Feasible Method to enable clear visualization of suspected bladder cancer with 18F-FDG PET/CT

PurposeTo evaluate value of a new method in detecting bladder lesion with ¹⁸F-FDG PET/CT.MethodsRoutine and delayed scans of 14 patients were retrospectively studied. All these bladder lesions were confirmed by pathology. By increasing display threshold of SUVmax, routine images were analyzed for the second time.ResultsOf 12 ¹⁸F-FDG-avid cases, 10 cases were confirmed to be primary bladder carcinoma, 2 false-positive cases were inflammation. There were 25% positive cases on routine display and 50% on display with increased SUVmax threshold.ConclusionThe method can effectively increase the sensitivity and accuracy in detecting bladder cancer with ¹⁸F-FDG PET/CT.     

Spectrum of malignant renal and urinary bladder tumors on 18F-FDG PET/CT: a pictorial essay

A wide variety of malignant renal and urinary bladder diseases can be detected on ¹⁸F-FDG PET/CT. Although the PET/CT findings are often nonspecific, the aim of this atlas was to demonstrate that the spectrum of renal and urinary bladder malignancy that can be evaluated with PET/CT is much broader than current medical literature would suggest. PET/CT readers and oncologists should be aware of the variety of urological tumor types that can be detected on PET/CT and some of the patterns of ¹⁸F-FDG uptake that can be observed in these cases.     

18F-FDG PET/CT of cervical carcinoma

OBJECTIVE: This article outlines the role of FDG PET/CT in patients with cervical carcinoma for evaluating tumor extent, assessing treatment response, and detecting disease recurrence. CONCLUSION: There is increasing evidence that FDG PET/CT has a role in the primary evaluation of cervical carcinoma-in particular, for evaluating lymph node status and distant metastatic disease. PET/CT is also helpful to determine prognosis, assess treatment response, and evaluate disease recurrence.     

Recurrent bladder carcinoma: clinical and prognostic role of 18 F-FDG PET/CT

Aim

A small number of studies evaluated the detection rate of lesions from bladder carcinoma (BC) of 18 F-FDG PET/CT in the restaging process. However, the prognostic role of FDG PET/CT still remains unclear. The aim of the present study was to evaluate the accuracy, the effect upon treatment decision, and the prognostic value of FDG PET/CT in patients with suspected recurrent BC.

Materials and Methods

Forty-one patients affected by BC underwent FDG PET/CT for restaging purpose. The diagnostic accuracy of visually interpreted FDG PET/CT was assessed compared to histology (n?=?8), other diagnostic imaging modalities (contrast-enhanced CT in 38/41 patients and MRI in 15/41) and clinical follow-up (n?=?41). Semiquantitative PET values (SUVmax, SUVmean, SUL, MTV, TLG) were calculated using a graph-based method. Progression-free survival (PFS) and overall survival (OS) were assessed by using Kaplan-Meier curves. The risk of progression (hazard ratio, HR) was computed by Cox regression analysis by considering all the available variables.

Results

PET was considered positive in 21 of 41 patients. Of these, recurrent BC was confirmed in 20 (95 %). Sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of FDG PET/CT were 87 %, 94 %, 95 %, 85 %, 90 %. AUC was 0.9 (95 %IC 0.8-1). Bayesian positive and negative likelihood ratios were 14.5 and 0.13, respectively. FDG PET/CT findings modified the therapeutic approach in 16 patients (modified therapy in 10 PET-positive patients, watch-and-wait in six PET-negative patients). PFS was significantly longer in patients with negative scan vs. those with pathological findings (85 % vs. 24 %, p?<?0.05; HR?=?12.4; p?=?0.001). Moreover, an unremarkable study was associated with a longer OS (88 % vs. 47 % after 2 years and 87 % vs. 25 % after 3 years, respectively, p?<?0.05). Standardized uptake value (SUV)max?>?6 and total lesion glycolysis (TLG)?>?8.5 were recognized as the most accurate thresholds to predict PFS (2-year PFS 62 % for SUVmax?<?6 vs. 15 % for SUVmax?>?6, p?=?0.018; 2-year PFS 66 % for TLG?<?8.5 vs. 18 % for TLG?>?8.5, p?=?0.09).

Conclusion

A very good diagnostic performance for FDG PET/CT was confirmed in patients with suspected recurrent BC. FDG PET/CT allowed for a change in treatment decision in about 40 % of cases and showed an important prognostic value in assessing PFS and OS.

