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1.
Fabio Pomerri Anna Rita Cervino Faise Al Bunni Laura Evangelista Pier Carlo Muzzio 《La Radiologia medica》2014,119(2):97-102
Purpose
18F-fluorodeoxyglucose-positron emission tomography/computed tomography (PET/CT) has proved effective in detecting recurrent or metastatic differentiated thyroid carcinoma (DTC) in the follow-up of operated DTC patients with high thyroglobulin (Tg) levels and negative findings on radioiodine whole-body scan. The aim of this retrospective study was to assess the impact of PET/CT on the planning of appropriate treatment for known recurrent disease in operated DTC patients.Materials and methods
The study concerned 44 consecutive DTC patients (36 papillary, 8 follicular), who underwent total thyroidectomy and thyroid remnant ablation with 131I and PET/CT. All patients had proven or strongly suspected recurrent disease judging from neck ultrasound (US) and fine-needle aspiration cytology, and detectable basal Tg levels.Results
PET/CT findings were positive in 25/44 patients (56.81 %) and negative in 19. A positive PET/CT result predicted resectable tumour recurrences in 19/25 patients, but also detected additional tumour sites that prompted changes to the treatment plan in 6/25 patients (24 %). A negative PET/CT result led to clinical monitoring for 11/19 patients (57.89 %).Conclusions
PET/CT can help select patients, who might benefit from a tailored therapy by improving the detection of local recurrences not apparent on neck US or metastases. 相似文献2.
Kim YN Yi CA Lee KS Kwon OJ Lee HY Kim BT Choi JY Kim SW Chung MP Han J Kim TS Chung MJ Shim YM 《European radiology》2012,22(7):1537-1546
Objectives
To determine the positive reading criteria for malignant nodes when interpreting combined MRI and PET/CT images for preoperative nodal staging in non-small-cell lung cancer (NSCLC).Methods
Forty-nine patients with biopsy-proven NSCLC underwent both PET/CT and thoracic MRI [diffusion weighted imaging (DWI)]. Each nodal station was evaluated for the presence of metastasis by applying either inclusive (positive if either one read positive) or exclusive (positive if both read positive) criteria in the combined interpretation of PET/CT and MRI. Nodal stage was confirmed pathologically. The combined diagnostic accuracy of PET/CT and MRI was determined on per-nodal station and per-patient bases and compared with that of PET/CT alone.Results
In 49 patients, 39 (19%) of 206 nodal stations harboured malignant cells. Out of 206 nodal stations, 186 (90%) had concordant readings, while the rest (10%) had discordant readings. Inclusive criteria of combined PET/CT and MRI helped increase sensitivity for detecting nodal metastasis (69%) compared with PET/CT alone (46%; P?=?0.003), while specificity was not significantly decreased.Conclusion
Inclusive criteria in combined MRI and PET/CT readings help improve significantly the sensitivity for detecting nodal metastasis compared with PET/CT alone and may decrease unnecessary open thoracotomy. Key Points ? Combined interpretation of MRI and PET/CT enhances the detection of nodal metastasis. ? Inclusive criteria of combined MRI/PET/CT improved the sensitivity for detecting nodal metastasis. ? Combined interpretation of MRI and PET/CT may reduce unnecessary open thoracotomies. 相似文献3.
Chieh Lin Alain Luciani Emmanuel Itti Taoufik El-Gnaoui Alexandre Vignaud Pauline Beaussart Shih-jui Lin Karim Belhadj Pierre Brugières Eva Evangelista Corinne Haioun Michel Meignan Alain Rahmouni 《European radiology》2010,20(8):2027-2038
Objective
To design a whole-body MR protocol using exclusively diffusion-weighted imaging (DWI) with respiratory gating and to assess its value for lesion detection and staging in patients with diffuse large B-cell lymphoma (DLBCL), with integrated FDG PET/CT as the reference standard.Methods
Fifteen patients underwent both whole-body DWI (b?=?50, 400, 800 s/mm2) and PET/CT for pretreatment staging. Lymph node and organ involvement were evaluated by qualitative and quantitative image analysis, including measurement of the mean apparent diffusion coefficient (ADC).Results
A total of 296 lymph node regions in the 15 patients were analysed. Based on International Working Group size criteria alone, DWI findings matched PET/CT findings in 277 regions (94%) (kappa score?=?0.85, P?<?0.0001), yielding sensitivity and specificity for DWI lymph node involvement detection of 90% and 94%. Combining visual ADC analysis with size measurement increased DWI specificity to 100% with 81% sensitivity. For organ involvement, the two techniques agreed in all 20 recorded organs (100%). All involved organ lesions showed restricted diffusion. Ann Arbor stages agreed in 14 (93%) of the 15 patients.Conclusion
Whole-body DWI with ADC analysis can potentially be used for lesion detection and staging in patients with DLBCL. 相似文献4.
