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1.
Ana María García Vicente Esther Domínguez Ferreras Victoria Sánchez Pérez Víctor Manuel Poblete García José Carlos Villa Guzmán Fátima Jiménez Aragón Maria Dolores Pineda Pineda Ceferino Molino Trinidad Ángel Soriano Castrejón 《European journal of radiology》2013
Purpose
Evaluate the diagnostic performance of contrast enhanced CT/PET (ceCT/PET) in the response assessment of patients with colorectal cancer liver metastases.Methods
33 ce CT/PET studies of 19 patients with colorectal liver metastases were prospectively evaluated. All of them, 13 (68.4%) were males and 6 (31.6%) females. Mean age and range were 63 [42–78]. All patients were treated with neoadjuvant chemotherapy. In all cases post-therapy diagnostic confirmation of liver lesions was obtained. A ce CT PET/was obtained 1 h after the injection of 370 MBq of 18F-FDG.Metabolic and morphologic studies were evaluated by two blinded nuclear physicians and radiologists respectively to assess the location, size and suspected diagnosis of lesions (benign or malignant). A combined assessment of both techniques was performed.The final diagnosis was established by histopathology or clinical/radiological follow-up greater than 6 months.Results
A total of 120 liver lesions were identified, 115 were malignant and 5 benign.From the malignant lesions, 105 were identified with the ceCT, 44 with the PET and 109 with ceCT/PET. All of the benign lesions were correctly classified with any of the three imaging techniques.The sensitivity of PET, ceCT and ceCT/PET were of 38%, 91% and 95% respectively and the specificity was 100% in all three of the diagnostic studies.Conclusion
Administration of intravenous contrast in the PET/CT is mandatory to evaluate treatment response rate of liver metastases due to the limitations of isolated metabolic images in these cases. 相似文献2.
Yin Q Wang M Wang C Wu Z Yuan F Chen K Tang Y Zhao X Miao F 《European journal of radiology》2012,81(11):3010-3018
Purpose
The purpose of this study was to determine if characteristic features on computed tomographic and (or) magnetic resonance imaging can differentiate benign and malignant solid pseudopapillary neoplasms (SPN).Materials and methods
A total of 82 pathologically diagnosed SPN patients were included. CT and MRI were reviewed by 3 radiologists. Each tumor was analyzed through the clinical and imaging features.Results
The highest occurrence of malignant SPN was observed in the group of patients (11–19 years old) followed by the group of patients (50–65 years old). When the tumor was located in the tail and the size was equal or larger than 6.0 cm, the positive and predictive value, the predictive value, sensitivity and specificity for a malignant SPN were 61.5%, 100%, 100% and 78.6%, respectively. Presence of complete encapsulation was more frequent in benign SPNs, but focal discontinuity in the malignant SPNs. Amorphous or scattered calcifications, all near-solid tumors and presence of upstream pancreatic ductal was found in the benign SPNs.Conclusion
A focal discontinuity of the capsule, large tumor size (>6.0 cm) and a pancreatic tail location may suggest malignancy of SPN. In contrast, tumors with amorphous or scattered calcifications, and all near-solid tumors may be indicative of benignancy. Age (less than 20 or more than 50 years old) is a possible risk factor of SPN. In comparison to other pancreatic neoplasms, such as ductal adenocarcinoma, a complete/incomplete pseudo-capsule, without upstream pancreatic duct dilatation and lymph nodes metastasis, and the presence of internal calcification and hemorrhage are more likely SPN. 相似文献3.
