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1.
Axel Wetter Christine Lipponer Felix Nensa Philipp Heusch Herbert Rübben Jens-Christian Altenbernd Thomas Schlosser Andreas Bockisch Thorsten Pöppel Thomas Lauenstein James Nagarajah 《European journal of nuclear medicine and molecular imaging》2014,41(1):79-88
Purpose
The aim of this study was to evaluate the positron emission tomography (PET) component of [18F]choline PET/MRI and compare it with the PET component of [18F]choline PET/CT in patients with histologically proven prostate cancer and suspected recurrent prostate cancer.Methods
Thirty-six patients were examined with simultaneous [18F]choline PET/MRI following combined [18F]choline PET/CT. Fifty-eight PET-positive lesions in PET/CT and PET/MRI were evaluated by measuring the maximum and mean standardized uptake values (SUVmax and SUVmean) using volume of interest (VOI) analysis. A scoring system was applied to determine the quality of the PET images of both PET/CT and PET/MRI. Agreement between PET/CT and PET/MRI regarding SUVmax and SUVmean was tested using Pearson’s product-moment correlation and Bland-Altman analysis.Results
All PET-positive lesions that were visible on PET/CT were also detectable on PET/MRI. The quality of the PET images was comparable in both groups. Median SUVmax and SUVmean of all lesions were significantly lower in PET/MRI than in PET/CT (5.2 vs 6.1, p?<?0.05 and 2.0 vs 2.6, p?<?0.001, respectively). Pearson’s product-moment correlation indicated highly significant correlations between SUVmax of PET/CT and PET/MRI (R?=?0.86, p?<?0.001) as well as between SUVmean of PET/CT and PET/MRI (R?=?0.81, p?<?0.001). Bland-Altman analysis revealed lower and upper limits of agreement of ?2.77 to 3.64 between SUVmax of PET/CT vs PET/MRI and ?1.12 to +2.23 between SUVmean of PET/CT vs PET/MRI.Conclusion
PET image quality of PET/MRI was comparable to that of PET/CT. A highly significant correlation between SUVmax and SUVmean was found. Both SUVmax and SUVmean were significantly lower in [18F]choline PET/MRI than in [18F]choline PET/CT. Differences of SUVmax and SUVmean might be caused by different techniques of attenuation correction. Furthermore, differences in biodistribution and biokinetics of [18F]choline between the subsequent examinations and in the respective organ systems have to be taken into account. 相似文献2.
Objectives
Physiological myocardial uptake of 18F-FDG during positron emission tomography can mask adjacent abnormal uptake in mediastinal malignancy and inflammatory cardiac diseases. Myocardial uptake is unpredictable and variable. This study evaluates the impact of a low-carbohydrate diet in reducing myocardial FDG uptake.Method
Patients attending for clinically indicated oncological FDG PET were asked to have an “Atkins-style” low-carbohydrate diet (less than 3 g) the day before examination and an overnight fast. A total of 120 patients following low-carbohydrate diet plus overnight fast were compared with 120 patients prepared by overnight fast alone. Patients having an Atkins-style diet also completed a diet compliance questionnaire. SUVmax and SUVmean for myocardium, blood pool and liver were measured in both groups.Results
Myocardial SUVmax fell from 3.53?±?2.91 in controls to 1.77?±?0.91 in the diet-compliant group. 98 % of diet-compliant patients had a myocardial SUVmax less than 3.6 compared with 67 % of controls. Liver and blood pool SUVmax rose from 2.68?±?0.49 and 1.82?±?0.30 in the control group to 3.14?±?0.57 and 2.06?±?0.30.Conclusion
An Atkins-style diet the day before PET, together with an overnight fast, effectively suppresses myocardial FDG uptake.Key Points
? Low-carbohydrate diet (LCD) the day before PET suppresses myocardial FDG uptake. ? LCD before PET increases liver and blood pool SUV max and SUV mean . ? Suppression of myocardial uptake may improve PET imaging of thoracic disease. ? Suppression of myocardial uptake may help imaging cardiac inflammatory disease with PET. 相似文献3.