Alexis Vrachimis Lars Stegger Christian Wenning Benjamin Noto Matthias Christian Burg Julia Renate Konnert Thomas Allkemper Walter Heindel Burkhard Riemann Michael Schäfers 《European journal of nuclear medicine and molecular imaging》2016,43(10):1765-1772
Purpose
The purpose of this study was to determine whether [68Ga]DOTATATE PET/MRI with diffusion-weighted imaging (DWI) can replace or complement [18F]FDG PET/CT in patients with radioactive-iodine (RAI)-refractory differentiated thyroid cancer (DTC).Methods
The study population comprised 12 patients with elevated thyroglobulin and a negative RAI scan after thyroidectomy and RAI remnant ablation who underwent both [18F]FDG PET/CT and [68Ga]DOTATATE PET/MRI within 8 weeks of each other. The presence of recurrent cancer was evaluated on a per-patient, per-organ and per-lesion basis. Histology, and prior and follow-up examinations served as the standard of reference.Results
Recurrent or metastatic tumour was confirmed in 11 of the 12 patients. [68Ga]DOTATATE PET(/MRI) correctly identified the tumour burden in all 11 patients, whereas in one patient local relapse was missed by [18F]FDG PET/CT. In the lesion-based analysis, overall lesion detection rates were 79/85 (93 %), 69/85 (81 %) and 27/82 (33 %) for [18F]FDG PET/CT, [68Ga]DOTATATE PET/MRI and DWI, respectively. [18F]FDG PET(/CT) was superior to [68Ga]DOTATATE PET(/MRI) in the overall evaluation and in the detection of pulmonary metastases. In the detection of extrapulmonary metastases, [68Ga]DOTATATE PET(/MRI) showed a higher sensitivity than [18F]FDG PET(/CT), at the cost of lower specificity. DWI achieved only poor sensitivity and was significantly inferior to [18F]FDG PET in the lesion-based evaluation in the detection of both extrapulmonary and pulmonary metastases.Conclusion
[18F]FDG PET/CT was more sensitive than [68Ga]DOTATATE PET/MRI in the evaluation of RAI-refractory DTC, mostly because of its excellent ability to detect lung metastases. In the evaluation of extrapulmonary lesions, [68Ga]DOTATATE PET(/MRI) was more sensitive and [18F]FDG PET(/CT) more specific. Furthermore, DWI did not provide additional information and cannot replace [18F]FDG PET for postoperative monitoring of patients with suspected RAI-refractory DTC.5.
Matthias M. Heck Michael Souvatzoglou Margitta Retz Roman Nawroth Hubert Kübler Tobias Maurer Mark Thalgott Bettina M. Gramer Gregor Weirich Ina-Christine Rondak Ernst J. Rummeny Markus Schwaiger Jürgen E. Gschwend Bernd Krause Matthias Eiber 《European journal of nuclear medicine and molecular imaging》2014,41(4):694-701
Purpose
The aim of this study was to prospectively compare diffusion-weighted magnetic resonance imaging (DWI) and [11C]choline positron emission tomography/computed tomography (PET/CT) with computed tomography (CT) for preoperative lymph node (LN) staging in prostate cancer (PCa) patients.Methods
Between June 2010 and May 2012, CT, DWI and [11C]choline PET/CT were performed preoperatively in 33 intermediate- and high-risk PCa patients undergoing radical prostatectomy (RP) and extended pelvic lymph node dissection (ePLND) including obturator fossa and internal, external and common iliac fields. Patient- and field-based performance characteristics for all three imaging techniques based on histopathological results are reported. Imaging techniques were compared by means of the area under the curve (AUC).Results
LN metastases were detected in 92 of 1,012 (9 %) LNs from 14 of 33 (42 %) patients. On patient-based analysis, sensitivity, specificity and accuracy for CT were 57, 68 and 64 %, respectively, for DWI were 57, 79 and 70 %, respectively, and for [11C]choline PET/CT were 57, 90 and 76 %, respectively. On field-based analysis, these numbers for CT were 47, 94 and 88 %, respectively, for DWI were 56, 97 and 92 %, respectively, and for [11C]choline PET/CT were 62, 96 and 92 %, respectively. Neither DWI nor [11C]choline PET/CT performed significantly better than CT on pairwise comparison of patient- and field-based results.Conclusion
All three imaging techniques exhibit a rather low sensitivity with less than two thirds of LN metastases being detected on patient- and field-based analysis. Overall diagnostic efficacy did not differ significantly between imaging techniques, whereas distinct performance characteristics, esp. patient-based specificity, were best for [11C]choline PET/CT followed by DWI and CT. 相似文献6.