Karsten Beiderwellen Benedikt Gomez Christian Buchbender Verena Hartung Thorsten D. Poeppel Felix Nensa Hilmar Kuehl Andreas Bockisch Thomas C. Lauenstein 《European journal of radiology》2013
Objectives
To assess the value of PET/MRI with [18F]-FDG using a whole body protocol for the depiction and characterization of liver lesions in comparison to PET/CT.Methods
70 patients (31 women, 39 men) with solid tumors underwent [18F]-FDG PET/CT and followed by an additional PET/MRI using an integrated scanner. Two readers rated the datasets (PET/CT; PET/MRI) regarding conspicuity of hepatic lesions (4-point ordinal scale) and diagnostic confidence (5-point ordinal scale). Median scores for lesion conspicuity and diagnostic confidence were compared using Wilcoxon's rank sum test. Prior examinations, histopathology and clinical follow-up (116 ± 54 days) served as standard of reference.Results
36 of 70 (51%) patients showed liver lesions. Using PET/CT and PET/MRI all patients with liver metastases could correctly be identified. A total of 97 lesions were found (malignant n = 26; benign n = 71). For lesion conspicuity significantly higher scores were obtained for PET/MRI in comparison to PET/CT (p < 0.001). Significantly better performance for diagnostic confidence was observed in PET/MRI, both for malignant as for benign lesions (p < 0.001).Conclusions
PET/MRI, even in the setting of a whole body approach, provides higher lesion conspicuity and diagnostic confidence compared to PET/CT and may therefore evolve as an attractive alternative in oncologic imaging. 相似文献4.
Almir G.V. Bitencourt Eduardo N.P. Lima Rubens Chojniak Elvira F. Marques Juliana A. Souza Wesley P. Andrade Marcos D. Guimarães 《European journal of radiology》2014
Objective
To evaluate the impact of adding 18F-fluorine-2-deoxy-d-glucose (FDG) positron emission tomography (PET) in the evaluation of suspicious breast lesions on magnetic resonance imaging (MRI).Methods
Sixty patients with suspicious breast lesions on MRI were selected to perform a PET–CT in prone position, dedicated to the evaluation of the breasts. The areas with increased 18F-FDG concentration relative to normal parenchyma were considered positive on PET–CT. Fusion of PET and MRI images (PET–MRI) was performed on a dedicated workstation to better locate corresponding lesions, and its findings were compared with histological results.Results
76 lesions were evaluated, including 64 mass lesions (84.2%) and 12 non-mass lesions (15.8%). Lesions’ mean diameter on MRI was 29.6 ± 19.2 mm (range 6–94 mm). PET–CT showed increased metabolically activity on 57 lesions (75.0%), with mean maximum SUV of 5.7 ± 5.0 (range 0.8–23.1). On histopathology, there were 17 (22.4%) benign and 59 (79.7%) malignant lesions. Considering all lesions, PET–MRI fusion provided 89.8% sensitivity, 76.5% specificity and 86.8% accuracy. Considering only mass lesions higher than 10 mm, PET–MRI fusion provided 95.8% sensitivity, 83.3% specificity and 93.3% accuracy.Conclusion
The inclusion of 18F-FDG PET on the evaluation of suspicious breast lesions on MRI helped to differentiate benign from malignant breast lesions, especially for mass lesions with a diameter higher than 10 mm. 相似文献5.
Lu YY Chen JH Liang JA Wang HY Lin CC Lin WY Kao CH 《European journal of radiology》2012,81(9):2411-2416
Aim
The purpose of the current study was to conduct a systemic review and meta-analysis of the published literature to evaluate the diagnostic accuracy of FDG PET or PET/CT in urinary bladder cancer.Materials and methods
The authors conducted a systematic MEDLINE search of articles published between January 2000 and December 2010. Two reviewers independently assessed the methodological quality of each study. We conducted a meta-analysis of pooled sensitivity and specificity in detecting primary and metastatic lesions of bladder cancer.Results
Six studies met the inclusion criteria. The pooled sensitivity and specificity of PET/CT for primary lesion detection of bladder cancer were 0.90 (95% CI: 0.70–0.99) and 1.00 (95% CI: 0.74–1.00), respectively. The pooled sensitivity and specificity of FDG PET or PET/CT for staging or restaging (metastatic lesions) of bladder cancer were 0.82 (95% CI: 0.72–0.89) and 0.89 (95% CI: 0.81–0.95), respectively.Conclusion
The diagnostic accuracy of FDG PET or PET/CT is good in metastatic lesions of urinary bladder cancer. Due to the small number of patients and limited number of studies analyzed, the diagnostic capability of FDG PET or PET/CT in detection of primary bladder wall lesions could not be assessed. 相似文献6.
