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1.
In POEMS syndrome the identification and biopsy of an osteosclerotic lesion or a lymph node typical of Castleman's disease (CD) is essential to establish the diagnosis and plan appropriate treatment. We report four patients in whom the localisation and identification of diagnostic bone lesions or lymphadenopathies were guided by fluorodeoxyglucose positron emission tomography integrated with computerised tomography (FDG PET/CT). FDG PET/CT identified bone lesions not detected with other techniques in one patient, and revealed hypermetabolic characteristics in bone lesions or adenopathies in the others, thus guiding the diagnostic biopsy in those with hypermetabolism. In conclusion, FDG PET/CT may be useful in detecting and selecting bone lesions and lymph nodes for biopsy in patients with suspected POEMS syndrome.  相似文献   

2.
Hibernoma is a rare benign but metabolically active tumor of brown fat origin, that can have cross-sectional imaging characteristics similar to those of other fat-containing tumors, such as lipomas and liposarcomas, and its presence can lead to false-positive interpretation by exhibiting increased F18-fluorodeoxyglucose (F18-FDG) activity. A 46-year-old woman was diagnosed with dermatofibrosarcoma protuberans underwent F18-FDG positron emission tomography/computed tomography (PET/CT) for detecting recurrence after excision. F18-FDG PET/CT showed incidental intense uptake in the back in addition to increased F18-FDG uptake at the previous lesion site. To our knowledge, this is the first case report of intense F18-FDG uptake in hibernoma in Korea.  相似文献   

3.
Myeloma is the most common primary bone malignancy. It accounts for 10% of all hematological malignancies and 1% of all cancers. In the United States, there are an estimated 16,000 new cases and over 11,000 deaths yearly due to myeloma. Plasma cell dyscrasias manifest themselves in a variety of forms that range from MGUS (monoclonal gammopathy of undetermined significance) and smoldering myeloma that require no therapy, to the “malignant” form of multiple myeloma. The role of imaging in the management of myeloma includes: an assessment of the extent of intramedullary bone disease, detection of any extramedullary foci, and severity of the disease at presentation; the identification and characterization of complications; subsequent assessment of disease status. This review will focus on the use of PET/CT and MR imaging for myeloma patients at the time of initial diagnosis and for follow-up management, based on current reports in the literature and our practice at the Marlene and Stewart Greenebaum Cancer Center, University of Maryland Medical Center in Baltimore, USA.  相似文献   

4.
噬血细胞综合征的18F-FDG PET/CT影像学特点   总被引:1,自引:0,他引:1  
目的探讨噬血细胞综合征的18F-FDG PET/CT显像的影像学特点。方法回顾性分析我院7例HLH临床资料和18F-FDG PET/CT影像资料。结果 7例患者均因不明原因发热入院,7例患者均符合HLH诊断指南2004修订版的标准。肝脏增大4例,3例合并FDG摄取增高,脾脏增大6例,5例合并FDG摄取增高,2例出现全身多发淋巴结增大并FDG摄取增高,2例表现为脑皮质FDG摄取弥漫性减低,6例出现肺部改变(肺炎、肺不张、胸腔积液等)。结论认识该疾病的18F-FDG PET/CT影像表现,有助于提高该疾病的诊断率。  相似文献   

5.
RATIONALE AND OBJECTIVES: We sought to assess the ability of (18)F-fluoro-2-deoxy-d-glucose (FDG) PET/CT to distinguish adrenal adenomas from nonadenomas in patients with suspected malignancy. METHODS: Fifty-nine adrenal masses were evaluated with coregistered (18)F-FDG PET (PET/CT). Two reviewers independently graded uptake of (18)F-FDG by visual inspection of the adrenal mass in comparison to liver and background. CT attenuation value of the adrenal mass and the standardized uptake value (SUV) of the mass, liver, background, and primary neoplasm (when visible) were measured. Mean SUVs of the adrenal mass, liver, and background and ratios of the SUVs were calculated. RESULTS: Of 47 adenomas, 43 measured <10 HU on unenhanced CT. Of 12, 12 nonadenomas measured >10 HU on unenhanced CT. Using qualitative assessment of FDG activity in the adrenal mass compared with liver, adenomas were less than, equal to, or more active than the liver in 51%, 38%, and 10%, respectively. Nonadenomas were less than, equal to, or more active than liver in 0%, 25%, and 75%, respectively. The mean SUV of adenomas (4.2) was significantly lower (P = .002) than that of their primary malignancies (9.2) but not that of liver (4.3). The mean SUV of adenomas was not significantly different than that of nonadenomas (5.2), but the mean adrenal/liver ratio (1.0) for the adenomas was significantly lower (P = .006) than that of the nonadenomas (2.1). CONCLUSION: Adrenal adenomas were better differentiated from nonadenomas using unenhanced CT measurements in combination with ratios of the SUVs. Adrenal mass activity, which was visibly less than liver, was more specific for adenoma, whereas adrenal mass activity visibly greater than liver was more specific for malignancy.  相似文献   

