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1.
Mana Ishibashi Yoshio Tanabe Shinya Fujii Toshihide Ogawa 《Annals of nuclear medicine》2017,31(6):437-453
We herein reviewed 18F-fluoro-2-deoxyglucose (18F-FDG) positron emission tomography (PET)/computed tomography (CT) findings in a number of musculoskeletal lesions including malignant tumors, benign tumors, and tumor-like lesions with correlations to other radiographic imaging modalities, and described the diversity of the 18F-FDG PET/CT findings of this entity. Malignant primary musculoskeletal tumors are typically 18F-FDG avid, whereas low-grade malignant tumors show mild uptake. Benign musculoskeletal tumors generally show a faint uptake of 18F-FDG, and tumor-like conditions also display various uptake patterns of 18F-FDG. Although musculoskeletal tumors show various uptakes of 18F-FDG on PET/CT, its addition to morphological imaging modalities such as CT and MRI is useful for the characterization and differentiation of musculoskeletal lesions. 相似文献
2.
Bernhard Nilica Dietmar Waitz Vlado Stevanovic Christian Uprimny Dorota Kendler Sabine Buxbaum Boris Warwitz Llanos Gerardo Benjamin Henninger Irene Virgolini Margarida Rodrigues 《European journal of nuclear medicine and molecular imaging》2016,43(9):1585-1592
Purpose
To determine the value of 68Ga-DOTA-TOC and 18F-FDG PET/CT for initial and follow-up evaluation of patients with neuroendocrine tumour (NET) treated with peptide receptor radionuclide therapy (PRRT).Methods
We evaluated 66 patients who had histologically proven NET and underwent both PRRT and three combined 68Ga-DOTA-TOC and 18F-FDG PET/CT studies. 68Ga-DOTA-TOC PET/CT was performed before PRRT, 3 months after completion of PRRT and after a further 6 – 9 months. 18F-FDG PET/CT was done within 2 months of 68Ga-DOTA-TOC PET/CT. Follow-up ranged from 11.8 to 80.0 months (mean 34.5 months).Results
All patients were 68Ga-DOTA-TOC PET-positive initially and at follow-up after the first full PRRT cycle. Overall, 62 of the 198 18F-FDG PET studies (31 %) were true-positive in 38 of the 66 patients (58 %). Of the 66 patients, 28 (5 grade 1, 23 grade 2) were 18F-FDG-negative initially and during follow-up (group 1), 24 (5 grade 1, 13 grade 2, 6 grade 3) were 18F-FDG-positive initially and during follow-up (group 2), 9 patients (2 grade 1, 6 grade 2, 1 grade 3) were 18F-FDG-negative initially but 18F-FDG-positive during follow-up (group 3), and 5 patients (all grade 2) were 18F-FDG-positive initially but 18F-FDG-negative during follow-up (group 4).18F-FDG PET showed more and/or larger metastases than 68Ga-DOTA-TOC PET in five patients of group 2 and four patients of group 3, all with progressive disease. In three patients with progressive disease who died during follow-up tumour SUVmax increased by 41 – 82 % from the first to the last follow-up investigation.Conclusion
In NET patients, the presence of 18F-FDG-positive tumours correlates strongly with a higher risk of progression. Initially, patients with 18F-FDG-negative NET may show 18F-FDG-positive tumours during follow-up. Also patients with grade 1 and grade 2 NET may have 18F-FDG-positive tumours. Therefore, 18F-FDG PET/CT is a complementary tool to 68Ga-DOTA-TOC PET/CT with clinical relevance for molecular investigation.3.
Sungwoo Bae Ji-In Bang Yoo Sung Song Won Woo Lee 《Nuclear Medicine and Molecular Imaging》2018,52(5):380-383
Respiratory-gated 18F-fluorodeoxygluocse (18F-FDG) PET/CT has been successfully used to better localize malignancies in the lung or upper abdominal organs. However, clinical usefulness of respiratory-gated 18F-FDG PET/CT in detection of fever focus has not been reported yet. A 68-year-old male patient with a history of living donor liver transplantation and biliary stenting was referred for 18F-FDG PET/CT due to fever of unknown origin (FUO). To find the accurate fever focus, respiratory-gated and non-gated 18F-FDG PET/CT was performed. Respiratory-gated PET/CT readily revealed prominent hypermetabolic lesion in the distal common bile duct (CBD) area where previous surgical graft was in situ. Maximum standardized uptake value (SUVmax) and SUV ratio (SUR) were greater in the gated PET/CT (SUVmax 5.4 and SUR 3.5) than in the non-gated PET/CT (SUVmax 4.6 and SUR 3.0). Fever dramatically subsided after removal of the graft in the CBD. This case report implies that respiratory-gated 18F-FDG PET/CT can visualize upper abdominal fever focus with better contrast than the conventional non-gated method. 相似文献
4.