Ahmed Wafaie Hassan Kassem Magdy Kotb Rania Zeitoun Salwa Ismail 《The Egyptian Journal of Radiology and Nuclear Medicine》2014
Background and purpose
Combined PET/CT using 18F-FDG is widely used in evaluation of various malignancies; in their initial staging and more efficiently in their follow up; hence, the importance of evaluation of its diagnostic role in the imaging of skeletal metastases. The purpose of this study is to evaluate precisely the efficiency of FDG PET/CT in detection and characterization of osseous metastatic lesions compared to isolated PET and CT in various malignancies.Patients and methods
The study included 123 patients divided into seven groups of malignancies to whom PET/CT was done. In this study population, a detailed retrograde lesion based analysis was performed for a total of 1705 detected bone lesions on PET, CT and fused PET/CT images. Sensitivity, specificity, PPV and NPV of each modality were calculated. Semi-quantitative and ROC curve analysis of the lesions were performed to study the relationship between the lesion’s SUV and its corresponding morphologic pattern on CT and to set a reliable SUVmax cut-off value that can predict the presence of malignant lesion.Results
The calculated fused PET/CT sensitivities and specificities in various malignancies ranged from 95.2% to 99.6% and 75% to 100%, respectively. The combined PET/CT has significantly improved the low CT sensitivity (especially in lymphoma) as well as both CT and PET specificities. Our ROC analysis suggested using SUVmax of 3 as a cut off value for malignant osseous lesions.Conclusion
Fused PET/CT was highly efficient in evaluation of skeletal metastases with superior performance in: detection of early bone marrow infiltration not apparent on CT, resolution of metabolic activity before definite signs of complete healing on CT, detection of missed sclerotic metastases on PET due to their relatively low metabolic activity, detection of intra and extra osseous recurrence and differentiation of benign from malignant bone lesions. 相似文献7.
Naglaa Mohamed Abdel Razek Amr Osama Azab Omar Sherif Omar Hussein Osama Soliman 《The Egyptian Journal of Radiology and Nuclear Medicine》2012
Background
Since 80% of abnormalities found in the breast are benign upon biopsy, New techniques must provide more precise evaluation of these indeterminate lesions .MR spectroscopy is one of the available new techniques on MRI, it refers to the measurement of biochemical compounds in the tissue using specialized sequences.Purpose
To evaluate the role of MR spectroscopy using the state of the art high field magnet (3 Tesla) as a diagnostic method in indeterminate breast lesions (BIRADS 3 and 4 lesions) aiming at decreasing the un-necessary breast intervention.Material & method
In this study 240 female patients classified as BIRADS 3 & 4 by sono-mammography (Sono-MX) were examined by MRI using the multiphase dynamic sequence and proton MR spectroscopy using a high field magnet (3 Tesla). Single voxel technique after adequate shimming was used.Results
Eighty eight cases (35%) were malignant (based on the presence of high choline peak in the spectrum) and 152 cases (65%) were benign (no choline peak). MR-spectroscopy has increased the sensitivity & specificity of Dynamic MR-Mammography for diagnosis of probable lesion from 93.6% (88/94) and 77.9% (152/195) to 96.7% (88/91) and 95.5% (152/159), False positive results were found in 4 cases and False negative results were found in 7 cases.Conclusion
MR Proton spectroscopy in the high field magnet (3T) offered additional information that increased the sensitivity and specificity of the conventional dynamic MRI in evaluating probable breast lesions and hence reduced the need for unnecessary intervention. 相似文献8.