Irene A. Burger Hebert Alberto Vargas Debra A. Goldman Mithat Gonen Anita Kumar Andrew D. Zelenetz Heiko Schöder Hedvig Hricak 《European journal of nuclear medicine and molecular imaging》2013,40(5):701-707
Purpose
Based on prior reports suggesting a positive correlation between fluorodeoxyglucose (FDG) uptake on positron emission tomography (PET)/CT and total sperm count and concentration, we sought to identify changes in testicular FDG uptake over the course of chemotherapy in young men with Hodgkin’s lymphoma.Methods
Fifty-two patients with a mean age of 24.2 years (range 15.5–44.4) at diagnosis monitored with FDG PET/CT to assess treatment response for Hodgkin’s lymphoma were selected for this retrospective analysis under an Institutional Review Board waiver. Of the patients, 26 were treated with a chemotherapy regimen known to cause prolonged and sometimes permanent azoospermia (BEACOPP—bleomycin, etoposide, doxorubicin, cyclophosphamide, vincristine, procarbazine, and prednisolone) and 26 with a regimen known to have a much milder effect on gonadal function (ABVD—doxorubicin, bleomycin, vincristine, and dacarbazine). Each patient underwent one FDG PET/CT before treatment and at least one FDG PET/CT after start of chemotherapy. In all examinations, FDG activity was measured in the testes with different quantification metrics: maximum standardized uptake value (SUVmax), SUVmean, functional volume (FV) and total testicular glycolysis (TTG), and blood pool activity determined (SUVmean).Results
Testicular FDG uptake (SUVmax) was significantly associated with blood pool activity (p?<?0.001). Furthermore, testicular FDG uptake metrics incorporating volume (e.g., FV and TTG) were associated with age. There was no significant change in SUVmax, SUVmean, FV, and TTG from the PET/CT at baseline to the PET/CTs over the course of chemotherapy either for patients treated with BEACOPP or for patients treated with ABVD.Conclusion
For patients undergoing chemotherapy for Hodgkin’s lymphoma, there is a significant association between testicular FDG uptake and blood pool activity, but no significant changes in FDG uptake over the course of chemotherapy. Therefore, FDG uptake may not be a feasible surrogate marker for fertility monitoring in patients with Hodgkin’s lymphoma undergoing chemotherapy. 相似文献4.
Ivan Platzek Bettina Beuthien-Baumann Matthias Schneider Volker Gudziol Jens Langner Georg Schramm Michael Laniado J?rg Kotzerke J?rg van den Hoff 《European journal of nuclear medicine and molecular imaging》2013,40(1):6-11
Purpose
To evaluate the feasibility of PET/MRI (positron emission tomography/magnetic resonance imaging) with FDG (18F-fluorodeoxyglucose) for initial staging of head and neck cancer.Methods
The study group comprised 20 patients (16 men, 4 women) aged between 52 and 81?years (median 64?years) with histologically proven squamous cell carcinoma of the head and neck region. The patients underwent a PET scan on a conventional scanner and a subsequent PET/MRI examination on a whole-body hybrid system. FDG was administered intravenously prior to the conventional PET scan (267?C395?MBq FDG, 348?MBq on average). The maximum standardized uptake values (SUVmax) of the tumour and of both cerebellar hemispheres were determined for both PET datasets. The numbers of lymph nodes with increased FDG uptake were compared between the two PET datasets.Results
No MRI-induced artefacts where observed in the PET images. The tumour was detected by PET/MRI in 17 of the 20 patients, by PET in 16 and by MRI in 14. The PET/MRI examination yielded significantly higher SUVmax than the conventional PET scanner for both the tumour (p?<?0.0001) and the cerebellum (p?=?0.0009). The number of lymph nodes with increased FDG uptake detected using the PET dataset from the PET/MRI system was significantly higher the number detected by the stand-alone PET system (64 vs. 39, p?=?0.001).Conclusion
The current study demonstrated that PET/MRI of the whole head and neck region is feasible with a whole-body PET/MRI system without impairment of PET or MR image quality. 相似文献5.
Hai-Jeon Yoon Keon Wook Kang In Kook Chun Nariya Cho Seock-Ah Im Sunjoo Jeong Song Lee Kyeong Cheon Jung Yun-Sang Lee Jae Min Jeong Dong Soo Lee June-Key Chung Woo Kyung Moon 《European journal of nuclear medicine and molecular imaging》2014,41(8):1534-1543
Purpose
Imaging biomarkers from functional imaging modalities were assessed as potential surrogate markers of disease status. Specifically, in this prospective study, we investigated the relationships between functional imaging parameters and histological prognostic factors and breast cancer subtypes.Methods
In total, 43 patients with large or locally advanced invasive ductal carcinoma (IDC) were analyzed (47.6?±?7.5 years old). 68Ga-Labeled arginine-glycine-aspartic acid (RGD) and 18F-fluorodeoxyglucose (FDG) positron emission tomography/computed tomography (PET/CT) were performed. The maximum and average standardized uptake values (SUVmax and SUVavg) from RGD PET/CT and SUVmax and SUVavg from FDG PET/CT were the imaging parameters used. For histological prognostic factors, estrogen receptor (ER), progesterone receptor (PR), and human epidermal growth factor receptor 2 (HER2) expression was identified using immunohistochemistry (IHC) or fluorescent in situ hybridization (FISH). Four breast cancer subtypes, based on ER/PR and HER2 expression (ER/PR+,Her2?, ER/PR+,Her2+, ER/PR?,Her2+, and ER/PR?,Her2?), were considered.Results
Quantitative FDG PET parameters were significantly higher in the ER-negative group (15.88?±?8.73 vs 10.48?±?6.01, p?=?0.02 for SUVmax; 9.40?±?5.19 vs 5.92?±?4.09, p?=?0.02 for SUVavg) and the PR-negative group (8.37?±?4.94 vs 4.79?±?3.93, p?=?0.03 for SUVavg). Quantitative RGD PET parameters were significantly higher in the HER2-positive group (2.42?±?0.59 vs 2.90?±?0.75, p?=?0.04 for SUVmax; 1.60?±?0.38 vs 1.95?±?0.53, p?=?0.04 for SUVavg) and showed a significant positive correlation with the HER2/CEP17 ratio (r?=?0.38, p?=?0.03 for SUVmax and r?=?0.46, p?<?0.01 for SUVavg). FDG PET parameters showed significantly higher values in the ER/PR?,Her2? subgroup versus the ER/PR+,Her2? or ER/PR+,Her2+ subgroups, while RGD PET parameters showed significantly lower values in the ER/PR?,Her2? subgroup versus the other subgroups. There was no correlation between FDG and RGD PET parameters in the overall group. Only the ER/PR?,Her2? subgroup showed a significant positive correlation between FDG and RGD PET parameters (r?=?0.59, p?=?0.03 for SUVmax).Conclusion
68Ga-RGD and 18F-FDG PET/CT are promising functional imaging modalities for predicting biomarkers and molecular phenotypes in breast cancer patients. 相似文献6.