Hyo Jung Seo Byung Wook Min Jae Seon Eo Sun Il Lee Sang Hee Kang Sung Yup Jung Sang Chul Oh Jae Gol Choe 《Nuclear Medicine and Molecular Imaging》2016,50(1):85-89
Metastatic mucinous adenocarcinoma in an inguinal hernia is a rare disease and the image findings of 18F-fluorodeoxyglucose (18F-FDG) positron emission tomography (PET)/computed tomography (CT) are little known. Here, we introduce a 57-year-old man with metastatic mucinous adenocarcinoma in an inguinal hernia. On initial 18F-FDG PET/CT, hypermetabolism was observed in mucinous adenocarcinoma of the cecum, and adenocarcinomas of the transverse and ascending colon, respectively. Follow-up 18F-FDG PET/CT revealed newly developed multiple hypermetabolism in peritoneal seeding masses and nodules in the pelvic cavity and scrotum. Peritoneal carcinomatosis in the right pelvic side wall was extended to the incarcerated peritoneum and mesentery in the right inguinoscrotal hernia.18F-FDG PET/CT was useful to reveal unexpected peritoneal seeding within the inguinal hernia. Also, this case demonstrated that metastatic mucinous adenocarcinomas had variably intense FDG uptake. 相似文献
5.
Ho KC Lai CH Wu TI Ng KK Yen TC Lin G Chang TC Wang CC Hsueh S Huang HJ 《European journal of nuclear medicine and molecular imaging》2008,35(3):484-492
Purpose Uterine carcinosarcomas clinically confined to the uterus usually harbor occult metastases. We conducted a pilot study to
evaluate the value of 18F-fluorodeoxyglucose (FDG) positron emission tomography (PET) in uterine carcinosarcoma.
Methods Patients with histologically confirmed uterine carcinosarcoma were enrolled. Abdominal and pelvic magnetic resonance imaging
(MRI)/whole-body computed tomography (CT) scan, and whole-body 18F-FDG PET or PET/CT were undertaken for primary staging, evaluating response, and restaging/post-therapy surveillance. The
clinical impact of 18F-FDG PET was determined on a scan basis.
Results A total of 19 patients were recruited and 31 18F-FDG PET scans (including 8 scans performed on a PET/CT scanner) were performed. Positive impacts of scans were found in
36.8% (7/19) for primary staging, 66.7% (2/3) for monitoring response, and 11.1% (1/9) for restaging/post-therapy surveillance.
PET excluded falsely inoperable disease defined by MRI in two patients. Aggressive treatment applying to three patients with
PET-defined resectable stage IVB disease seemed futile. Two patients died of disease shortly after salvage therapy restaged
by PET. With PET monitoring, one stage IVB patient treated by targeted therapy only was alive with good performance. Using
PET did not lead to improvement of overall survival of this series compared with the historical control (n = 35) (P = 0.779).
Conclusions The preliminary results suggest that 18F-FDG PET is beneficial in excluding falsely inoperable disease for curative therapy and in making a decision on palliation
for better quality of life instead of aggressive treatment under the guidance of PET. PET seems to have limited value in post-therapy
surveillance or restaging after failure. 相似文献
6.