Wong KK Arabi M Bou-Assaly W Marzola MC Rubello D Gross MD 《European journal of radiology》2012,81(3):441-450
Background and purpose
Incidentally discovered adrenal masses are commonly seen with high resolution diagnostic imaging performed for indications other than adrenal disease. Although the majority of these masses are benign and non-secretory, their unexpected discovery prompts further biochemical and often repeated imaging evaluations, sufficient to identify hormonally active adrenal masses and/or primary or metastatic neoplasms to the adrenal(s). In the present paper we investigate the role of PET and PET/CT for the detection of adrenal incidentalomas in comparison with CT and MRI.Materials and methods
a systematic revision of the papers published in PubMed/Medline until September 2010 was done.Results
The diagnostic imaging approach to incidentally discovered adrenal masses includes computed tomography (CT), magnetic resonance imaging (MRI) and more recently positron emission tomography (PET) with radiopharmaceuticals designed to exploit mechanisms of cellular metabolism, adrenal substrate precursor uptake, or receptor binding.Conclusion
The functional maps created by PET imaging agents and the anatomic information provided by near-simultaneously acquired, co-registered CT facilitates localization and diagnosis of adrenal dysfunction, distinguishes unilateral from bilateral disease, and aids in characterizing malignant primary and metastatic adrenal disease. 相似文献9.
Cho N Kim SM Park JS Jang M Kim SY Chang JM Moon WK 《European journal of radiology》2012,81(7):1520-1526
Objectives
To retrospectively investigate the added value of kinetic features measured by computer-aided diagnosis (CAD) for differentiating benign and malignant contralateral breast lesions detected by preoperative MRI in breast cancer patients.Methods
This study was approved by our institutional review board, and the requirement for informed consent was waived. Fifty-two breast MR images and their CAD kinetic features were obtained for 52 consecutive breast cancer patients with contralateral breast lesions detected by preoperative MRI and confirmed by excision (23 cancers and 29 benign lesions). Three experienced radiologists independently reviewed the MR images without CAD information and assessed probabilities of malignancy. Four weeks later, these probabilities were reanalyzed using stored CAD data. Diagnostic performances and detection rates of delayed washout components were compared between interpretations without and with CAD for each reader.Results
Use of MR CAD increased detection of washout component by 2.4- to 3.7-fold than visual assessment for enhancing contralateral lesions, which increased sensitivity (91% vs. 87% in reader 1; 96% vs. 74% in reader 2; 91% vs. 70% in reader 3) and decreased specificity, but statistical significance was only found for decreased specificity in one reader (52% vs. 28%, P = 0.039), and overall performance (areas under ROC curves 0.672 vs. 0.616 in reader 1; 0.624 vs. 0.603 in reader 2; 0.706 vs. 0.590 in reader 3) remained unimproved.Conclusion
Addition of MR CAD increased sensitivity and decreased specificity than radiologist's assessment alone for differentiating benign and malignant contralateral lesions in breast cancer patients and overall performance remained unimproved. 相似文献10.
Vassiou K Kanavou T Vlychou M Poultsidi A Athanasiou E Arvanitis DL Fezoulidis IV 《European journal of radiology》2009,70(1):69-76
Objective
Evaluation of the diagnostic value of magnetic resonance mammography and comparison with conventional mammography and ultrasonography in cases of women with suspicious breast lesions.Subjects and methods
Sixty-nine women (age range 39–68 years) with 78 focal breast lesions were examined with mammography, ultrasonography and dynamic magnetic resonance mammography. The lesions were classified according to the Breast Imaging Reporting and Data System (BI-RADS) lexicon of the American College of Radiology for each diagnostic method. Histological reports were available after biopsy or surgical excision of the lesions.Results
Pathological examination confirmed that 53 lesions were malignant and 25 benign. Conventional mammography estimated a total of 59/78 lesions as malignant with 44 true positive lesions, ultrasonography estimated a total of 50/78 lesions as malignant with 44 true positive lesions and magnetic resonance mammography estimated a total of 66/78 lesions as malignant with 52 true positive lesions. Sensitivity and specificity of magnetic resonance mammography in the diagnosis of malignancy was 98.1% and 44%, of conventional mammography 83% and 40% and of ultrasonography 83% and 76%. Negative predictive value for magnetic resonance mammography was 91.7%, for ultrasonography 67.9% and for mammography 52.6% for malignancies.Conclusion
Magnetic resonance mammography has the highest negative predictive value compared with mammography and ultrasound in cases of suspicious breast lesions. The combination of morphologic and enhancement criteria can improve the diagnostic capability of magnetic resonance mammography (MRM) in breast lesion characterization. 相似文献11.
