] Open
Abstract
PURPOSE Circulating tumor cells (CTCs) and [(18)F]fluorodeoxyglucose (FDG) positron emission tomography (PET)/computed tomography (CT) are two new promising tools for therapeutic monitoring. In this study, we compared the prognostic value of CTC and FDG-PET/CT monitoring during systemic therapy for metastatic breast cancer (MBC). PATIENTS AND METHODS A retrospective analyses of 115 MBC patients who started a new line of therapy and who had CTC counts and FDG-PET/CT scans performed at baseline and at 9 to 12 weeks during therapy (midtherapy) was performed. Patients were categorized according to midtherapy CTC counts as favorable (ie, < five CTCs/7.5 mL blood) or unfavorable (> or = five CTCs/7.5 mL blood) outcomes. CTC counts and FDG-PET/CT response at midtherapy were compared, and univariate and multivariate analyses were performed to identify factors associated with survival. RESULTS In 102 evaluable patients, the median overall survival time was 14 months (range, 1 to > 41 months). Midtherapy CTC levels correlated with FDG-PET/CT response in 68 (67%) of 102 evaluable patients. In univariate analysis, midtherapy CTC counts and FDG-PET/CT response predicted overall survival (P < .001 and P = .001, respectively). FDG-PET/CT predicted overall survival (P = .0086) in 31 (91%) of 34 discordant patients who had fewer than five CTCs at midtherapy. Only midtherapy CTC levels remained significant in a multivariate analysis (P = .004). CONCLUSION Detection of five or more CTCs during therapeutic monitoring can accurately predict prognosis in MBC beyond metabolic response. FDG-PET/CT deserves a role in patients who have fewer than five CTCs at midtherapy. Prospective trials should evaluate the most sensitive and cost-effective modality for therapeutic monitoring in MBC.
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Affiliation(s)
- Ugo De Giorgi
- The University of Texas M. D. Anderson Cancer Center, Houston, 77030, USA
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Kitajima K, Murakami K, Yamasaki E, Domeki Y, Tsubaki M, Sunagawa M, Kaji Y, Suganuma N, Sugimura K. Performance of integrated FDG PET/contrast-enhanced CT in the diagnosis of recurrent colorectal cancer: Comparison with integrated FDG PET/non-contrast-enhanced CT and enhanced CT. Eur J Nucl Med Mol Imaging 2009; 36:1388-96. [PMID: 19370346 DOI: 10.1007/s00259-009-1081-5] [Citation(s) in RCA: 52] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2008] [Accepted: 01/23/2009] [Indexed: 12/25/2022]
Abstract
PURPOSE The aim of our study was to evaluate the accuracy of integrated positron emission tomography and computed tomography (PET/CT) using (18)F-fluorodeoxyglucose (FDG) with IV contrast for depiction of suspected recurrent colorectal cancer and to assess the impact of PET/contrast-enhanced CT findings on clinical management compared with PET/non-contrast-enhanced CT and CT component. METHODS One hundred seventy patients previously treated for colorectal cancer underwent PET/CT consisting of non-enhanced and contrast-enhanced CT for suspected recurrence. PET/contrast-enhanced CT, PET/non-contrast-enhanced CT and enhanced CT were interpreted by two experienced radiologists by consensus for each investigation. Lesion status was determined on the basis of histopathology, radiological imaging and clinical follow-up for longer than 6 months. RESULTS Patient-based analysis showed that the sensitivity, specificity and accuracy of PET/contrast-enhanced CT were 93.2 (69/74), 95.8 (92/96) and 94.7% (161/170), respectively, whereas those of PET/non-contrast-enhanced CT were 89.2 (66/74), 94.8 (91/96) and 92.4% (157/170), respectively, and those of enhanced CT were 79.7 (59/74), 93.8 (90/96) and 87.6% (149/170), respectively. Sensitivity and accuracy differed significantly among the three modalities (Cochran's Q test: p = 0.0004 and p = 0.0001, respectively).The findings of PET/contrast-enhanced CT resulted in a change of management for 64 of the 170 patients (38%) and had an effect on patient management in 12 patients (7%) diagnosed by enhanced CT alone and 4 patients (2%) diagnosed by PET/non-contrast-enhanced CT. CONCLUSION Integrated PET/contrast-enhanced CT is an accurate modality for assessing colorectal cancer recurrence and led to changes in the subsequent appropriate therapy.