Byun BH Jeong UG Hong SP Min JJ Chong A Song HC Bom HS 《Annals of nuclear medicine》2012,26(6):471-477
Purpose
The presence of central lymph node (LN) metastasis increases the risk of cervical LN recurrence or distant metastasis in patients with papillary thyroid microcarcinoma (PTMC). We investigated the value of preoperative 18F-fluoro-2-deoxy-d-glucose-positron emission tomography (FDG PET)?Ccomputerized tomography (CT) and ultrasonography (US) to predict central LN metastasis from PTMC.Patients and methods
Two hundred patients with newly diagnosed unifocal PTMC were enrolled. Preoperative FDG PET?CCT was performed, and the highest SUV (SUVmax) of focally increased uptake at thyroid was measured. Tumor size was measured using preoperative US. Uni- and multivariate analyses were performed using the presence of focally increased uptake at thyroid (FDG positivity), SUVmax, tumor size, and clinical risk factor for central LN metastasis. ROC curves for risk factors were then analyzed. These analyses were undertaken in two groups: the all patients group and the FDG-positive group. Finally, we combined risk factors associated with central LN metastasis to improve predictive accuracy.Results
Tumor size >6?mm was associated with central LN metastasis. FDG positivity was identified in 110 patients (55.0?%) and the SUVmax ranged from 1.8 to 12.8 (median 3.0). In FDG-positive group, SUVmax >2.8 was associated with central LN metastasis. Addition of SUVmax >2.8 to size >6?mm of PTMC improved sensitivity of predicting central LN metastasis from 55.0 to 67.5?%, while specificity remained at 70.6?%.Conclusion
Both FDG PET?CCT and US are valuable for preoperative prediction of central LN metastasis from PTMC. Combined use of SUVmax and tumor size improves sensitivity without changing specificity. 相似文献7.
B. B. Koolen M. J. T. F. D. Vrancken Peeters J. Wesseling E. H. Lips W. V. Vogel T. S. Aukema E. van Werkhoven K. G. A. Gilhuijs S. Rodenhuis E. J. Th. Rutgers R. A. Valdés Olmos 《European journal of nuclear medicine and molecular imaging》2012,39(12):1830-1838
Purpose
The aim of this study was to evaluate the association of primary tumour 18F-fluorodeoxyglucose (FDG) uptake with clinical, histopathological and molecular characteristics of breast cancer patients scheduled for neoadjuvant chemotherapy. Second, we wished to establish for which patients pretreatment positron emission tomography (PET)/CT could safely be omitted because of low FDG uptake.Methods
PET/CT was performed in 214 primary stage II or III breast cancer patients in the prone position with hanging breasts. Tumour FDG uptake was qualitatively evaluated to determine the possibility of response monitoring with PET/CT and was quantitatively assessed using maximum standardized uptake values (SUVmax). FDG uptake was compared with age, TNM stage, histology, hormone and human epidermal growth factor receptor 2 status, grade, Ki-67 and molecular subtype in univariable and multivariable analyses.Results
In 203 tumours (95?%) FDG uptake was considered sufficient for response monitoring. No subgroup of patients with consistently low tumour FDG uptake could be identified. In a univariable analysis, SUVmax was significantly higher in patients with distant metastases at staging examination, non-lobular carcinomas, tumours with negative hormone receptors, triple negative tumours, grade 3 tumours, and in tumours with a high proliferation index (Ki-67 expression). After multiple linear regression analysis, triple negative and grade 3 tumours were significantly associated with a higher SUVmax.Conclusion
Primary tumour FDG uptake in breast cancer patients scheduled for neoadjuvant chemotherapy is significantly higher in tumours with prognostically unfavourable characteristics. Based on tumour characteristics associated with low tumour FDG uptake, this study was unable to identify a subgroup of patients unlikely to benefit from pretreatment PET/CT. 相似文献8.