Marcelo A. Queiroz Martin Hüllner Felix Kuhn Gerhardt Huber Christian Meerwein Spyros Kollias Gustav von Schulthess Patrick Veit-Haibach 《European journal of nuclear medicine and molecular imaging》2014,41(12):2212-2221
Objective
The purpose of this study was to analyze whether diffusion-weighted imaging (DWI) adds significant information to positron emission tomography/magnetic resonance imaging (PET/MRI) on lesion detection and characterization in head and neck cancers.Methods
Seventy patients with different head and neck cancers were enrolled in this prospective study. All patients underwent sequential contrast-enhanced (ce) PET/computed tomography (CT) and cePET/MRI using a tri-modality PET/CT-MR setup either for staging or re-staging. First, the DWI alone was evaluated, followed by the PET/MRI with conventional sequences, and in a third step, the PET/MRI with DWI was evaluated. McNemar’s test was used to evaluate differences in the accuracy of PET/MRI with and without DWI compared to the standard of reference.Results
One hundred eighty-eight (188) lesions were found, and of those, 118 (62.8 %) were malignant and 70 (37.2 %) were benign. PET/MRI without DWI had a higher accuracy in detecting malignant lesions than DWI alone (86.8 % vs. 60.6 %, p?0.001). PET/MRI combined with DWI detected 120 concurrent lesions (89 malignant and 31 benign), PET/MRI alone identified 48 additional lesions (20 malignant and 28 benign), and DWI alone detected 20 different lesions (nine malignant and 11 benign). However, lesions detected on DWI did not change overall staging. SUV maximum and mean were significantly higher in malignant lesions than in benign lesions. DWI parameters between malignant and benign lesions were not statistically different.Conclusion
The use of DWI as part of PET/MRI to evaluate head and neck cancers does not provide remarkable information. Thus, the use of DWI might not be needed in clinical PET/MRI protocols for the staging or restaging of head and neck cancers. 相似文献7.
Diagnostic value of diffusion-weighted magnetic resonance imaging (DWI) compared to FDG PET/CT for whole-body breast cancer staging 总被引:1,自引:0,他引:1
Till-Alexander Heusner Sherko Kuemmel Angela Koeninger Monia E. Hamami Steffen Hahn Anton Quinsten Andreas Bockisch Michael Forsting Thomas Lauenstein Gerald Antoch Alexander Stahl 《European journal of nuclear medicine and molecular imaging》2010,37(6):1077-1086
Purpose
The aim of the study was to prospectively compare the diagnostic value of whole-body diffusion-weighted imaging (DWI) and FDG PET/CT for breast cancer (BC) staging.Methods
Twenty BC patients underwent whole-body FDG PET/CT and 1.5-T DWI. Lesions with qualitatively elevated signal intensity on DW images (b?=?800 s/mm2) were rated as suspicious for tumour and mapped to individual lesions and different compartments (overall 552 lesions). The apparent diffusion coefficient (ADC) value was determined for quantitative evaluation. Histopathology, MRI findings, bone scan findings, concordant findings between FDG PET/CT and DWI, CT follow-up scans and plausibility served as the standards of reference defining malignancy.Results
According to the standards of reference, breasts harboured malignancy in 11, regional lymph nodes in 4, M1 lymph nodes in 3, bone in 7, lung in 2, liver in 3 and other tissues in 3 patients. On a compartment basis, the sensitivity, specificity, accuracy, positive predictive value (PPV) and negative predictive value (NPV) for the detection of malignancies were 94, 99, 98, 97 and 98% for FDG PET/CT and 91, 72, 76, 50 and 96% for DWI, respectively. Of the lesions seen on DWI only, 348 (82%) turned out to be false-positive compared to 23 (11%) on FDG PET/CT. The average lesion ADC was 820?±?300 with true-positive lesions having 929?±?252 vs 713?±?305 in false-positive lesions (p?<?0.0001).Conclusion
Based on these initial data DWI seems to be a sensitive but unspecific modality for the detection of locoregional or metastatic BC disease. There was no possibility to quantitatively distinguish lesions using ADC. DWI alone may not be recommended as a whole-body staging alternative to FDG PET(/CT). Further studies are necessary addressing the question of whether full-body MRI including DWI may become an alternative to FDG PET/CT for whole-body breast cancer staging. 相似文献8.