Purpose
This study sought to evaluate and compare the utility of 18-F-fluorodihydroxyphenylalanine (18F-DOPA) and 18-F-fluorodeoxyglucose (18F-FDG) positron emission tomography/computed tomography (PET/CT) for identification of lesions in patients with recurrent medullary thyroid carcinoma (MTC). In addition, we analyzed the correlation between the calcitonin (Ct), carcinoembryonic antigen (CEA) levels, each doubling time (DT), and PET positivity. We evaluated the reliability of the 150 pg/mL Ct cutoff set by the American Thyroid Association guidelines for further imaging (including 18F-DOPA PET/CT).Methods
We prospectively recruited 18 patients with recurrent MTC, identified by elevation of Ct or CEA. Each patient underwent a 18F-FDG PET/CT and a 18F-DOPA PET/CT.Results
Abnormal uptakes were detected with 18F-DOPA (n=12) and 18F-FDG (n=9), (sensitivity of 66.7% vs. 50%; p<0.01). Twenty-eight lesions were detected with 18F-DOPA vs. 16 lesions with 18F-FDG (1.56±1.5 vs. 0.89±1.18 lesions per patient; p=0.01). None of our patients showed additional lesions with 18F-FDG in comparison to 18F-DOPA. Patient-based detection rate increased significantly with Ct levels ≥150 pg/mL vs. Ct<150 pg/mL for both 18F-DOPA (sensitivity 90.9% vs. 28.6%; p=0.013) and 18F-FDG PET/CT (sensitivity 72.7% vs. 14.3%; p=0.025). Using a CEA cutoff of ≥5 ng/mL, detection rates of 18F-DOPA and 18F-FDG PET/CT were 81.1% and 72.7%, respectively. No correlation between Ct-DT or CEA-DT and PET positivity was found. Histological confirmation was obtained in eight patients.Conclusions
18F-DOPA PET/CT appears to be superior to 18F-FDG PET/CT in detecting and locating lesions in patients with recurrent MTC. This technique tends to be especially useful in patients with negative results in other imaging modalities and Ct≥150 pg/mL or CEA≥5 ng/mL.7.
Beuthien-Baumann B Strumpf A Zessin J Bredow J Kotzerke J 《European journal of nuclear medicine and molecular imaging》2007,34(10):1604-1609
Purpose In patients with medullary thyroid carcinoma (MTC), rising levels of the tumour markers calcitonin and CEA after primary surgery
indicate tumour recurrence or metastases. The only chance of cure is the resection of localised tumour tissue. For positron
emission tomography (PET) with 18F-fluorodeoxyglucose (18F-FDG) and 18F-dihydroxyphenylalanine (18F-DOPA), sensitivities of 78% and 63% have been reported, but in a considerable percentage of MTC patients the source of tumour
marker elevation is not detected. The aim of this retrospective data evaluation was to compare the value of PET with 18F-FDG, 18F-DOPA and the amino acid tracer 3-O-methyl-6-[18F]fluoro-DOPA (18F-OMFD) in the detection of MTC recurrence.
Methods Fifteen patients with elevated calcitonin were investigated with PET as part of their individual clinical work-up. All patients
underwent 18F-FDG PET and 18F-DOPA PET, and ten patients underwent 18F-OMFD PET.
Results With 18F-FDG, seven patients showed foci in the neck, mediastinum, upper abdomen or bone. In seven patients, 18F-DOPA revealed suspicious foci; five of these seven patients showed partially corresponding uptake of 18F-FDG in the neck and mediastinum. Two of these patients underwent surgery and metastases were verified. With 18F-OMFD, a small focus in the liver was suspected in one patient without a correlate on 18F-FDG PET, 18F-DOPA PET or conventional imaging.
Conclusion
18F-FDG and 18F-DOPA showed foci that were highly suspicious for local recurrence or metastasis of MTC, although histological verification
in these patients with numerous previous surgical interventions was performed in only two patients. The amino acid tracer
18F-OMFD had no diagnostic impact in these patients. 相似文献
8.