Xiang Li Daniel Heber Ivo Rausch Dietrich Beitzke Marius E. Mayerhoefer Sazan Rasul Michael Kreissl Markus Mitthauser Wolfgang Wadsak Markus Hartenbach Alexander Haug Xiaoli Zhang Christian Loewe Thomas Beyer Marcus Hacker 《European journal of nuclear medicine and molecular imaging》2016,43(8):1503-1512
Purpose
PET with 18F-FDG has the potential to assess vascular macrophage metabolism. 18F-FDG is most often used in combination with contrast-enhanced CT to localize increased metabolism to specific arterial lesions. Novel 18F-FDG PET/MRI hybrid imaging shows high potential for the combined evaluation of atherosclerotic plaques, due to the superior morphological conspicuity of plaque lesions. The purpose of this study was to evaluate the reliability and accuracy of 18F-FDG PET/MRI uptake quantification compared to PET/CT as a reference standard in patients with carotid atherosclerotic plaques.Methods
The study group comprised 34 consecutive oncological patients with carotid plaques who underwent both PET/CT and PET/MRI with 18F-FDG on the same day. The presence of atherosclerotic plaques was confirmed by 3 T MRI scans. Maximum standardized uptake values (SUVmax) for carotid plaque lesions and the average SUV of the blood pool within the adjacent internal jugular vein were determined and target-to-blood ratios (TBRs, plaque to blood pool) were calculated.Results
Atherosclerotic lesions with maximum colocalized focal FDG uptake were assessed in each patient. SUVmax values of carotid plaque lesions were significantly lower on PET/MRI than on PET/CT (2.3?±?0.6 vs. 3.1?±?0.6; P?<?0.01), but were significantly correlated between PET/CT and PET/MRI (Spearman’s r?=?0.67, P?<?0.01). In contrast, TBRmax values of plaque lesions were similar on PET/MRI and on PET/CT (2.2?±?0.3 vs. 2.2?±?0.3; P?=?0.4), and again were significantly correlated between PET/MRI and PET/CT (Spearman’s r?=?0.73, P?<?0.01). Considering the increasing trend in SUVmax and TBRmax values from early to delayed imaging time-points on PET/CT and PET/MRI, respectively, with continuous clearance of radioactivity from the blood, a slight underestimation of TBRmax values may also be expected with PET/MRI compared with PET/CT.Conclusion
SUVmax and TBRmax values are widely accepted reference parameters for estimation of the radioactivity of atherosclerotic plaques on PET/CT. However, due to a systematic underestimation of SUVmax and TBRmax with PET/MRI, the optimal cut-off values indicating the presence of inflamed plaque tissue need to be newly defined for PET/MRI.9.
Hongzan Sun Jun Xin Shaomin Zhang Qiyong Guo Yueyue Lu Wei Zhai Long Zhao Weiai Peng Baijun Wang 《European journal of nuclear medicine and molecular imaging》2014,41(5):898-905
Purpose
To evaluate the concordance among 18F-FDG PET imaging, MR T2-weighted (T2-W) imaging and apparent diffusion coefficient (ADC) maps with diffusion-weighted (DW) imaging in cervical cancer using hybrid whole-body PET/MR.Methods
This study prospectively included 35 patients with cervical cancer who underwent pretreatment 18F-FDG PET/MR imaging. 18F-FDG PET and MR images were fused using standard software. The percent of the maximum standardized uptake values (SUVmax) was used to contour tumours on PET images, and volumes were calculated automatically. Tumour volumes measured on T2-W and DW images were calculated with standard techniques of tumour area multiplied by the slice profile. Parametric statistics were used for data analysis.Results
FDG PET tumour volumes calculated using SUVmax (14.30?±?4.70) and T2-W imaging volume (33.81?±?27.32 cm3) were similar (P?>?0.05) at 35 % and 40 % of SUVmax (32.91?±?18.90 cm3 and 27.56?±?17.19 cm3 respectively) and significantly correlated (P?<?0.001; r?=?0.735 and 0.766). The mean DW volume was 30.48?±?22.41 cm3. DW volumes were not significantly different from FDG PET volumes at either 35 % SUVmax or 40 % SUVmax or from T2-W imaging volumes (P?>?0.05). PET subvolumes with increasing SUVmax cut-off percentage showed an inverse change in mean ADC values on DW imaging (P?<?0.001, ANOVA).Conclusion
Hybrid PET/MR showed strong volume concordance between FDG PET, and T2-W and DW imaging in cervical cancer. Cut-off at 35 % or 40 % of SUVmax is recommended for 18F-FDG PET/MR SUV-based tumour volume estimation. The linear tumour subvolume concordance between FDG PET and DW imaging demonstrates individual regional concordance of metabolic activity and cell density. 相似文献10.