Shigeki Nagamachi Ryuichi Nishii Hideyuki Wakamatsu Youichi Mizutani Shogo Kiyohara Seigo Fujita Shigemi Futami Tatefumi Sakae Eiji Furukoji Shozo Tamura Hideo Arita Kazuo Chijiiwa Keiichi Kawai 《Annals of nuclear medicine》2013,27(6):554-563
Purpose
This study aimed at demonstrating the feasibility of retrospectively fused 18F FDG-PET and MRI (PET/MRI fusion image) in diagnosing pancreatic tumor, in particular differentiating malignant tumor from benign lesions. In addition, we evaluated additional findings characterizing pancreatic lesions by FDG-PET/MRI fusion image.Methods
We analyzed retrospectively 119 patients: 96 cancers and 23 benign lesions. FDG-PET/MRI fusion images (PET/T1 WI or PET/T2WI) were made by dedicated software using 1.5 Tesla (T) MRI image and FDG-PET images. These images were interpreted by two well-trained radiologists without knowledge of clinical information and compared with FDG-PET/CT images. We compared the differential diagnostic capability between PET/CT and FDG-PET/MRI fusion image. In addition, we evaluated additional findings such as tumor structure and tumor invasion.Results
FDG-PET/MRI fusion image significantly improved accuracy compared with that of PET/CT (96.6 vs. 86.6 %). As additional finding, dilatation of main pancreatic duct was noted in 65.9 % of solid types and in 22.6 % of cystic types, on PET/MRI-T2 fusion image. Similarly, encasement of adjacent vessels was noted in 43.1 % of solid types and in 6.5 % of cystic types. Particularly in cystic types, intra-tumor structures such as mural nodule (35.4 %) or intra-cystic septum (74.2 %) were detected additionally. Besides, PET/MRI-T2 fusion image could detect extra benign cystic lesions (9.1 % in solid type and 9.7 % in cystic type) that were not noted by PET/CT.Conclusions
In diagnosing pancreatic lesions, FDG-PET/MRI fusion image was useful in differentiating pancreatic cancer from benign lesions. Furthermore, it was helpful in evaluating relationship between lesions and surrounding tissues as well as in detecting extra benign cysts. 相似文献12.
Takeo Kasuya Ukihide Tateishi Kazufumi Suzuki Hiromitsu Daisaki Yuji Nishiyama Masaharu Hata Tomio Inoue 《European journal of radiology》2013
Purpose
The aim of this study is to ascertain role of respiratory-gated PET/CT for accurate diagnosis of pancreatic tumors.Materials and methods
Prior to clinical study, the phantom study was performed to evaluate the impact of respiratory motion on lesion quantification. Twenty-two patients (mean age 65 years) with pancreatic tumors were enrolled. Pathological diagnoses by surgical specimens consisted of pancreatic cancer (n = 15) and benign intraductal papillary mucinous neoplasm (IPMN, n = 7). Whole-body scan of non-respiratory-gated PET/CT was performed at first, and subsequent respiratory-gated PET/CT for one bed position was performed. All PET/CT studies were performed prior to surgery. The SUV max obtained by non-respiratory-gated PET/CT and respiratory-gated PET/CT, and percent difference in SUVmax (%SUVmax) were compared.Results
The profile curve of 5 respiratory bin image was most similar to that of static image. The third bin of 5 respiratory bin image showed highest FWHM (24.0 mm) and FWTM (32.7 mm). The mean SUVmax of pancreatic cancer was similar to that of benign IPMN on non-respiratory-gated PET/CT (p = 0.05), whereas significant difference was found between two groups on respiratory-gated PET/CT (p = 0.016). The mean %SUV of pancreatic cancer was greater than that of benign IPMN (p < 0.0001). Identification of the primary tumor in pancreatic head (n = 13, 59%) was improved by using respiratory-gated PET/CT because of minimal affection of physiological accumulation in duodenum.Conclusion
Respiratory-gated PET/CT is a feasible technique for evaluation of pancreatic tumors and allows more accurate identification of pancreatic tumors compared with non-respiratory-gated PET/CT. 相似文献13.