Aim
The aim of this study was to assess the combined use of the radiotracers 18F-FDG and 18F-NaF in treatment response evaluation of a group of multiple myeloma (MM) patients undergoing high-dose chemotherapy (HDT) followed by autologous stem cell transplantation (ASCT) by means of static (whole-body) and dynamic PET/CT (dPET/CT).Patients and methods
Thirty-four patients with primary, previously untreated MM scheduled for treatment with HDT followed by ASCT were enrolled in the study. All patients underwent PET/CT scanning with 18F-FDG and 18F-NaF before and after therapy. Treatment response by means of PET/CT was assessed according to the European Organization for Research and Treatment of Cancer (EORTC) 1999 criteria. The evaluation of dPET/CT studies was based on qualitative evaluation, semi-quantitative (SUV) calculation, and quantitative analysis based on two-tissue compartment modelling and a non-compartmental approach leading to the extraction of fractal dimension (FD).Results
An analysis was possible in 29 patients: three with clinical complete response (CR) and 26 with non-CR (13 patients near complete response-nCR, four patients very good partial response-VGPR, nine patients partial response-PR). After treatment, 18F-FDG PET/CT was negative in 14/29 patients and positive in 15/29 patients, showing a sensitivity of 57.5 % and a specificity of 100 %. According to the EORTC 1999 criteria, 18F-FDG PET/CT-based treatment response revealed CR in 14 patients (18F-FDG PET/CT CR), PR in 11 patients (18F-FDG PET/CT PR) and progressive disease in four patients (18F-FDG PET/CT PD). In terms of 18F-NaF PET/CT, 4/29 patients (13.8 %) had a negative baseline scan, thus failed to depict MM. Regarding the patients for which a direct lesion-to-lesion comparison was feasible, 18F-NaF PET/CT depicted 56 of the 129 18F-FDG positive lesions (43 %). Follow-up 18F-NaF PET/CT showed persistence of 81.5 % of the baseline 18F-NaF positive MM lesions after treatment, despite the fact that 64.7 % of them had turned to 18F-FDG negative. Treatment response according to 18F-NaF PET/CT revealed CR in one patient (18F-NaF PET/CT CR), PR in five patients (18F-NaF PET/CT PR), SD in 12 patients (18F-NaF PET/CT SD), and PD in seven patients (18F-NaF PET/CT PD). Dynamic 18F-FDG and 18F-NaF PET/CT studies showed that SUVaverage, SUVmax, as well as the kinetic parameters K1, influx and FD from reference bone marrow and skeleton responded to therapy with a significant decrease (p?<?0.001).Conclusion
F-FDG PET/CT demonstrated a sensitivity of 57.7 % and a specificity of 100 % in treatment response evaluation of MM. Despite its limited sensitivity, the performance of 18F-FDG PET/CT was satisfactory, given that 6/9 false negative patients in follow-up scans (66.7 %) were clinically characterized as nCR, a disease stage with very low tumor mass. On the other hand, 18F-NaF PET/CT does not seem to add significantly to 18F-FDG PET/CT in treatment response evaluation of MM patients undergoing HDT and ASCT, at least shortly after therapy.9.
Lin FI Rao JE Mittra ES Nallapareddy K Chengapa A Dick DW Gambhir SS Iagaru A 《European journal of nuclear medicine and molecular imaging》2012,39(2):262-270
Purpose
Typically, 18F-FDG PET/CT and 18F-NaF PET/CT scans are done as two separate studies on different days to allow sufficient time for the radiopharmaceutical from the first study to decay. This is inconvenient for the patients and exposes them to two doses of radiation from the CT component of the examinations. In the current study, we compared the clinical usefulness of a combined 18F-FDG/18F-NaF PET/CT scan with that of a separate 18F-FDG-only PET/CT scan. 相似文献10.
Paulo Schiavom Duarte Luciana Audi de Castroneves Heitor Naoki Sado Marcelo Tatit Sapienza Ana Amélia Fialho de Oliveira Hoff Carlos Alberto Buchpiguel 《Nuclear Medicine and Molecular Imaging》2018,52(4):318-323
Herein, we report a case of a 19-year-old man with multiple endocrine neoplasia type 2B (MEN2B) and medullary thyroid carcinoma (MTC) diagnosed when he was 12 years of age. The patient had previously undergone total thyroidectomy, cervical radiotherapy, and chemotherapy. He progressed with known bone, pulmonary, and lymph node metastases and was scanned with 18F-fluoride (18F-NaF) and 68Ga-dotatate whole-body positron emission tomography/computed tomography (PET/CT) for metastatic disease monitoring. We found that the MTC bone metastases and soft tissue calcified metastases were better characterized on 18F-NaF PET/CT than on 68Ga-dotatate PET/CT. This case illustrates that the 18F-NaF PET/CT could be helpful not only to the detection of bone metastases but also to the detection of calcified soft tissue metastases in patients with MTC. 相似文献
11.