Ryogo Minamimoto Kazuo Kubota Miyako Morooka Kimiteru Ito Takuya Mitsumoto Momoko Okasaki Takuro Shimbo Niro Tayama 《Annals of nuclear medicine》2012,26(5):405-411
Objective
Vocal cord palsy (VCP) is a potential cause of hoarseness that results in decreasing mobility of the vocal cord. VCP can arise from a variety of causes; so, systematic screening is warranted for the management of patients with VCP. Asymmetrical fluorodeoxyglucose (FDG) uptake in vocal cords is a well-known feature in patients with VCP, but no detailed analysis has been performed. This study aimed at reevaluating the 18F-FDG positron emission tomography/computed tomography (PET/CT) for patients with VCP.Methods
We retrospectively surveyed the results of FDG-PET/CT for 59 patients with VCP, compared to laryngoscopic findings. Quantitative analysis was performed using maximum standardized uptake value (SUVmax), and regions of interest were drawn over bilateral vocal cords as confirmed from the CT portion of PET/CT. Patients were divided into 3 groups: Group 1 (n?=?14), in which VCP was caused by the lesion of the laryngeal area; Group 2 (n?=?40), in which VCP was caused by the lesion on the root of the recurrent laryngeal nerve; and Group 3 (n?=?5), in which VCP was caused by the lesion from the vagal center to the proximal vagus nerve.Results
For Group 1, higher FDG uptake in the paralyzed vocal cord was seen in 86?% of patients (mean SUVmax 8.1?±?5.3 vs. 2.3?±?0.4, paralyzed vs. non-paralyzed, respectively; P?<?0.002). The sensitivity of FDG-PET/CT for indicating the lesion causing VCP was 79?% for Group 1. Group 2 showed dominant FDG uptake in the non-paralyzed vocal cord (mean SUVmax 2.1?±?0.9 vs. 1.5?±?0.4, non-paralyzed vs. paralyzed, respectively; P?<?0.001). The sensitivity of FDG-PET/CT for indicating the lesion causing VCP was 93?% for Group 2. Group 3 showed no statistically significant difference in FDG accumulation between non-paralyzed and paralyzed vocal cords (mean SUVmax 1.8?±?0.3 vs. 1.7?±?0.3, non- paralyzed vs. paralyzed, respectively; P?=?0.30). The sensitivity of FDG-PET/CT for indicating the lesion causing VCP was 60?% for Group 3.Conclusions
FDG accumulation in the vocal cords is dependent on the lesion site causing VCP. In addition, FDG-PET/CT can contribute to identification of the lesion responsible for inducing VCP. 相似文献11.
Isabel Martínez-Rodríguez N. Martínez-Amador I. Banzo R. Quirce J. Jiménez-Bonilla M. De Arcocha-Torres S. Ibáñez-Bravo C. Lavado-Pérez Z. Bravo-Ferrer R. Blanco M. A. González-Gay J. M. Carril 《European journal of nuclear medicine and molecular imaging》2014,41(12):2319-2324
Purpose
The aim of this study was to evaluate the contribution of semiquantitative analysis of 180-min 18F-fluorodeoxyglucose (FDG) positron emission tomography (PET)/CT images for the assessment of aortitis in cases of suspected large vessel vasculitis (LVV) and to establish a threshold index for application in the clinical setting.Methods
This prospective study included 43 patients (mean age 67.5?±?12.9?years) with suspicion of LVV (25 with a final diagnosis of aortitis). 18F-FDG PET/CT scan was acquired 180 min after injection of 7 MBq/kg of 18F-FDG. A semiquantitative analysis was performed calculating the aortic wall maximum standardized uptake value (SUVmax) (T), the lumen SUVmax (B) and the target to background ratio (TBR). These results were also compared with those obtained in a control population.Results
The mean aortic wall SUVmax was 2.00?±?0.62 for patients with aortitis and 1.45?±?0.31 for patients without aortitis (p?0.0001). The TBR was 1.66?±?0.26 for patients with aortitis and 1.24?±?0.08 for patients without aortitis (p?0.0001). The differences were also statistically significant when the patients with aortitis and controls were compared. Receiver-operating characteristic (ROC) analysis revealed that the area under the curve was greater for the TBR than for the aortic wall SUVmax (0.997 vs 0.871). The highest sensitivity and specificity was obtained for a TBR of 1.34 (sensitivity 100 %, specificity 94.4 %).Conclusion
Semiquantitative analysis of PET/CT images acquired 180 min after 18F-FDG injection and the TBR index of 1.34 show very high accuracy and, therefore, are strongly recommended for the diagnosis of aortitis in the clinical setting. 相似文献12.
Henry Lindholm Ove Johansson Cathrine Jonsson Hans Jacobsson 《European journal of nuclear medicine and molecular imaging》2012,39(11):1685-1690
Purpose
At 18F-2-fluoro-2-deoxy-D-glucose (FDG) positron emission tomography (PET) examinations a high tracer uptake of the skeletal muscles is sometimes encountered which can lead to reduced uptake in pathological lesions. This was evaluated in retrospect in patients being recalled for a repeat examination after reducing the muscular uptake.Methods
Ten patients with increased muscular tracer uptake were examined with FDG PET/CT on two occasions with a mean of 6?days. All patients showed at least one pathological lesion with increased tracer uptake. The muscular uptake was reduced at the second examination by informing the patient to refrain from physical activity together with pretreatment with diazepam. The maximum standardized uptake value (SUVmax) of the pathological lesion and SUVmean of certain skeletal muscles, liver, spleen, lungs, blood and certain bone marrow portions were calculated.Results
In all patients, the muscular uptake was reduced to a normal level at visual evaluation as well as at comparison of SUVs with 25 consecutive clinical patients exhibiting a normal FDG distribution (p?<?0.001). The mean lesion SUVmax increased from 2.4 to 3.7 (54?%) between the examinations (p?<?0.05). All reference tissues/organs showed a significant increase of SUV at the second examination. Relating lesion SUVmax to the activity of any of the reference tissues/organs there was no significant difference between the studies.Conclusion
The distribution of FDG constitutes a relative mechanism. This must be especially considered at longitudinal examinations in the same patient at therapy evaluations. In examinations with a somehow distorted general distribution of the activity, it may be more relevant to relate the lesion activity to a reference tissue/organ than relying on SUV assessments. 相似文献13.