6.
POEMS syndrome is a multisystemic disorder related to a plasma cell dyscrasia. Radiologically, this syndrome is characterized by sclerotic focal bone lesions with a normal radionuclide bone scan. We report a case of POEMS syndrome with an expansile lytic lesion in the sternum showing periosteal reaction and soft tissue mass, which revealed locally increased uptake of radiotracer in bone scintigraphy. These unusual findings and the differential diagnosis are discussed. Received 8 March 1996; Revision received 6 September 1996; Accepted 28 April 1997  相似文献   

7.
目的评价18氟-脱氧葡萄糖(18FDG)PET/CT在原发性肝细胞癌中的应用价值.材料和方法28例患者被分成3组.第一组为未经相关治疗的HCC组,共13例;第二组为肝脏良性病变组,共9例;第三组为HCC治疗后疗效观察组,共6例.18FDG PET/CT影像学表现结合手术病理及临床随访,计算18FDG PET/CT对HCC诊断的敏感性,并分析标准摄取值(SUV)的影响因素.结果第一组患者Ⅰ型表现7例,Ⅱ型表现5例,Ⅲ型表现1例;第二组患者Ⅰ型表现0例,Ⅱ型表现4例,Ⅲ型表现5例;18FDG PET/CT对HCC诊断的灵敏度为53.8%,其SUV值的大小和肿瘤的生物学行为有关.第三组患者Ⅰ型表现5例,Ⅱ型表现0例,Ⅲ型表现1例,其SUV值的大小与肿瘤残留有关.结论18FDG PET/CT显像在HCC生物学特性评估及HCC治疗后疗效监测方面有明显优势.  相似文献   

8.
The aim of this study was to investigate physiological fluorine 18-labeled fluourodeoxyglucose accumulation in the gallbladder (GB) during clinical positron emission tomography (PET) examinations.

Three patient groups were included. In Group 1, nine patients with higher fluourodeoxyglucose (FDG) accumulation in the GB than in the liver were examined, followed up and finally diagnosed. In Group 2, the correlations between FDG GB accumulation and various parameters in 286 patients were investigated. In Group 3, changes in FDG GB accumulation between early and delayed PET scans were analyzed in 12 patients.

In Group 1, all nine patients who exhibited a high FDG GB accumulation had no evidence of GB disease. In Group 2, FDG GB accumulation was significantly correlated with the injection–scan time interval and inversely correlated with the GB size index. Group 3 showed a significant increase in FDG accumulation in the GB on delayed PET scans, compared with that seen on early scans.

In clinical PET studies, FDG accumulation within the GB is infrequently observed but may be due to FDG excretion into the bile. Recognition of this phenomenon may be important to avoid misdiagnosing physiological GB FDG accumulation as indicating a pathologic status and preventing unnecessary examinations.  相似文献   


9.
《Radiography》2023,29(1):145-151
IntroductionThe use of medical imaging for diagnosis, staging and follow-up in Oncology context is incredibly important, being the use of [18F]-FDG PET/CT particularly advantageous in specific contexts like the case of obese patients. However, imaging the latter can be challenging sometimes, since their own body size may affect overall image quality and adds technical difficulties for the operator(s) performing the examination.MethodsThis research project was developed with the aim of analysing the current personal practices of Portuguese Nuclear Medicine Technologists (NMTs) in the adaptation of 18F-FDG PET/CT oncological protocols for obese patients and comparing the results with parameters referenced in literature. A non-experimental research study was conducted using a survey delivered online to NMTs through social media platforms (Facebook® and LinkedIn®) and by sending the link directly to contacts within the research team professional and personal networks.ResultsAnswers from a total of 26 participants were obtained, with 88.5% of participants admitting modifying technical protocols in examinations for obese patients. Changes in PET protocols included an increase in the administered activity (60.9%), an increase in scan time per individual bed position (69.6%) and the use of Time-of-Flight (TOF) technology whenever available. Protocol changes in CT included increasing the mA (82.6%), raising the KVp (47.8%), the application of iterative reconstruction (69.6%) and the use of automatic exposure control (AEC) (52.2%). The remaining parameters (pitch, algorithm, slice thickness, display FOV, gantry rotation time and energy acceptance window) were claimed not to be modified by around 90% of professionals.ConclusionPortuguese NMTs tend to change the [18F]-FDG PET/CT protocols for obese patients. However, while some of the parameters appear to be contradictory or redundant, others require further optimisation, especially in the CT component.Implications for practiceEfforts should be made to optimize acquisition protocols used in [18F]-FDG PET/CT scans for obese patients.  相似文献   