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Affiliation(s)
- Kazuhiro Kitajima
- Department of Radiology, Dokkyo University School of Medicine, Mibu, Japan.
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Quirce Pisano R, Banzo Marraco I, Jiménez-Bonilla JF, Martínez-Rodríguez I, Sainz Esteban A, Carril Carril JM. [Potential sources of diagnostic pitfall and variants in FDG-PET/CT]. ACTA ACUST UNITED AC 2008; 27:130-59. [PMID: 18367053 DOI: 10.1157/13117196] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
UNLABELLED Oncological FDG PET show variants and findings that may lead to a diagnostic error and that may be clarified by the morfofunctional imaging from PET/CT. In this article we show the experience acquired since a Siemens PET/CT Biograph LSO Pico3D was applied in our centre. We describe some representative examples of FDG distribution patterns which may lead to erroneous interpretations of the clinical studies when they refer to specific clinical situations. The examples included are classified into two main groups according to the cause: Technical and biological, and the latter into physiological and non-physiological (pathophysiological). Patterns are described within the biological group showing changes of the FDG biodistribution that may reduce the uptake in tumoural lesions, the physiological variants that may be interpreted as pathology, the effects of previous treatment and uptakes related to benign diseases. CONCLUSION We consider that knowledge of these variants and findings to be crucial in order to obtain optimal performance of PET/CT and to overcome the PET limitations.
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Affiliation(s)
- R Quirce Pisano
- Servicio de Medicina Nuclear, Hospital Universitario Marqués de Valdecilla, Facultad de Medicina, Universidad de Cantabria, Santander, Cantabria, España.
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50
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(18)F-FDG accumulation in the oral cavity is associated with periodontal disease and apical periodontitis: an initial demonstration on PET/CT. Ann Nucl Med 2008; 22:587-93. [PMID: 18756361 DOI: 10.1007/s12149-008-0153-0] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2008] [Accepted: 03/18/2008] [Indexed: 10/21/2022]
Abstract
OBJECTIVE The objective of this study was to prospectively investigate the relationship between high accumulation of 2-deoxy-2-[(18)F] fluoro-D: -glucose (FDG) in the oral cavity and dental infections on positron emission tomography/computed tomography (PET/CT). METHODS FDG-PET/CT scans of 103 patients who underwent a health screening were evaluated. The dental examination was performed prior to each PET/CT scan, and dental infections were assessed. Dental infections were classified into six blocks. The severity of dental caries was classified into five grades, and periodontal disease and apical periodontitis were classified into three grades. Two radiologists classified the PET images in the same manner as the dental examination. They evaluated the intensity of FDG uptake by a four-point visual PET image score for each block. The comparison of the dental examination, as a gold standard, and the visual PET image score was performed on a patient or block basis. RESULTS On a patient-based analysis, 21 of 103 patients (20.4%) showed PET positive findings in the oral cavity; 18 of the 21 patients (85.7%) had dental infections. On a block-based analysis, 25 of 605 blocks (4.1%) showed PET positive findings in the oral cavity; 22 of the 25 blocks (88.0%) had dental infections. On a detailed block-based analysis, a significant difference was observed between the presence of periodontal disease, or apical periodontitis and the positivity of the visual PET image findings (P < 0.01). Their severity correlated with the visual PET image score (P < 0.05). CONCLUSIONS Periodontal disease or apical periodontitis, but not dental caries, caused FDG accumulation in the oral cavity. This finding should be taken into account when a head and neck FDG-PET study is interpreted.
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