Arthur Varoquaux Olivier Rager Karl-Olof Lovblad Karen Masterson Pavel Dulguerov Osman Ratib Christoph D. Becker Minerva Becker 《European journal of nuclear medicine and molecular imaging》2013,40(6):842-852
Purpose
Head and neck squamous cell carcinoma (HNSCC) may cause a decreased apparent diffusion coefficient (ADC) on diffusion-weighted magnetic resonance imaging (DW MRI) and an increased standardized uptake value (SUV) on fluorodeoxyglucose (FDG) positron emission tomography (PET/CT). We analysed the reproducibility of ADC and SUV measurements in HNSCC and evaluated whether these biomarkers are correlated or independent.Methods
This retrospective analysis of DW MRI and FDG PET/CT data series included 34 HNSCC in 33 consecutive patients. Two experienced readers measured tumour ADC and SUV values independently. Statistical comparison and correlation with histopathology was done. Intra- and inter-observer agreement for ADC and SUV measurements was assessed.Results
Intraclass correlation coefficient (ICC) analysis showed almost perfect reproducibility (>0.90) for ADCmean, ADCmin, SUVmax and SUVmean values for intra-observer and inter-observer agreement. Mean ADCmean and ADCmin in HNSCC were 1.05?±?0.34 × 10?3?mm2/s and 0.65?±?0.29 × 10?3?mm2/s, respectively. Mean SUVmean and mean SUVmax were 7.61?±?3.87 and 12.8?±?5.0, respectively. Although statistically not significant, a trend towards higher SUV and lower ADC was observed with increasing tumour dedifferentiation. Pearson’s correlation analysis showed no significant correlation between ADC and SUV measurements (r ?0.103, ?0.051; p 0.552, 0.777).Conclusion
Our data suggest that ADC and SUV values are reproducible and independent biomarkers in HNSCC. 相似文献14.
Buvat I Necib H Garcia C Wagner A Vanderlinden B Emonts P Hendlisz A Flamen P 《European journal of nuclear medicine and molecular imaging》2012,39(10):1628-1634
Purpose
Medical oncology needs early identification of patients that are not responding to systemic therapy. 18F-Fluorodeoxyglucose (FDG) positron emission tomography (PET) performed before and early during treatment has been proposed for this purpose. However, the best way to assess the change in FDG uptake between two scans has not been identified. We studied cutoff thresholds to identify responding tumours as a function of the method used to measure tumour uptake.Methods
The study included 28 metastatic colorectal cancer (mCRC) patients who underwent 2 FDG PET/CT scans (baseline and at day 14 of the first course of polychemotherapy). For 78 tumour lesions, 4 standardized uptake value (SUV) indices were measured: maximum SUV (SUVmax) and mean SUV in a region obtained using an isocontour (SUV40?%), with each of these SUV normalized either by the patient body weight (BW) or body surface area (BSA). The per cent change and absolute change in tumour uptake between the baseline and the early PET scans were measured based on these four indices. These changes were correlated to the RECIST 1.0-based response using contrast-enhanced CT at baseline and at 6–8?weeks on treatment.Results
The 78 tumours were classified as non-responding (NRL, n?=?58) and responding lesions (RL, n?=?20). Receiver-operating characteristic (ROC) curves characterizing the performance in NRL/RL classification using early FDG PET uptake had areas under the curve between 0.75 and 0.84, without significant difference between the indices. The cutoff threshold in FDG uptake per cent change to get a 95?% sensitivity of RL detection depended on the way uptake was measured: ?14?% (specificity of 53?%) and ?22?% (specificity of 64?%) for SUVmax and SUV40?%, respectively. Thresholds expressed as absolute SUV decrease instead of per cent change were less sensitive to the SUV definition: an SUV decline by 1.2 yielded a sensitivity of RL detection of 95?% for SUVmax and SUV40?%. For a given cutoff threshold, the sensitivity was the same whatever the normalization (by BSA or BW).Conclusion
A 14?% drop of tumour FDG SUVmax, 22?% drop of SUV40?% or 1.2 drop of SUVmax or SUVmean after one single course of polychemotherapy predicts objective response in mCRC lesions with a high sensitivity, potentially allowing the early identification of non-responding patients. 相似文献15.