10.
Purpose The diagnostic accuracy of [18F]fluorodeoxyglucose (FDG) PET is insufficient to characterise hepatocellular carcinoma (HCC) in liver masses and to diagnose all cases of recurrent HCC. HCC has been reported to take up [11C]acetate, but routine use of this tracer is difficult. Choline is another tracer of lipid metabolism, present in large amounts in HCC. In a proof-of-concept study, we evaluated [18F]fluorocholine (FCH) uptake by HCC and compared FCH PET/CT with FDG PET/CT.Methods Twelve patients with newly diagnosed (n=8) or recurrent HCC (n=4) were prospectively enrolled. HCC was assessed by histology in eight cases and by American Association for the Study of Liver Diseases (AASLD) criteria in four cases. All patients underwent whole-body PET/CT 10 min after injection of 4 MBq/kg FCH. Within 1 week, 9 of the 12 patients also underwent whole-body FDG PET/CT 1 h after injection of 5 MBq/kg FDG.Results The per-patient analysis showed a detection rate of 12/12 using FCH PET/CT for both newly diagnosed and recurrent HCC. The median signal to noise ratio was 1.5±0.38. There was a trend towards a higher FCH SUVmax in well-differentiated HCC (15.6±7.9 vs 11.9±0.9, NS). Of the nine patients who underwent FCH and FDG PET/CT, all nine were positive with FCH whereas only five were positive with FDG.Conclusion FCH provides a high detection rate for HCC, making it potentially useful in the initial evaluation of HCC or in the detection of recurrent disease. The favourable result of this proof-of-concept study opens the way to a phase III prospective study.  相似文献   

11.
Objective To determine the usefulness of FDG PET/CT scanning in the management and staging of myeloma and to assess its strengths and limitations.Design FDG PET/CT scans and all other available imaging studies were reviewed retrospectively from 16 consecutive patients by two experienced musculoskeletal radiologists and two nuclear medicine physicians working in consensus.Patients The 16 patients had undergone a total of 19 FDG PET/CT scans. Radiographs were available in all cases, including 13 skeletal surveys; 25 CT scans (16 chest, three abdominal, four pelvic, one spine, one neck) and 22 MR imaging studies (17 spine, three pelvic, two extremity) also were reviewed. Patients’ records were examined for relevant clinical information. All focal areas of abnormal FDG uptake were correlated with the other imaging studies to determine clinical significance. FDG PET/CT scans also were reviewed to see if small lesions shown on the other imaging studies could be identified in retrospect.Results The 12 men and four women had an average age of 58 years (range 30–69 years). All 16 patients had an established diagnosis of multiple myeloma, with average duration of disease, from time of initial diagnosis to review, of 30 months (range 6 months to 11+ years). The FDG PET/CT scans revealed a total of 104 sites (90 in bone, 14 soft tissue) that were suspicious for neoplastic activity based on a standardized uptake value (SUV) greater than 2.5. Fifty-seven of these sites (55%) were new or previously undetected. The other imaging studies (X-ray, CT, MR) and clinical information confirmed the other 47 areas but also revealed 133 other small skeletal lesions. Six of these 133 additional lesions showed mild FDG uptake on re-review of the PET/CT scans. The FDG PET/CT findings led to management changes in 9/16 patients. MR imaging revealed five cases of diffuse bone involvement (four spine, one scapula) that were not evident by FDG PET/CT.Conclusion FDG PET/CT scans are useful for the management and staging of myeloma. However, if PET/CT were the sole imaging study done, it would miss many additional small lytic skeletal lesions and could miss diffuse spine involvement.  相似文献   

12.

Objective

To evaluate the contrast medium enhancement and [18F]-FDG uptake of liver metastases in patients suffering from colon or breast carcinoma prior to therapy.