Hohmann J Skrok J Basilico R Jennett M Müller A Wolf KJ Albrecht T 《European journal of radiology》2012,81(3):e317-e324
Objective
To compare on-site and blinded off-site reading of baseline ultrasound (US) and contrast enhanced ultrasound (CEUS) for classification and characterisation of focal liver lesions.Materials and methods
99 patients (57 women and 42 men, age range 18–89 years, mean age: 59 years) with 53 malignant and 46 benign liver lesions were studied with unenhanced US followed by contrast enhanced US after injection of 2.4 ml SonoVue® (Bracco, Milano, Italy). Image interpretation was performed on-site with clinical information available by consensus of two readers and off-site by two independent blinded readers at two different centers. Comparison of pre and post contrast scans and of the different readers was performed. Reference examinations were histology, intraoperative US, MRI or CT.Results
Sensitivity for malignancy improved from 81/89/66% (on-site/off-site reader 1/2) before to 100/96/96% post contrast administration (p < 0.05, except for reader 1). Specificity improved from 48/48/54% on baseline US to 89/80/76% on CEUS (p < 0.05). Accuracy for specific lesion diagnosis was 62/59/50% pre and 90/77/72% post contrast (p < 0.05). Classification and characterisation post contrast were mildly inferior for off-site reading. Agreement between on-site and off-site readers of unenhanced scans was fair (κ = 0.29–0.39) while it was good for CEUS (κ = 0.63–0.79).Conclusions
CEUS improves classification and characterisation of focal liver lesions and interobserver agreement compared to conventional US. Classification and characterisation post contrast were mildly but statistically significantly better for on-site than for off-site reading. 相似文献14.
M.C. Aznar R. Sersar J. Saabye C.N. Ladefoged F.L. Andersen J.H. Rasmussen J. Löfgren T. Beyer 《European journal of radiology》2014
Purpose
In combined PET/MRI standard PET attenuation correction (AC) is based on tissue segmentation following dedicated MR sequencing and, typically, bone tissue is not represented. We evaluate PET quantification in whole-body (WB)-PET/MRI following MR-AC without considering bone attenuation and then investigate different strategies to account for bone tissue in clinical PET/MR imaging. To this purpose, bone tissue representation was extracted from separate CT images, and different bone representations were simulated from hypothetically derived MR-based bone classifications.Methods
Twenty oncology patients referred for a PET/CT were injected with either [18F]-FDG or [18F]-NaF and imaged on PET/CT (Biograph TruePoint/mCT, Siemens) and PET/MRI (mMR, Siemens) following a standard single-injection, dual-imaging clinical WB-protocol. Routine MR-AC was based on in-/opposed-phase MR imaging (orgMR-AC). PET(/MRI) images were reconstructed (AW-OSEM, 3 iterations, 21 subsets, 4 mm Gaussian) following routine MR-AC and MR-AC based on four modified attenuation maps. These modified attenuation maps were created for each patient by non-linear co-registration of the CT images to the orgMR-AC images, and adding CT bone mask values representing cortical bone: 1200 HU (cortCT), spongiosa bone: 350 HU (spongCT), average CT value (meanCT) and original CT values (orgCT). Relative difference images of the PET following AC using the modified attenuation maps were compared. SUVmean was calculated in anatomical reference regions and for PET-positive lesions.Results