Ludovic Le Dortz Sophie De Guibert Sahar Bayat Anne Devillers Roch Houot Yan Rolland Marc Cuggia Florence Le Jeune Haïfa Bahri Marie-Luce Barge Thierry Lamy Etienne Garin 《European journal of nuclear medicine and molecular imaging》2010,37(12):2307-2314
Purpose
The aim of this study was to assess the usefulness of positron emission tomography/computed tomography in staging, prognosis evaluation and restaging of patients with follicular lymphoma.Methods
A retrospective study was performed on 45 patients with untreated biopsy-proven follicular lymphoma who underwent 18F-fluorodeoxyglucose PET/CT (FDG PET/CT) and CT before and after chemoimmunotherapy induction treatment (rituximab combined with cyclophosphamide, doxorubicin, vincristine and prednisone).Results
PET/CT detected more nodal (+51%) and extranodal (+89%) lesions than CT. PET/CT modified Ann Arbor staging in eight patients (18%). Five patients (11%) initially considered as being early stage (I/II) were eventually treated as advanced stage (III/IV). In this study, an initial PET/CT prognostic score was significantly more accurate than the Follicular Lymphoma International Prognostic Index score in identifying patients with poor prognosis (i.e. patients with incomplete therapeutic response or early relapse). The accuracy of PET/CT for therapeutic response assessment was higher than that of CT (0.97 vs 0.64), especially due to its ability to identify inactive residual masses. In addition, post-treatment PET/CT was able to predict patients’ outcomes. The median progression-free survival was 48 months in the PET/CT-negative group as compared with 17.2 months for the group with residual uptake (p?<?10?4).Conclusion
FDG PET/CT is useful for staging and assessing the prognosis and therapeutic response of patients with follicular lymphoma. 相似文献9.
Marius E. Mayerhoefer Ahmed Ba-Ssalamah Michael Weber Markus Mitterhauser Harald Eidherr Wolfgang Wadsak Markus Raderer Siegfried Trattnig Andreas Herneth Georgios Karanikas 《European radiology》2013,23(7):1978-1985
Objectives
To compare fused gadoxetate-enhanced Ga-68-DOTANOC PET/MRI and Ga-68-DOTANOC PET/DWI (diffusion-weighted imaging) for the assessment of abdominal neuroendocrine tumours (NETs).Methods
Eighteen patients with suspected or histologically proven NETs of the abdomen were enrolled in this retrospective study. All patients underwent Ga-68-DOTANOC PET/CT for a primary search, staging, or restaging, and received an additional MRI, including dynamic gadoxetate-enhanced T1-weighted sequences and DWI (b-values 50, 300 and 600). Co-registered gadoxetate-enhanced PET/MRI and PET/DWI were separately analysed for NET lesions by a nuclear medicine physician and a radiologist in consensus. Sensitivity and specificity were calculated on a per-region, per-organ and per-patient basis.Results
Eighty-seven out of 684 anatomical regions, and 23 out of 270 organs, were NET-positive in 14 out of 18 patients. Region-based sensitivities and specificities were 97.7 % and 99.7 % for gadoxetate-enhanced PET/MRI and 98.9 % and 99.7 % for PET/DWI. Organ-based sensitivities and specificities were 91.3 % and 99.6 % for gadoxetate-enhanced PET/MRI and 95.7 % and 99.6 % for PET/DWI. Finally, patient-based sensitivities and specificities were 100 % and 100 % for gadoxetate-enhanced PET/MRI and 100 % and 75 % for PET/DWI. Sensitivities and specificities of the two methods did not differ significantly.Conclusions
Gadoxetate-enhanced Ga-68-DOTANOC PET/MRI and Ga-68-DOTANOC PET/DWI are equally useful for the assessment of abdominal NETs.Key Points
? Positron emission tomography and magnetic resonance imaging can both assess neuroendocrine tumours. ? Fusion of PET/MR imaging provides helpful information. ? Gadoxetate-enhanced Ga-68-DOTANOC PET/MRI and Ga-68-DOTANOC PET/DWI assess neuroendocrine tumours equally well. ? PET/DWI is inherently simpler than gadoxetate-enhanced PET/MRI. ? Only benign hepatic lesions pose a potential diagnostic dilemma for PET/DWI. 相似文献10.
Oh JR Byun BH Hong SP Chong A Kim J Yoo SW Kang SR Kim DY Song HC Bom HS Min JJ 《European journal of nuclear medicine and molecular imaging》2011,38(8):1459-1468
Purpose
The aim of this study was to compare 131I whole-body scintigraphy (WBS), WBS with 131I single photon emission computed tomography/computed tomography (SPECT/CT), and 18F-fluorodeoxyglucose (FDG) positron emission tomography (PET)/CT in the detection of distant metastases of differentiated thyroid cancer (DTC).Methods
A total of 140 patients with 258 foci of suspected distant metastases were evaluated. 131I WBS, 131I SPECT/CT, and 18F-FDG PET/CT images were interpreted separately. The final diagnosis was obtained from histopathologic study, serum thyroglobulin level, other imaging modalities, and/or clinical follow-up.Results
Of the 140 patients with 258 foci, 46 patients with 166 foci were diagnosed as positive for distant metastasis. The sensitivity, specificity, and diagnostic accuracy of each imaging modality were 65, 55, and 59%, respectively, for 131I WBS; 65, 95, and 85% for 131I SPECT/CT, respectively; and 61, 98, and 86%, respectively, for 18F-FDG PET/CT in patient-based analyses. Lesion-based analyses demonstrated that both SPECT/CT and PET/CT were superior to WBS (p<0.001) in all patient groups. SPECT/CT was superior to WBS and PET/CT (p<0.001) in patients who received a single challenge of radioiodine therapy, whereas PET/CT was superior to WBS (p=0.005) and SPECT/CT (p=0.013) in patients who received multiple challenges.Conclusion
Both SPECT/CT and PET/CT demonstrated high diagnostic performance in detecting metastatic thyroid cancer. SPECT/CT was highly accurate in patients who underwent a single challenge of radioiodine therapy. In contrast, 18F-FDG PET/CT presented the highest diagnostic performance in patients who underwent multiple challenges of radioiodine therapy. 相似文献11.