Material and methods

PET/CT (Philips Gemini) with 200 MBq [18F]-FDG and contrast medium was performed in 50 patients with colon and 39 patients with breast carcinoma. Lesions were characterized with the presence or the absence of a rim enhancement. The area size, the HUmean, HUmax, SUVmean, SUVmax of the lesion and of the liver were determined. The standard uptake values (SUVs) were correlated with the tumor markers CEA and CA 15-3.

Results

The lesions of colon carcinoma had HUmean-values of 70.7 ± 19.2 and of breast carcinoma 88.1 ± 21.7 (p < 0.0001). In breast cancer the SUVmean was 3.9 ± 1.3 versus 4.4 ± 1.9 in colon carcinoma (p = 0.0182). Lesion of colon carcinoma with rim enhancement had a significantly higher SUVmean (4.4 ± 1.5 versus 3.6 ± 1.2; p = 0.001) and SUVmax (6.7 ± 2.6 versus 5.1 ± 2.1; p = 0.000) than lesions without a rim enhancement. A good correlation between tumor markers and SUVsmax could be found in both tumor groups; r = 0.83 (p < 0.01) for colon carcinoma and r = 0.82 (p < 0.01) for breast carcinoma.

Conclusions

The rim enhancement of the lesions in colon carcinoma indicate a significantly higher SUV.  相似文献   

13.
目的:多发性骨髓瘤是一种浆细胞恶性增殖性疾病,大约有80%的患者存在骨骼侵犯.本文探讨多发性骨髓瘤的18F-fluorodexoxyglucose(18F-FDG)PET/CT表现特点,提高对多发性骨髓瘤的认识.方法:26例按2001年WHO诊断标准确诊为多发性骨髓瘤的患者,均在治疗前行18F-FDG PET/CT显像.所有患者均依赖骨髓穿刺或活检取得明确病理学诊断.结果:26名患者均出现不同程度的骨质疏松.25例患者出现多发性骨质破坏,占总数的96.2%;其中11例患者出现颅骨破坏,占42.3%;25例出现脊柱骨质破坏,占96.2%;15例出现胸骨骨质破坏,占57.7%;21例出现肋骨骨质破坏,占80.8%;21例出现骨盆骨质破坏,占80.8%.部分骨破坏病灶呈18F-FDG高代谢灶.结论:多发性骨髓瘤的18F-FDG PET/CT表现具有一定特征,结合临床、影像、实验室和病理学检查能提高本病的诊断率.  相似文献   

14.
目的 系统评价18F-FDOPA与18F-FDG PET/CT显像在脑肿瘤诊断中的临床价值.方法 采用Meta分析与直接比较方法.使用计算机检索中国期刊全文数据库、中文科技期刊数据库、万方数据库、中国生物医学文献数据库、PubMed、Embase、The Cochrane Library,从建库至2016年10月,搜索直接比较18F-FDOPA与18F-FDG PET/CT诊断脑肿瘤的诊断性试验.用Meta-Disc 1.4软件进行分析,计算两种不同显像剂的合并敏感度(sensitivity,SEN)、合并特异度(specificity,SPE)、合并阳性似然比(positive likelihood ratio,+LR)、合并阴性似然比(negative likelihood ratio,-LR)、诊断优势比(diagnostic odds ratio,DOR),并绘制综合受试者工作特征曲线计算曲线下面积(area under curve,AUC)与Q*值.结果 最终共纳入4篇文章,Meta 分析结果显示,18F-FDOPA PET/CT对脑肿瘤诊断的合并SEN为0.97(95% CI =0.90 ~ 1.00),SPE为0.67(95% CI =0.45 ~0.84),+LR为2.31 (95% CI=1.40 ~3.81),-LR为0.07 (95% CI =0.02~ 0.24),DOR为39.72(95% CI=8.94~176.48),AUC为0.9725,Q*为0.9239.18F-FDG PET/CT对脑肿瘤诊断的合并SEN为0.51(95%CI=0.39~0.63),SPE为0.75(95% CI=0.53 ~0.90,+LR为l.59(95% CI=0.70 ~ 3.61),-LR为0.63(95% CI =0.47 ~0.86),DOR为2.55(95% CI =0.82 ~7.92),AUC为0.5848,Q*为0.5638.结论 18F-FDOPA PET/CT显像诊断脑肿瘤的敏感性比18F-FDG高,对脑肿瘤具有良好的诊断价值,可作为脑肿瘤诊断的方法之一.  相似文献   