Alexander Haug Christoph J. Auernhammer Björn Wängler Reinhold Tiling Gerwin Schmidt Burkhard Göke Peter Bartenstein Gabriele Pöpperl 《European journal of nuclear medicine and molecular imaging》2009,36(5):765-770
Aim To compare the diagnostic impact of 68Ga-DOTA-TATE and 18F-DOPA PET in the diagnosis of well-differentiated metastatic neuroendocrine tumours (NET).
Methods PET/CT using both 68Ga-DOTA-TATE and 18F-DOPA was performed in 25 patients with histologically proven metastatic NET (nine gut, five pancreas, six lung, one paranasal
sinus, four with unknown primary). Analyses of PET examinations were patient-based (pathological uptake: yes/no), and based
on tumour regions (primary tumour if present and metastases of liver, lung, bones and lymph nodes). The results were compared
with the results of contrast enhanced CT, and with plasma serotonin levels, which were available in 24 of the 25 patients.
Results Patient-based sensitivities were 96% for 68Ga-DOTA-TATE PET and 56% for 18F-DOPA PET. 68Ga-DOTA-TATE PET delineated metastases in 54 of 55 positive metastatic tumour regions in contrast to 29 of 55 delineated by
18F-DOPA PET. Overall, 68Ga-DOTA-TATE was superior to 18F-DOPA in 13 patients (two patients showed fewer positive tumour regions with 18F-DOPA PET). The results were comparable in 12 patients. In 13 of 24 patients, plasma serotonin levels were elevated, and
11 of these 13 patients showed pathological uptake of 18F-DOPA. Of the 11 patients with normal levels of serotonin, 3 also showed positive 18F-DOPA uptake. In patients positive for 18F-DOPA uptake the maximum tumour SUVs were correlated with the levels of serotonin (r=0.66, p=0.01).
Conclusion In this study 68Ga-DOTA-TATE PET proved clearly superior to 18F-DOPA PET for detection and staging of NET. 18F-DOPA uptake tended to be increased in those patients with elevated plasma serotonin. We conclude that 18F-DOPA PET should be employed in patients with NET with negative 68Ga-DOTA-TATE PET and elevated plasma serotonin. 相似文献
12.
Elba C. Etchebehere Brian P. Hobbs Denái R. Milton Osama Malawi Shreyaskumar Patel Robert S. Benjamin Homer A. Macapinlac 《European journal of nuclear medicine and molecular imaging》2016,43(5):860-870
Purpose
Twelve years ago a meta-analysis evaluated the diagnostic performance of 18F-fluorodeoxyglucose (FDG) positron emission tomography (PET) in assessing musculoskeletal soft tissue lesions (MsSTL). Currently, PET/CT has substituted PET imaging; however, there has not been any published meta-analysis on the use of PET/CT or a comparison of PET/CT with PET in the diagnosis of MsSTL. Therefore, we conducted a meta-analysis to identify the current diagnostic performance of 18F-FDG PET/CT and determine if there is added value when compared to PET.Methods
A systematic review of English articles was conducted, and MEDLINE PubMed, the Cochrane Library, and Embase were searched from 1996 to March 2015. Studies exploring the diagnostic accuracy of 18F-FDG PET/CT (or dedicated PET) compared to histopathology in patients with MsSTL undergoing investigation for malignancy were included.Results
Our meta-analysis included 14 articles composed of 755 patients with 757 soft tissue lesions. There were 451 (60 %) malignant tumors and 306 benign lesions. The 18F-FDG PET/CT (and dedicated PET) mean sensitivity, specificity, accuracy, positive predictive value, and negative predictive value for diagnosing MsSTL were 0.96 (0.90, 1.00), 0.77 (0.67, 0.86), 0.88 (0.85, 0.91), 0.86 (0.78, 0.94), and 0.91 (0.83, 0.99), respectively. The posterior mean (95 % highest posterior density interval) for the AUC was 0.92 (0.88, 0.96). PET/CT had higher specificity, accuracy, and positive predictive value when compared to a dedicated PET (0.85, 0.89, and 0.91 vs 0.71, 0.85, and 0.82, respectively).Conclusion
18F-FDG PET/CT and dedicated PET are both highly accurate in the diagnosis of MsSTL. PET/CT is more accurate and specific and has a higher positive predictive value than PET.13.