Elif Özdemir Nilufer Yildirim Poyraz Sefika Burcak Polat Seyda Turkolmez Reyhan Ersoy Bekir Cakir 《Annals of nuclear medicine》2014,28(3):241-247
Objective
The aim of the study was to disclose the place of 18F-FDG PET/CT to predict recurrent disease in patients with differentiated thyroid cancer (DTC), negative radioiodine whole-body scan (WBS) and high serum thyroglobulin (Tg).Methods
Seventy-one patients who underwent total thyroidectomy followed by radioactive iodine ablation and had negative radioiodine WBS but elevated Tg levels underwent PET/CT. They were followed up for 6–50 months (median 23) for the occurence of recurrent disease as detected by either clinical findings, other imaging modalities or histopathological examination. The place of PET/CT findings at baseline to predict the presence of recurrent disease was evaluated. Correlation between PET/CT findings and Tg levels was examined and a threshold for Tg level above which the predictive value of PET/CT was highest was determined.Results
PET/CT was positive for recurrent disease in 38 (53.5 %) patients. The sensitivity, specificity, PPV, NPV and diagnostic accuracy of PET/CT to predict the occurence of recurrent disease at follow-up were 68.8, 78.3, 86.8, 54.5 and 71.9 %, respectively. The sensitivity, accuracy and PPV of PET/CT increased with increasing Tg levels. The highest diagnostic accuracy of PET/CT, with a sensitivity of 76.2 % and a specificity of 100 % to detect recurrent disease appeared to be at a Tg level greater than 29 ng/mL.Conclusion
Our findings suggest that 18F-FDG-PET/CT is a valuable tool to predict the occurence of recurrent disease in patients with DTC, negative WBS and elevated Tg levels. PET/CT positivity has been shown to be strongly and positively correlated with Tg levels in this patient subset. 相似文献12.
Jung MY Chong A Seon HJ Choi S Kim YH Shin SS Kim JW Bom HS 《Annals of nuclear medicine》2012,26(4):327-336
Purpose
To evaluate the diagnostic performance of 18F-fluorodeoxyglucose (FDG) PET/CT (PET/CT) for determining the presence of pleural metastasis in patients with indeterminate findings on a contrast-enhanced chest CT (CECT) for non-small cell lung cancer (NSCLC).Materials and methods
This is a retrospective study. NSCLC patients (n?=?63) who underwent thoracentesis and/or pleural biopsy were enrolled. CECT and PET/CT reports of pleural metastasis were analyzed based on comparison with cytological or histological confirmation. Negative cytologic results were re-confirmed with follow-up study prior to cancer-related therapy. CECT results were classified into 3 categories: negative, indeterminate, and positive for pleural metastasis. PET/CT results were classified into 2 categories (negative and positive for pleural metastasis) based on FDG uptake visual grading. The level of max SUV of pleura was also analyzed. ROC analysis was done for establishing the max SUV cut-off value.Result
PET/CT could differentiate pleural metastasis with 70.8% diagnostic accuracy when the CECT finding was indeterminate (n?=?24). Optimal cut-off value to predict pleural metastasis was 2.8 for max SUV. Diagnosis by max SUV 2.8 had lower sensitivity (86.3 vs. 92.2%), but higher specificity (66.7 vs. 58.3%) than PET/CT by FDG visual grading criteria.Conclusion
PET/CT showed better diagnostic performance than CECT for detecting pleural metastasis in NSCLC patients. When the finding of CECT is controversial, PET/CT can differentiate the metastatic pleural lesion. Both FDG uptake visual grading and max SUG cut-off value can be used as diagnostic criteria for pleural metastasis. 相似文献13.