Groheux D Giacchetti S Moretti JL Porcher R Espié M Lehmann-Che J de Roquancourt A Hamy AS Cuvier C Vercellino L Hindié E 《European journal of nuclear medicine and molecular imaging》2011,38(3):426-435
Purpose
The aim of this study was to determine the impact of the main clinicopathological and biological prognostic factors of breast cancer on 18F-fluorodeoxyglucose (FDG) uptake. Only women with tumours larger than 20?mm (T2?CT4) were included in order to minimize bias of partial volume effect.Methods
In this prospective study, 132 consecutive women received FDG PET/CT imaging before starting neoadjuvant chemotherapy. Maximum standardized uptake values (SUVmax) were compared to tumour characteristics as assessed on core biopsy.Results
There was no influence of T and N stage on SUV. Invasive ductal carcinoma showed higher SUV than lobular carcinoma. However, the highest uptake was found for metaplastic tumours, representing 5% of patients in this series. Several biological features usually considered as bad prognostic factors were associated with an increase in FDG uptake: the median of SUVmax was 9.7 for grade 3 tumours vs 4.8 for the lower grades (p?0.0001); negativity for oestrogen receptors (ER) was associated with higher SUV (ER+?SUV?=?5.5; ER? SUV?=?7.6; p?=?0.003); triple-negative tumours (oestrogen and progesterone receptor negative, no overexpression of c-erbB-2) had an SUV of 9.2 vs 5.8 for all others (p = 0005); p53 mutated tumours also had significantly higher SUV (7.8 vs 5.0; p?0.0001). Overexpression of c-erbB-2 had no effect on the SUV value.Conclusion
Knowledge of the factors influencing uptake is important when interpreting FDG PET/CT scans. Also, findings that FDG uptake is highest in those patients with poor prognostic features (high grade, hormone receptor negativity, triple negativity, metaplastic tumours) is helpful to determine who are the best candidates for baseline staging. 相似文献16.
Herrmann K Erkan M Dobritz M Schuster T Siveke JT Beer AJ Wester HJ Schmid RM Friess H Schwaiger M Kleeff J Buck AK 《European journal of nuclear medicine and molecular imaging》2012,39(5):846-851
Purpose
Despite recent advances in clinical imaging modalities, differentiation of pancreatic masses remains difficult. Here, we tested the diagnostic accuracy of molecular-based imaging including 3′-deoxy-3′-[18F]fluorothymidine (FLT) positron emission tomography (PET) and [18F]fluorodeoxyglucose (FDG) PET/CT in patients with suspected pancreatic masses scheduled to undergo surgery.Methods
A total of 46 patients with pancreatic tumours suspicious for malignancy and scheduled for resective surgery were recruited prospectively. In 41 patients, FLT PET and FDG PET/CT scans were performed. A diagnostic CT performed on a routine basis was available in 31 patients. FLT PET and FDG PET/CT emission images were acquired according to standard protocols. Tracer uptake in the tumour [FDG and FLT standardized uptake value (SUV)] was quantified by the region of interest (ROI) technique. For FDG PET/CT analysis, correct ROI placement was ensured via side-by-side reading of corresponding CT images.Results
Of 41 patients, 33 had malignancy, whereas 8 patients had benign disease. Visual analysis of FDG and FLT PET resulted in sensitivity values of 91% (30/33) and 70% (23/33), respectively. Corresponding specificities were 50% (4/8) for FDG PET and 75% (6/8) for FLT PET. In the subgroup of patients with contrast-enhanced CT (n?=?31), sensitivities were 96% (PET/CT), 88% (CT alone), 92% (FDG PET) and 72% (FLT PET), respectively. Mean FLT uptake in all malignant tumours was 3.0 (range SUVmax 1.1–6.5; mean FDG SUVmax 7.9, range 3.3–17.8; p?0.001).Conclusion
For differentiation of pancreatic tumours, FDG PET and FDG PET/CT showed a higher sensitivity but lower specificity than FLT PET. Interestingly, visual analysis of FLT PET led to two false-positive findings by misinterpreting physiological bowel uptake as pathological FLT uptake in the pancreas. Due to the limited number of patients, the clinical value of adding FLT PET to the diagnostic workup of pancreatic tumours remains to be determined. 相似文献17.
Hye Ryoung Koo Jeong Seon Park Keon Wook Kang Nariya Cho Jung Min Chang Min Sun Bae Won Hwa Kim Su Hyun Lee Mi Young Kim Jin You Kim Mirinae Seo Woo Kyung Moon 《European radiology》2014,24(3):610-618
Objectives
To determine whether a correlation exists between maximum standardized uptake value (SUVmax) on 18F-fluorodeoxyglucose positron emission tomography (FDG-PET) and the subtypes of breast cancer.Methods
This retrospective study involved 548 patients (mean age 51.6 years, range 21–81 years) with 552 index breast cancers (mean size 2.57 cm, range 1.0–14.5 cm). The correlation between 18F-FDG uptake in PET/CT, expressed as SUVmax, and immunohistochemically defined subtypes (luminal A, luminal B, human epidermal growth factor receptor 2 (HER2) positive and triple negative) was analyzed.Results
The mean SUVmax value of the 552 tumours was 6.07?±?4.63 (range 0.9–32.8). The subtypes of the 552 tumours were 334 (60 %) luminal A, 66 (12 %) luminal B, 60 (11 %) HER2 positive and 92 (17 %) triple negative, for which the mean SUVmax values were 4.69?±?3.45, 6.51?±?4.18, 7.44?±?4.73 and 9.83?±?6.03, respectively. In a multivariate regression analysis, triple-negative and HER2-positive tumours had 1.67-fold (P?<?0.001) and 1.27-fold (P?=?0.009) higher SUVmax values, respectively, than luminal A tumours after adjustment for invasive tumour size, lymph node involvement status and histologic grade.Conclusion
FDG uptake was independently associated with subtypes of invasive breast cancer. Triple-negative and HER2-positive breast cancers showed higher SUVmax values than luminal A tumours.Key Points
? 18 F-FDG PET demonstrates increased tissue glucose metabolism, a hallmark of cancers. ? Immunohistochemically defined subtypes appear significantly associated with FDG uptake (expressed as SUV max ). ? Triple-negative tumours had 1.67-fold higher SUV max values than luminal A tumours. ? HER2-positive tumours had 1.27-fold higher SUV max values than luminal A tumours. 相似文献18.