The relative differences in SUVmean across patients following orgMR-AC and orgCT in soft tissue lesions and in bone lesions were similar (range: 0.0% to −22.5%), with an average underestimation of SUVmean of 7.2% and 10.0%, respectively when using orgMR-AC. In bone lesions, spongCT values were closest to orgCT (median bias of 1.3%, range: –9.0% to 13.5%) while the overestimation of SUVmean with respect to orgCT was highest for cortCT (40.8%, range: 1.5% to 110.8%). For soft tissue lesions the bias was highest using cortCT (13.4%, range: –2.3% to 17.3%) and lowest for spongCT (–2.2%, range: 0.0% to –13.7%).Conclusions
In PET/MR imaging using standard MR-AC PET uptake values in soft lesions and bone lesions are underestimated by about 10%. In individual patients this bias can be as high as 22%, which is significant during clinical follow-up exams. If bone segmentation is available, then assigning a fixed attenuation value of spongious bone to all bone structures appears reasonable and results in only a minor bias of 5%, or less in uptake values of soft tissue and bone lesions. 相似文献15.
Purpose
To compare FDG PET/CT and CT for the guidance of percutaneous biopsies with histological confirmation of lesions.Methods
We prospectively evaluated 323 patients of whom 181 underwent FDG PET/CT-guided biopsy (total 188 biopsies) and 142 underwent CT-guided biopsy (total 146 biopsies). Biopsies were performed using the same PET/CT scanner with a fluoroscopic imaging system. Technical feasibility, clinical success and complication rates in the two groups were evaluated.Results
Of the 188 biopsies with PET/CT guidance, 182 (96.8%) were successful with conclusive tissue samples obtained and of the 146 biopsies with CT guidance, 137 (93.8%) were successful. Therefore, 6 of 188 biopsies (3.1%) with PET/CT guidance and 9 of 146 (6.1%) with CT guidance were inconclusive (p?=?0.19). Due to inconclusive histological results, 4 of the 188 lesions (2.1%) were rebiopsied with PET/CT guidance and 3 of 146 lesions (2.0%) were rebiopsied with CT guidance. Histology demonstrated that 142 of 188 lesions (75.5%) were malignant, and 40 (21.2%) were benign in the PET/CT-guided group, while 89 of 146 lesions (60.9%) were malignant and 48 (32.8%) were benign in the CT-guided group (p?=?0.004 and 0.01, respectively). Patients with a histological diagnosis of benign lesion had no recurrence of disease with a minimum of 6 months follow-up. Of the 188 PET/CT-guided biopsies, 6 (3.1%) were repeat biopsies due to a previous nondiagnostic CT-guided biopsy performed in a different diagnostic centre. The interval between the two biopsies was less than a month in all cases. Histology revealed five malignant lesions and one benign lesion among these. The complication rate in the PET/CT-guided biopsy group was 12.7% (24 of 188), while in the CT-guided group, was 9.5% (14 of 146, p?=?0.26). Therefore, there was no significant difference in complication rates between PET/CT and CT guidance.Conclusion
PET/CT-guided biopsy is already known to be a feasible and accurate method in the diagnostic work-up of suspected malignant lesions. This prospective analysis of a large number of patients demonstrated the feasibility and advantages of using PET/CT as the imaging method of choice for biopsy guidance, especially where FDG-avid foci do not show corresponding lesions on the CT scan. There were no significant differences in the ability to obtain a diagnostic specimen or in the complication rates between PET/CT and CT guidance.16.