Caecilia S. Reiner Paul Stolzmann Lars Husmann Irene A. Burger Martin W. Hüllner Niklaus G. Schaefer Paul M. Schneider Gustav K. von Schulthess Patrick Veit-Haibach 《European journal of nuclear medicine and molecular imaging》2014,41(4):649-658
Purpose
To compare the accuracy of PET/MR imaging with that of FDG PET/CT and to determine the MR sequences necessary for the detection of liver metastasis using a trimodality PET/CT/MR set-up.Methods
Included in this single-centre IRB-approved study were 55 patients (22 women, age 61?±?11 years) with suspected liver metastases from gastrointestinal cancer. Imaging using a trimodality PET/CT/MR set-up (time-of-flight PET/CT and 3-T whole-body MR imager) comprised PET, low-dose CT, contrast-enhanced (CE) CT of the abdomen, and MR with T1-W/T2-W, diffusion-weighted (DWI), and dynamic CE imaging. Two readers evaluated the following image sets for liver metastasis: PET/CT (set A), PET/CECT (B), PET/MR including T1-W/T2-W (C), T1-W/T2-W with either DWI (D) or CE imaging (E), and a combination (F). The accuracy of each image set was determined by receiver-operating characteristic analysis using image set B as the standard of reference.Results
Of 120 liver lesions in 21/55 patients (38 %), 79 (66 %) were considered malignant, and 63/79 (80 %) showed abnormal FDG uptake. Accuracies were 0.937 (95 % CI 89.5 – 97.9 %) for image set A, 1.00 (95 % CI 99.9 – 100.0 %) for set C, 0.998 (95 % CI 99.4 – 100.0 %) for set D, 0.997 (95 % CI 99.3 – 100.0 %) for set E, and 0.995 (95 % CI 99.0 – 100.0 %) for set F. Differences were significant for image sets D – F (P?<?0.05) when including lesions without abnormal FDG uptake. As shown by follow-up imaging after 50 – 177 days, the use of image sets D and both sets E and F led to the detection of metastases in one and three patients, respectively, and further metastases in the contralateral lobe in two patients negative on PET/CECT (P?=?0.06).Conclusion
PET/MR imaging with T1-W/T2-W sequences results in similar diagnostic accuracy for the detection of liver metastases to PET/CECT. To significantly improve the characterization of liver lesions, we recommend the use of dynamic CE imaging sequences. PET/MR imaging has a diagnostic impact on clinical decision making. 相似文献14.
Purpose
To compare the sensitivity and specificity of 18F-fluordesoxyglucose positron emission tomography/computed tomography (18F-FDG PET/CT), 18F-FDG PET/magnetic resonance (18F-FDG PET/MR) and 18F-FDG PET/MR including diffusion weighted imaging (DWI) in the detection of sentinel lymph node metastases in patients suffering from malignant melanoma.Material & Methods
Fifty-two patients with malignant melanoma (female: n =?30, male: n =?22, mean age 50.5?±?16.0 years, mean tumor thickness 2.28?±?1.97 mm) who underwent 18F-FDG PET/CT and subsequent PET/MR & DWI for distant metastasis staging were included in this retrospective study. After hybrid imaging, lymphoscintigraphy including single photon emission computed tomography/CT (SPECT/CT) was performed to identify the sentinel lymph node prior to sentinel lymph node biopsy (SLNB). In a total of 87 sentinel lymph nodes in 64 lymph node basins visible on SPECT/CT, 17 lymph node metastases were detected by histopathology. In separate sessions PET/CT, PET/MR, and PET/MR & DWI were assessed for sentinel lymph node metastases by two independent readers. Discrepant results were resolved in a consensus reading. Sensitivities, specificities, positive predictive values and negative predictive values were calculated with histopathology following SPECT/CT guided SLNB as a reference standard.Results
Compared with histopathology, lymph nodes were true positive in three cases, true negative in 65 cases, false positive in three cases and false negative in 14 cases in PET/CT. PET/MR was true positive in four cases, true negative in 63 cases, false positive in two cases and false negative in 13 cases. Hence, we observed a sensitivity, specificity, positive predictive value and negative predictive value of 17.7, 95.6, 50.0 and 82.3% for PET/CT and 23.5, 96.9, 66.7 and 82.3% for PET/MR. In DWI, 56 sentinel lymph node basins could be analyzed. Here, the additional analysis of DWI led to two additional false positive findings, while the number of true positive findings could not be increased.Conclusion
In conclusion, integrated 18F-FDG PET/MR does not reliably differentiate N-positive from N-negative melanoma patients. Additional DWI does not increase the sensitivity of 18F-FDG PET/MR. Hence, sentinel lymph node biopsy cannot be replaced by 18F-FDG-PE/MR or 18F-FDG-PET/CT.15.