18F-fluoro-2-deoxy-d-glucose positron emission tomography (18F-FDG PET/CT) has developed into the standard of care for investigating patients with non-small cell lung cancer (NSCLC) to
determine the optimal treatment. However, although the majority of patients with NSCLC do have intense uptake of tracer, false
negatives do occur and should be considered. We report cases of patients that have synchronous NSCLCs. In both cases, there
was intense uptake of FDG in one tumour type, with very low grade uptake in the separate tumour. Histology confirmed separate
lung malignancies, demonstrating that differential FDG uptake may not always be inflammatory and should be considered to have
a separate malignant aetiology. 相似文献
14.
Akira Toriihara Makoto Ohtake Kensuke Tateishi Ayako Hino-Shishikura Tomohiro Yoneyama Yoshio Kitazume Tomio Inoue Nobutaka Kawahara Ukihide Tateishi 《Annals of nuclear medicine》2018,32(4):264-271
Objective
The potential of positron emission tomography/computed tomography using 62Cu-diacetyl-bis (N4-methylthiosemicarbazone) (62Cu-ATSM PET/CT), which was originally developed as a hypoxic tracer, to predict therapeutic resistance and prognosis has been reported in various cancers. Our purpose was to investigate prognostic value of 62Cu-ATSM PET/CT in patients with glioma, compared to PET/CT using 2-deoxy-2-[18F]fluoro-d-glucose (18F-FDG).Method
56 patients with glioma of World Health Organization grade 2–4 were enrolled. All participants had undergone both 62Cu-ATSM PET/CT and 18F-FDG PET/CT within mean 33.5 days prior to treatment. Maximum standardized uptake value and tumor/background ratio were calculated within areas of increased radiotracer uptake. The prognostic significance for progression-free survival and overall survival were assessed by log-rank test and Cox’s proportional hazards model.Results
Disease progression and death were confirmed in 37 and 27 patients in follow-up periods, respectively. In univariate analysis, there was significant difference of both progression-free survival and overall survival in age, tumor grade, history of chemoradiotherapy, maximum standardized uptake value and tumor/background ratio calculated using 62Cu-ATSM PET/CT. Multivariate analysis revealed that maximum standardized uptake value calculated using 62Cu-ATSM PET/CT was an independent predictor of both progression-free survival and overall survival (p?<?0.05). In a subgroup analysis including patients of grade 4 glioma, only the maximum standardized uptake values calculated using 62Cu-ATSM PET/CT showed significant difference of progression-free survival (p?<?0.05).Conclusions
62Cu-ATSM PET/CT is a more promising imaging method to predict prognosis of patients with glioma compared to 18F-FDG PET/CT.15.
Hee Jeong Park Seong Young Kwon Sang-Geon Cho Jahae Kim Ho-Chun Song Sung Sun Kim Yeon Hong Yoon Jin Gyoon Park 《Nuclear Medicine and Molecular Imaging》2016,50(4):348-352
Giant cell tumor (GCT) is a generally benign bone tumor accounting for approximately 5 % of all primary bone neoplasms. Cystic components in GCTs that indicate secondary aneurysmal bone cysts (ABCs) are reported in 14 % of GCTs. Although both of them have been described separately in previous reports that may show considerable fluorodeoxyglucose (FDG) uptake despite their benign nature, the findings of GCT with secondary ABC on 18F-FDG positron emission tomography/computed tomography (PET/CT) have not been well-known. We report a case of GCT with secondary ABC in a 26-year-old woman. 18F-FDG PET/CT revealed a heterogeneous hypermetabolic lesion in the left proximal femur with the maximum standardized uptake value of 4.7. The solid components of the tumor showed higher FDG uptake than the cystic components. These observations suggest that the ABC components in GCTs show heterogeneous metabolic patterns on 18F-FDG PET/CT. 相似文献
16.