Purpose
To highlight the role of ADC value measurement in differentiating benign from malignant ovarian tumors.Materials and methods
Twenty patients with ovarian neoplasms underwent conventional MRI including ADC value calculation before surgery. Retrospective analysis of the pathological specimen with lesion morphology, signal characteristics, enhancement criteria and correlation with the appearance at DWI followed by ADC value measurement were obtained.Results
Twenty patients with ovarian mass lesions were included. They were divided into purely solid, purely cystic and complex solid/cystic lesions. All solid malignant lesions showed diffusion restriction as well as the wall and septations of most malignant cystic lesion however, except one case. All benign lesions did not display diffusion restriction in DWI. The best cut off value of ADC to discriminate between benign and malignant lesions was 0.9 with specificity of 100%, sensitivity of 88.9%, NPV of 75%, PPV of 100% and accuracy of 91.7%.Conclusion
Addition of ADC value measurement to conventional MRI increases its specificity from 78.6% to 85.7% which could be useful in differentiating benign from malignant lesions. 相似文献17.
Faten Fawzy Hazim I. Tantawy Ahmad Ragheb Safwat Abo Hashem 《The Egyptian Journal of Radiology and Nuclear Medicine》2013
Background
Vertebral collapse is a common problem due to benign bone marrow lesions, trauma or malignant process. The diagnosis is often correctly predicted from characteristic imaging appearance. Some vertebral collapses have atypical imaging appearance that may cause diagnostic confusion.Aim
To evaluate the value of the ADC obtained in DW-MR sequences for the differentiation between benign and malignant bone marrow lesions.Patients
Sixty patients were included in this study, referred from Neurosurgery and Radiotherapy Departments and proved to have vertebral compression based on conventional MR imaging.Results
The ADC value resulted in statistically significant characterization between (osteoporotic and post-traumatic collapse) and (malignant vertebral collapse) (P < 0.0001) while there was no statistically significant findings between infective spondylodiscitis and malignant vertebral collapse (P > 0.05). The sensitivity, specificity, PPV, NPD of DWI and ADC values in differentiating benign from malignant vertebral collapse were 100%, 83.3%, 60% and 100% respectively.Conclusions
ADC values are a useful complementary MRI tool to characterize bone marrow lesions, in order to distinguish acute benign fractures from malignant or infectious bone marrow lesions. However, ADC values are not valuable in order to differentiate malignancy from infection with diagnostic overlap in the subacute traumatic vertebral collapse. 相似文献18.
Fuccio C Castellucci P Schiavina R Guidalotti PL Gavaruzzi G Montini GC Nanni C Marzola MC Rubello D Fanti S 《European journal of radiology》2012,81(8):e893-e896
Aim
to evaluate the utility of 11C-choline PET/CT in prostate cancer (PC) patients who have demonstrated a biochemical recurrence and a negative bone scintigraphy (BS).Materials and methods
123 consecutive PC patients (mean age 67.6 years; range 54–83) with a biochemical relapse (mean PSA value 3.3 ng/mL; range 0.2–25.5) after radical prostatectomy (RP) were included in our retrospective study. Patients underwent a BS that resulted negative and a 11C-choline PET/CT within 4 months from BS (range: 1 day to 4 months; mean: 2.5 months). Validation of results was established by: (1) a positive biopsy, (2) a positive subsequent BS, CT or MR and (3) a normalization of 11C-choline uptake after systemic therapy or a progression of the disease.Results
11C-choline PET/CT was positive in 42/123 patients (34.1%). 11C-choline PET/CT detected lesions in: bone (10 patients), lymph-nodes (20 patients), bone and lymph nodes (7 patients), bone and lung (1 patient), lymph-nodes and lung (1 patient), local relapse (3 patients). Overall, 11C-choline PET/CT showed a total of 30 unknown bone lesions in 18/123 (14.6%) patients.Conclusion
11C-choline PET/CT showed a better sensitivity than BS in patients with biochemical relapse after RP: 11C-choline PET/CT detected unknown bone lesions in 18/123 (14.6%) patients. 相似文献19.
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20.
Ehab A. Abdelgawad Ahmed Mahrous A. Rahim Al shimaa Mahfooz A. Rahman 《The Egyptian Journal of Radiology and Nuclear Medicine》2018,49(4):899-902