Do-Hoon Kim Ji-hoon Jung Seung Hyun Son Choon-Young Kim Chae Moon Hong Shin Young Jeong Sang-Woo Lee Jaetae Lee Byeong-Cheol Ahn 《Nuclear Medicine and Molecular Imaging》2014,48(1):55-62
Purpose
To evaluate differences in clinical, radiological and laboratory findings between pulmonary metastasis with and without radioiodine avidity in thyroidectomized differentiated thyroid cancer (DTC) patients with pulmonary metastasis who underwent high-dose I-131 treatment.Methods
A total of 105 DTC patients with pulmonary metastasis (age, 48.7 ± 16.8 years; women/men, 78/27) were included. Clinical characteristics, chest computed tomography (CT), F-18 fluorodeoxyglucose positron emission tomography (F-18 FDG PET)/CT and thyroid-stimulating hormone (TSH)-stimulated serum thyroglobulin (s-Tg) level were compared between patients with and without radioiodine uptake in metastatic lung lesions. The response to I-131 treatment was evaluated with follow-up study.Results
Eighty-nine patients (84.8 %, whole-body scan positive [WBSP] group) showed radioiodine uptake at pulmonary metastasis on post I-131 treatment whole-body scan (WBS) and 16 patients (15.2 %, WBS negative [WBSN] group) did not show uptake at pulmonary lesions on the WBS. Ninety percent and 87 % of the WBSP group had visible metastatic lesions on CT and F-18 FDG PET/CT; however, all of the patients in the WBSN group showed lesions on CT and F-18 FDG PET/CT. In seven (6.7 %) of 105 patients, CT and F-18 FDG PET/CT could not detect pulmonary lesions, which were diagnosed by post I-131 treatment WBS. Complete disease remission was achieved in six (5.7 %) patients and all of them were in the WBSP group.Conclusions
Metastatic lesion was not visualized on chest CT or F-18 FDG PET/CT in 6.7 % of DTC patients with pulmonary metastasis and the lesion was visualized only on post I-131 treatment WBS. Complete remission was achieved in 5.7 % of DTC patients with pulmonary metastasis and the cured metastases were non-visualizing or micronodular lesions on chest CT and demonstrated radioiodine avidity on post I-131 treatment WBS. 相似文献16.
Sang Min Lee Jin Mo Goo Chang Min Park Soon Ho Yoon Jin Chul Paeng Gi Jeong Cheon Young Tae Kim Young Sik Park 《European radiology》2016,26(11):3850-3857
Objectives
To prospectively compare the accuracies of PET/MR and PET/CT in the preoperative staging of non-small cell lung cancer (NSCLC).Methods
Institutional review board approval and patients’ informed consents were obtained. 45 patients with proven or radiologically suspected lung cancer which appeared to be resectable on CT were enrolled. PET/MR was performed for the preoperative staging of NSCLC followed by PET/CT without contrast enhancement on the same day. Dedicated MR images including diffusion weighted images were obtained. Readers assessed PET/MR and PET/CT with contrast-enhanced CT. Accuracies of PET/MR and PET/CT for NSCLC staging were compared.Results
Primary tumour stages (n?=?40) were correctly diagnosed in 32 patients (80.0 %) on PET/MR and in 32 patients (80.0 %) on PET/CT (P?=?1.0). Node stages (n?=?42) were correctly determined in 24 patients (57.1 %) on PET/MR and in 22 patients (52.4 %) on PET/CT (P?=?0.683). Metastatic lesions in the brain, bone, liver, and pleura were detected in 6 patients (13.3 %). PET/MR missed one patient with pleural metastasis while PET/CT missed one patient with solitary brain metastasis and two patients with pleural metastases (P?=?0.480).Conclusions
This study demonstrated that PET/MR in combination with contrast-enhanced CT was comparable to PET/CT in the preoperative staging of NSCLC while reducing radiation exposure.Key points
? PET/MR can be comparable to PET/CT for preoperative NSCLC staging.? PET/MR and PET/CT show excellent correlation in measuring SUVmax of primary lesions.? Using PET/MR, estimated radiation dose can decrease by 31.1?% compared with PET/CT.17.
Joon Ho Choi Byung Hyun Byun Ilhan Lim Hansol Moon Jihyun Park Kyoung Jin Chang Byung Il Kim Chang Woon Choi Sang Moo Lim 《Nuclear Medicine and Molecular Imaging》2018,52(2):135-143
Purpose
We aimed to evaluate the prognostic values of radiography, F-18 FDG PET, and I-131 whole body scans in patients with lung-only metastasis from differentiated thyroid carcinoma (DTC).Methods
Between 1998 and 2013, we included 31 patients (F: 26, M: 5) with lung-only metastasis from DTC who had been treated with I-131 and underwent PET. Lung metastasis was categorized according to the size (macronodular ≥1.0 cm vs. micronodular <1.0 cm), FDG avidity (avid vs. non-avid), and I-131 avidity (avid vs. non-avid). Progression-free survival (PFS) was evaluated for each patient.Results
Among 31 patients, seven (23%) had macronodular lung metastasis, 26 (84%) had FDG avid lung metastasis, and 16 (52%) had I-131 avid lung metastasis. During the median follow-up period of 9.4 y, median PFS was 6.1 y. Based on Kaplan-Meier analysis, macronodular lung metastasis (p = 0.017) and I-131 non-avid lung metastasis (p = 0.059) were significantly associated with worse outcomes, but FDG avid lung metastasis was not (p = 0.135). Patients with FDG non-avid lung metastasis did not experience disease progression during follow-up, while 11 of 26 patients (42%) experienced disease progression. Based on univariate analysis, the hazard ratio for a poor prognosis was 3.78 (p = 0.029) for macronodular lung metastasis and 3.29 (p = 0.079) for I-131 non-avid lung metastasis.Conclusions
Macronodular and I-131 non-avid lung metastasis were associated with a poor prognosis in lung-only metastasis from DTC. Although FDG avid lung metastasis may be associated with a poor prognosis, a larger-scale study is needed.18.