Jihyun Kim Jeong-Ok Lee Jin Ho Paik Won Woo Lee Sang Eun Kim Yoo Sung Song 《Annals of nuclear medicine》2017,31(1):1-11
Purpose
Diffuse large B-cell lymphoma (DLBCL) is a pathologically heterogeneous disease with different prognoses according to its molecular profiles. Despite the broad usage of 18F-fluoro-2-dexoxy-d-glucose (FDG) positron emission tomography/computed tomography (PET/CT), previous studies that have investigated the value of interim 18F-FDG PET/CT in DLBCL have given the controversial results. The purpose of this study was to evaluate the prognostic value of interim 18F-FDG PET/CT in DLBCL according to germinal center B cell-like (GCB) and non-GCB molecular profiling.Methods
We enrolled 118 newly diagnosed DLBCL patients treated with rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisolone (R-CHOP). Interim 18F-FDG PET/CT scans performed after 2 or 3 cycles of R-CHOP treatment were evaluated based on the Lugano response criteria. Patients were grouped as GCB or non-GCB molecular subtypes according to immunohistochemistry results of CD10, BCL6, and MUM1, based on Hans’ algorithm.Results
In total 118 DLBCL patients, 35 % were classified as GCB, and 65 % were classified as non-GCB. Interim PET/CT was negative in 70 %, and positive in 30 %. During the median follow-up period of 23 months, the positive interim 18F-FDG PET/CT group showed significantly inferior progression free survival (PFS) compared to the negative interim 18F-FDG PET/CT group (P = 0.0004) in entire patients. A subgroup analysis according to molecular profiling demonstrated significant difference of PFS between the positive and negative interim 18F-FDG PET groups in GCB subtype of DLBCL (P = 0.0001), but there was no significant difference of PFS between the positive and negative interim 18F-FDG PET groups in non-GCB subtype of DLBCL.Conclusions
Interim 18F-FDG PET/CT scanning had a significant predictive value for disease progression in patients with the GCB subtype of DLBCL treated with R-CHOP, but not in those with the non-GCB subtype. Therefore, molecular profiles of DLBCL should be considered for interim 18F-FDG PET/CT practice.17.
Clément Morgat Fritz-Line Vélayoudom-Céphise Paul Schwartz Martine Guyot Delphine Gaye Delphine Vimont Jürgen Schulz Joachim Mazère Marie-Laure Nunes Denis Smith Elif Hindié Philippe Fernandez Antoine Tabarin 《European journal of nuclear medicine and molecular imaging》2016,43(7):1258-1266
Context
Somatostatin receptor scintigraphy with 111In-pentetreotide (SRS) is used to detect duodenopancreatic neuroendocrine tumors (dpNETs) in multiple endocrine neoplasia type 1 (MEN1). However, SRS has limited sensitivity for this purpose. Positron emission tomography/computed tomography (PET/CT) with 68Ga-DOTA-TOC has a higher rate of sporadic dpNETs detection than SRS but there is little data for dpNETs detection in MEN1.Purpose
To compare the performances of 68Ga-DOTA-TOC PET/CT, SRS and contrast-enhanced computed tomography (CE-CT) to diagnose dpNETs in MEN1.Design and setting
Single-institution prospective comparative studyPatients and methods
Nineteen consecutive MEN1 patients (aged 47?±?13 years) underwent 68Ga-DOTA-TOC PET/CT, SRS, and CE-CT within 2 months in random order. Blinded readings of images were performed separately by experienced physicians. Unblinded analysis of CE-CT, combined with additional magnetic resonance imaging, endoscopic-ultrasound, 18F-2-fluoro-deoxy-d-glucose (18F-FDG) PET/CT or histopathology results served as reference standard for dpNETs diagnosis.Results
The sensitivity of 68Ga-DOTA-TOC PET/CT, SRS, and CE-CT was 76, 20, and 60 %, respectively (p?<?0.0001). All the true-positive lesions detected by SRS were also depicted on 68Ga-DOTA-TOC PET/CT. 68Ga-DOTA-TOC PET/CT detected lesions of smaller size than SRS (10.7?±?7.6 and 15.2?±?5.9 mm, respectively, p?<?0.03). False negatives of 68Ga-DOTA-TOC PET/CT included small dpNETs (<10 mm) and 18F-FDG PET/CT positive aggressive dpNETs. No false positives were recorded. In addition, whole-body mapping with 68Ga-DOTA-TOC PET/CT identified extra-abdominal MEN1-related tumors including one neuroendocrine thymic carcinoma identified by the three imaging procedures, one bronchial carcinoid undetected by CE-CT and three meningiomas undetected by SRS.Conclusions
Owing to higher diagnostic performance, 68Ga-DOTA-TOC PET/CT (or alternative 68Ga-labeled somatostatin analogues) should replace 111In-pentetreotide in the investigation of MEN1 patients.18.