Kobe C Scheffler M Holstein A Zander T Nogova L Lammertsma AA Boellaard R Neumaier B Ullrich RT Dietlein M Wolf J Kahraman D 《European journal of nuclear medicine and molecular imaging》2012,39(7):1117-1127
Purpose
To evaluate the predictive value of early and late residual 18F-fluorodeoxyglucose (FDG) and 18F-fluorothymidine (FLT) uptake using different SUV measurements in PET in patients with advanced non-small-cell lung cancer (NSCLC) treated with erlotinib.Methods
We retrospectively reviewed data from 30 patients with untreated stage IV NSCLC who had undergone a combined FDG PET and FLT PET scan at 1?week (early) and 6?weeks (late) after the start of erlotinib treatment. Early and late residual FDG and FLT uptake were measured in up to five lesions per scan with different quantitative standardized uptake values (SUVmax, SUV2Dpeak, SUV3Dpeak, SUV50, SUVA50, SUVA41) and compared with short-term outcome (progression vs. nonprogression after 6?weeks of erlotinib treatment). Receiver-operating characteristics (ROC) curve analysis was used to determine the optimal cut-off value for detecting nonprogression after 6?weeks. Kaplan-Meier analysis and the log-rank test were used to evaluate the association between residual uptake and progression-free survival (PFS).Results
Nonprogression after 6?weeks was associated with a significantly lower early and late residual FDG uptake, measured with different quantitative parameters. In contrast, nonprogression after 6?weeks was not associated with early and late residual FLT uptake. Furthermore, patients with a lower early residual FDG uptake measured in terms of SUVmax and SUV2Dpeak had a significantly prolonged PFS (282?days vs. 118?days; p?=?0.022) than patients with higher values. Similarly, lower late residual FDG uptake and early residual FLT uptake measured in terms of SUV3Dpeak, SUVA50 and SUVA41, and late FLT uptake measured in terms of SUV3Dpeak and SUVA50 was associated with an improved PFS.Conclusion
Early and late residual FDG uptake, measured using different quantitative SUV parameters, are predictive factors for short-term outcome in patients with advanced NSCLC treated with erlotinib. Additionally, low residual FDG and FLT uptake early and late in the course of erlotinib treatment is associated with improved PFS. 相似文献19.
Lee JW Lee SM Lee MS Shin HC 《European journal of nuclear medicine and molecular imaging》2012,39(9):1425-1434
Purpose
The study evaluated the role of preoperative 18F-fluorodeoxyglucose (FDG) positron emission tomography (PET)/CT in the prediction of recurrent gastric cancer after curative surgical resection.Methods
A total of 271 patients with gastric cancer who underwent 18F-FDG PET/CT and subsequent curative surgical resection were enrolled. All patients underwent follow-up for cancer recurrence with a mean duration of 24?±?12?months. 18F-FDG PET/CT images were visually assessed and, in patients with positive 18F-FDG cancer uptake, the maximum standardized uptake value (SUVmax) of cancer lesions was measured. 18F-FDG PET/CT findings were tested as prognostic factors for cancer recurrence and compared with conventional prognostic factors. Furthermore, 18F-FDG PET/CT findings were assessed as prognostic factors according to histopathological subtypes.Results
Of 271 patients, 47 (17?%) had a recurrent event. Positive 18F-FDG cancer uptake was shown in 149 patients (55?%). Tumour size, depth of invasion, presence of lymph node metastasis, positive 18F-FDG uptake and SUVmax were significantly associated with tumour recurrence in univariate analysis, while only depth of invasion, positive 18F-FDG uptake and SUVmax had significance in multivariate analysis. The 24-month recurrence-free survival rate was significantly higher in patients with negative 18F-FDG uptake (95?%) than in those with positive 18F-FDG uptake (74?%; p?0.0001). In subgroup analysis, 18F-FDG uptake was a significant prognostic factor in patients with tubular adenocarcinoma (p?=?0.003) or poorly differentiated adenocarcinoma (p?=?0.0001). However, only marginal significance was shown in patients with signet-ring cell carcinoma and mucinous carcinoma (p?=?0.05).Conclusion
18F-FDG uptake of gastric cancer is an independent and significant prognostic factor for tumour recurrence. 18F-FDG PET/CT could provide effective information on the prognosis after surgical resection of gastric cancer, especially in tubular adenocarcinoma and poorly differentiated adenocarcinoma. 相似文献20.
M.G. Caprio A. Cangiano M. Imbriaco F. Soscia G. Di Martino A. Farina G. Avitabile L. Pace P. Forestieri M. Salvatore 《La Radiologia medica》2010,115(2):215-224