Wolfgang Luboldt Teresa Volker Bärbel Wiedemann Klaus Zöphel Ursula Wehrmann Arne Koch Todd Toussaint Nasreddin Abolmaali Markus Middendorp Daniela Aust Jörg Kotzerke Frank Grünwald Thomas J. Vogl Hans-Joachim Luboldt 《European radiology》2010,20(9):2274-2285
Objective:
To determine the performance of FDG-PET/CT in the detection of relevant colorectal neoplasms (adenomas ≥10 mm, with high-grade dysplasia, cancer) in relation to CT dose and contrast administration and to find a PET cut-off.Methods:
84 patients, who underwent PET/CT and colonoscopy (n?=?79)/sigmoidoscopy (n?=?5) for ${\left( {{\hbox{79}} \times {\hbox{6}} + {\hbox{5}} \times {\hbox{2}}} \right)} = {\hbox{484}}$ colonic segments, were included in a retrospective study. The accuracy of low-dose PET/CT in detecting mass-positive segments was evaluated by ROC analysis by two blinded independent reviewers relative to contrast-enhanced PET/CT. On a per-lesion basis characteristic PET values were tested as cut-offs.Results:
Low-dose PET/CT and contrast-enhanced PET/CT provide similar accuracies (area under the curve for the average ROC ratings 0.925 vs. 0.929, respectively). PET demonstrated all carcinomas (n?=?23) and 83% (30/36) of relevant adenomas. In all carcinomas and adenomas with high-grade dysplasia (n?=?10) the SUVmax was ≥5. This cut-off resulted in a better per-segment sensitivity and negative predictive value (NPV) than the average PET/CT reviews (sensitivity: 89% vs. 82%; NPV: 99% vs. 98%). All other tested cut-offs were inferior to the SUVmax.Conclusion:
FDG-PET/CT provides promising accuracy for colorectal mass detection. Low dose and lack of iodine contrast in the CT component do not impact the accuracy. The PET cut-off SUVmax?≥?5 improves the accuracy. 相似文献19.
Jeong Won Lee Sang Mi Lee Ho Sung Lee Yong Hoon Kim Won Kyoung Bae 《Annals of nuclear medicine》2012,26(8):627-633
Objective
The aim of this study was to compare the diagnostic ability of 18F-fluorodeoxyglucose (18F-FDG) positron emission tomography/computed tomography (PET/CT) with that of 99mTc-methylene diphosphonate (99mTc-MDP) bone scan for bone metastasis in staging patients with small cell lung cancer (SCLC).Methods
Ninety-five patients with SCLC who underwent both 18F-FDG PET/CT and 99mTc-MDP bone scan for initial staging work-up were retrospectively enrolled. All 18F-FDG PET/CT and bone scan images were visually assessed. Bone metastasis was confirmed by histopathological results and all available clinical information.Results
Of 95 patients with SCLC, metastatic bone lesions were found in 30 patients, and 84 metastatic lesions were evaluated on a lesion-basis analysis. The sensitivity of 18F-FDG PET/CT was 100?% on a per-patient basis and 87?% on a per-lesion basis, and there was no false-positive lesion on PET/CT images. In contrast, the sensitivity of the bone scan was 37?% on a per-patient basis and 29?% on a per-lesion basis. The bone scan showed 11 false-positive lesions. The bone scan detected two metastatic lesions that were not detected by PET/CT, which were outside the region scanned by PET/CT. On follow-up bone scan, 21 lesions that were not detected by the initial bone scan but were detected by PET/CT were newly detected.Conclusions
In patients with SCLC, 18F-FDG PET/CT showed higher detection rate of bone metastasis than 99mTc-MDP bone scan. Thus, 18F-FDG PET/CT can replace bone scan in staging patients with SCLC. 相似文献20.
Matheoud R Leva L Secco C Sacchetti G Monica PD Brambilla M Inglese E 《Annals of nuclear medicine》2011,25(3):179-188