     

False positive 18F-FDG PET/CT due to inflamed concha bullosa

A 62-year-old woman with a history of breast cancer was referred for an (18)F-FDG PET/CT scan. She had an active upper respiratory infection at the time of examination. An FDG avid (SUV(max) = 7.7) middle turbinate was identified, correlating with an inflamed concha bullosa. A short review of concha bullosa is given.     

18F-FDG PET/CT in the assessment of carcinoma of unknown primary origin

PURPOSE: Metastatic cancers of unknown primary origin are characterised by a poor prognosis, with a survival rate from diagnosis of approximately 12 months. Conventional radiological imaging allows detection of 20%-27% of primary cancers, whereas the detection rate with positron emission tomography (PET) is 24%-40%. The aim of this study was to assess the role of 18F-fluorodeoxyglucose (FDG) PET/computed tomography (CT) in the identification of occult primary cancers. MATERIALS AND METHODS: The study population consisted of 38 consecutive patients with histologically proven metastatic disease and negative or nonconclusive conventional diagnostic procedures. All patients were studied by 18F-FDG PET performed according to the standard procedure (6 h of fasting, intravenous injection of 370 MBq 18F-FDG, and image acquisition with a PET/CT scanner for 4 min per bed position). RESULTS: 18F-FDG-PET/CT detected the occult primary cancer in 20 cases (53%), showing higher sensitivity than that reported for any other imaging modality, including PET. CONCLUSIONS: The encouraging results, if validated by larger series, support the use of PET/CT in patients with carcinoma of unknown primary origin and negative conventional imaging results.     

~(18)F-FDG PET/CT在食管癌的应用进展

食管癌恶性程度高、预后差,严重威胁了人类健康,18F-FDG PET/CT集功能和解剖信息于一身,这种医学影像技术在食管癌的应用优势日益受到广大医务工作者的关注。本文综述了18F-FDG PET/CT在食管癌的诊断、分期、复发、疗效和预后评估、放射治疗计划制定等方面的研究进展。     

Left ventricular myocardium metastasis in a patient with primary renal cell carcinoma detected by 18F-FDG PET/CT

Cardiac metastases from renal cell carcinoma are rare but should be recognized when present. We report PET/CT findings in a patient with headache and diplopia and cerebral metastasis from an unknown primary of clear cell adenocarcinoma origin. PET/CT revealed uptake with a left renal cell carcinoma, and revealed multiple metastatic lesions, including an FDG-avid metastasis within the left ventricular myocardium.     

Cosmetic-related changes on 18F-FDG PET/CT

We present 4 cases of cosmetic-related changes on 18F-FDG PET/CT. These cases represent post-treatment changes from facial juvederm injection, silicone injection in the chest wall and gluteal areas, paraffin injection in the gluteal region, and liposuction. Recognition of cosmetic-related changes and their appearance on PET and CT will help to avoid potential false-positive interpretations.     

A rare case of malignant urinary bladder paraganglioma with distant metastases demonstrated by 18F-FDG PET/CT

Urinary bladder paragangliomas are rare tumors, with malignant ones being still rarer. Demonstration of metastases by imaging is crucial, as histological examination of primary cannot reliably distinguish between benign and malignant tumors. We describe a rare case of a patient with malignant urinary bladder paraganglioma in whom 18F-FDG PET/CT was useful in detection of regional lymph nodal and distant metastases. In addition, 18F-FDG PET/CT suggested an easily accessible site of biopsy to confirm the metastatic disease.     

细支气管肺泡癌^18F—FDG PET／CT显像的代谢和形态特征

目的分析细支气管肺泡癌（BAC）在^18F-脱氧葡萄糖（FDG）PET／CT图像中的代谢和形态结构特征,并与非细支气管肺泡型腺癌（non—BAC AC）的显像结果进行比较,探讨PET／CT在BAC诊断及鉴别诊断中的价值。方法回顾性分析经病理检查确诊的32例BAC及55例non—BAC AC的FDG PET／CT显像资料。测量病灶最大标准摄取值（SUVmax）,分析病灶位置、形态及边界、密度分布及其他典型CT结构征象。统计分析比较2组的平均SUVmax,评价与肿瘤分型有关的CT征象,比较单独PET、CT及PET和CT联合诊断的准确性。采用SPSS12．0软件对数据行t检验、McNemar检验、Fisher精确检验等。结果BAC组共47个病灶,non—BACAC组共63个病灶,组间SUVmax差异有统计学意义（1．51±0．17与6．28±3．04,t=-10．374,P〈0．0001）。BAC组纯磨玻璃密度影（45％的病灶,21／47）是相关的CT征象（Fisher精确检验,P〈0．0001）。结合PET代谢和CT解剖结构特征的联合诊断准确性与单独PET或CT对比,差异均有统计学意义（P=0．001和0．039）,诊断准确性分别为88％（28／32）、47％（15／32）和66％（21／32）。结论理解FDG PET／CT显像中BAC的代谢和形态结构特征,有利于提高诊断准确性。如动态观察中呈持续的CT磨玻璃密度影,即使低FDG摄取,也要考虑BAC可能。     