Sampanna Jung Rayamajhi Bhagwant Rai Mittal Venkata Nagarjuna Maturu Ritesh Agarwal Amanjit Bal Pranab Dey Jaya Shukla Dheeraj Gupta 《Annals of nuclear medicine》2016,30(3):207-216
Purpose
There is currently no single modality for accurate characterization of enlarged mediastinal lymph nodes into benign or malignant. Recently 18F-fluorothymidine (FLT) has been used as a proliferation marker. In this prospective study, we examined the role of 18F-fluorodeoxyglucose (18F-FDG) positron emission tomography/computed tomography (PET/CT) and 18F-FLT PET/CT in categorizing mediastinal lymph nodes as benign or malignant.Materials and methods
A total of 70 consecutive patients with mediastinal lymphadenopathy detected on computed tomography (CT) or chest radiograph underwent whole body 18F-FLT PET/CT and 18F-FDG PET/CT (within 1 week of each other). Lymph nodal tracer uptake was determined by calculation of standardized uptake value (SUV) with both the tracers. Results of PET/CT were compared with histopathology of the lymph nodes.Results
Histopathology results showed thirty-seven patients with sarcoidosis, seven patients with tuberculosis, nine patients with non-small cell lung cancer, five patients with Hodgkin’s lymphoma and twelve patients with non-Hodgkin’s lymphoma. The mean FDG SUVmax of sarcoidosis, tuberculosis, Hodgkin’s and non-Hodgkin’s lymphoma was 12.7, 13.4, 8.2, and 8.8, respectively, and the mean FLT SUVmax was 6.0, 5.4, 4.4, and 3.8, respectively. It was not possible to characterize mediastinal lymphadenopathy as benign or malignant solely based on FDG SUVmax values (p > 0.05) or FLT SUVmax values (p > 0.05). There was no significant difference in FDG uptake (p > 0.9) or FLT uptake (p > 0.9) between sarcoidosis and tuberculosis. In lung cancer patients, the FDG SUVmax and FLT SUVmax of those lymph nodes with tumor infiltration on biopsy was 6.7 and 3.9, respectively, and those without nodal infiltration was 6.4 and 3.7, respectively, and both the tracers were not able to characterize the nodal status as malignant or benign (p > 0.05).Conclusion
Though 18F-FLT PET/CT and 18F-FDG PET/CT reflect different aspects of biology, i.e., proliferation and metabolism, respectively, neither tracer could provide satisfactory categorization of benign and malignant lymph nodes. The results of this study clearly suggest that differentiation of mediastinal nodes into benign and malignant solely based on SUVmax values cannot be relied upon, especially in settings where tuberculosis and sarcoidosis are common.19.
Gianpiero Manca Eleonora Vanzi Domenico Rubello Francesco Giammarile Gaia Grassetto Ka Kit Wong Alan C. Perkins Patrick M. Colletti Duccio Volterrani 《European journal of nuclear medicine and molecular imaging》2016,43(7):1360-1375
18F-FDG PET/CT plays a crucial role in the diagnosis and management of patients with head and neck squamous cell cancer (HNSCC). The major clinical applications of this method include diagnosing an unknown primary tumour, identifying regional lymph node involvement and distant metastases, and providing prognostic information. 18F-FDG PET/CT is also used for precise delineation of the tumour volume for radiation therapy planning and dose painting, and for treatment response monitoring, by detecting residual or recurrent disease. Most of these applications would benefit from a quantitative approach to the disease, but the quantitative capability of 18F-FDG PET/CT is still underused in HNSCC. Innovations in PET/CT technology promise to overcome the issues that until now have hindered the employment of dynamic procedures in clinical practice and have limited “quantification” to the evaluation of standardized uptake values (SUV), de facto a semiquantitative parameter, the limits of which are well known to the nuclear medicine community. In this paper the principles of quantitative imaging and the related technical issues are reviewed so that professionals involved in HNSCC management can reflect on the advantages of “true” quantification. A discussion is then presented on how semiquantitative information is currently used in clinical 18F-FDG PET/CT applications in HNSCC, by discussing the improvements that could be obtained with more advanced and “personalized” quantification techniques. 相似文献
20.
Domenico Albano Giovanni Bosio Raffaele Giubbini Francesco Bertagna 《Japanese journal of radiology》2017,35(10):574-583