11C-胆碱对18F-FDG PET/CT显像诊断鼻咽癌和肝细胞肝癌的补充价值

目的 探讨11C-胆碱(CHO) PET/CT对18F-FDG PET/CT显像诊断鼻咽癌(NPC)和HCC的补充价值.方法 将明确诊断的NPC和HCC患者纳入该研究.该研究经医院伦理委员会通过,患者均签署知情同意书.2007年12月至2010年1月,15例局部进展型NPC和76例HCC患者均行18 F-FDG PET/CT显像,其中43例(15例NPC和28例HCC)同时行局部11C-CHO PET/CT显像.病灶处出现18 F-FDG或11C-CHO高摄取者为阳性.半定量分析采用SUVmax、肿瘤/脑(T/B)比值和肿瘤/肝(T/L)比值等指标.统计学分析采用两样本t检验、x2检验、Fisher确切概率法和直线相关分析.结果 (1)在15例局部进展型NPC患者中,病灶处18F-FDG SUVmax明显高于11 C-CHO SUVmax (12.81 ±5.00与6.84±2.76;t =6.416,P＜0.01),但11C-CHO PET/CT显像T/B比值明显高于18F-FDG PET/CT显像(18.62±7.95与1.38±0.59;t=8.801,P＜0.01).2种显像剂在病灶处的摄取结果明显相关(r =0.712,P＜0.01).与18F-FDG PET/CT显像比较,11C-CHO显像改进了50.0％(12/12与6/12;x2=8.000,P＜0.05)患者颅内侵犯病灶、4/14患者颅底侵犯病灶和3/3患者眼眶侵犯病灶的显示.(2)在76例HCC患者中,63.1％ (48/76)的患者18F-FDG PET/CT显像阳性.在28例18 F-FDG PET/CT显像阴性者中,71.4％ (20/28)的患者11C-CHO PET/CT显像阳性.18F-FDG联合11C-CHO使PET/CT诊断HCC的灵敏度从63.1％(48/76)提高到89.5％ (68/76;x2=14.559,P＜0.01).与18F-FDG PET/CT显像比较,11C-CHO PET/CT显像倾向易于检出高分化HCC[6/9与35.7％(5/14);P =0.214];在检测中分化HCC方面,两者差异无统计学意义[6/7与72.0％(18/25),P=0.648].11C-CHO PET/CT显像在检测直径＜5.0 cm的HCC方面较18 F-FDG PET/CT显像灵敏[72.7％ (16/22)与42.1％ (16/38);x2=5.249,P＜0.05],特别是＜2.0 cm病灶[5/7与0/7;P=0.021].结论 11C-CHO与18F-FDG相结合可提高PET/CT对局部进展型NPC T分期诊断的准确性.11C-CHO可弥补18F-FDG显像在高中分化HCC诊断中的不足,从而提高PET/CT的诊断灵敏度.     

18F-FDG PET显像在原发性胃癌中的应用

目的　探讨1 8F 脱氧葡萄糖 (FDG)PET显像在原发性胃癌中的应用价值。方法　 2 2例经组织病理学证实的原发性胃癌患者行1 8F FDGPET显像。图像分析采用视觉及半定量方法 [标准摄取值 (SUV) ],其中 2 1例与近期CT结果比较。结果　①PET检出原发性胃癌的灵敏度为 91% (2 0 2 2例 ) ,2例假阴性均为印戒细胞癌 ,原发肿瘤直径 <1cm (T1 期 )。② 17例手术患者中 ,胃局部淋巴结转移 10例 ,PET检出 6例 ,其灵敏度、特异性和准确性分别为 6 0 %、10 0 %和 75 % ,CT仅检出 1例。③PET检出远处转移 9例 ,CT仅检出 5例。结论　1 8F FDGPET诊断原发性胃癌较为灵敏 ,检出胃癌局部淋巴结及远处转移可能优于CT。