15.
目的 探讨18F-FDG PET/CT在鼻咽癌中的诊断价值.方法 回顾性分析我院2007年3月~2010年3月以鼻咽部肿块就诊的36例患者资料,所有患者均行鼻咽部18F-FDG PET/CT检查及鼻内镜下取材病检确诊.结果 24例病检后确诊为鼻咽癌患者,18F-FDG PET/CT检查均为局限性高代谢灶;12例病检后确诊为鼻咽部炎性肿块患者中,8例18F-FDG PET/CT检查均为鼻咽部局限性低代谢灶,考虑炎症,有4例18F-FDG PET/CT检查为鼻咽部局限性高代谢灶,误诊为鼻咽癌.结论 18F-FDG PET/CT检查是诊断鼻咽癌的较好方法,结合患者临床症状,可以为鼻咽部肿块的良恶性鉴别提供可靠依据.  相似文献   

16.
PET/CT在乳腺癌中的应用   总被引:2,自引:0,他引:2  
乳腺癌是女性最常见的恶性肿瘤,如能得到早期诊断并早期治疗可明显地改善患者的预后情况甚至可以完全治愈。近年来正电子发射断层显像(PET)以及18F-FDG的广泛应用极大地改善了肿瘤患者的诊断和分期问题,及时改变了相应的治疗方法,而单纯的PET显像由于解剖定位欠清,有时正常生理性摄取与异常病理性摄取可能会难以鉴别,PET/CT的出现弥补了上述缺点,使FDGPET/CT在乳腺癌的分期与再分期、疗效监测、术前评估、原发病灶的诊断以及治疗方案的制订中都体现出自身独特的优势。  相似文献   

17.
Purpose Co-registration accuracy in combined whole-body (WB) PET/CT imaging is impaired by respiration-induced mismatches between the CT and the PET. Furthermore, PET/CT misregistration may bias the PET tracer distribution following CT-based attenuation correction (CT-AC). With the introduction of multi-row CT technology of up to 16 detector rows into PET/CT designs, we investigated the incidence of respiration artifacts in WB PET/CT examinations of patients who were unable to follow any breath-hold instructions.Methods A total of 80 WB studies from six international sites operating PET/CT tomographs with 1-, 2-, 4-, 6-, 8-, and 16-row spiral CT were included. PET/CT examinations were acquired with the patients breathing normally during both the CT and the PET scan, and CT-AC was performed routinely. All studies were anonymized and reviewed independently by three radiologists and three nuclear medicine specialists. We report the frequency and severity of artifacts on CT and PET for the thorax and the abdomen.Results In WB PET/CT imaging of normally breathing patients, significant gains in diagnostic image quality can be expected from employing CT technology with six or more detector rows. In our study, fewer PET images appear distorted than corresponding CT images, which is due to the limited propagation of only mild CT image artifacts after the resampling of the CT-based attenuation map during CT-AC.Conclusion In whole-body PET/CT imaging of normally breathing patients, respiration-induced artifacts are reduced in both magnitude and prominence for PET/CT systems employing CT components of six or more detector rows.  相似文献   

18.

Purpose

The purpose of this study was to evaluate the role of integrated PET/CT in the staging of lung cancer compared with CT alone or PET alone.

Materials and methods

Thirty-three patients underwent integrated PET/CT for the staging of lung cancer. The tumor, node and metastasis (TNM) stages were assessed with CT, PET and integrated PET–CT and compared with the surgical and pathological staging.

Results

CT correctly evaluated the (T) status in (64%) of the patients, PET in (59%) and PET/CT in (86%). CT correctly evaluated the (N) status in (73%) of the patients, PET in (76%), and PET/CT (88%) with accuracy, sensitivity, specificity, PPV and NPV were 73%, 78%, 71%, 50% and 94% for CT, 76%, 67%, 79%, 55% and 95% for PET and 88%, 89%, 88%, 73% and 100% for PET/CT respectively, and for (M) status were 91%, 86%, 92%, 75% and 96% for CT, 88%, 71%, 92%, 71% and 92% for PET and 97%, 100%, 96%, 88% and 100% for PET/CT respectively. Regarding the overall TNM staging CT correctly staged 24 patients. PET correctly staged 23 cases while PET/CT correctly staged 30 cases. A significant difference in the accuracy of overall tumor staging between PET/CT and CT (P = 0.0412) or PET (P = 0.0233).

Conclusion

The integrated PET/CT is superior to either CT or PET in the staging of lung cancer which has an important impact on selection of the appropriate treatment regimen.  相似文献   

19.
ObjectivesThe purpose of this study was to evaluate the differential diagnostic value of 18F-fluorodeoxy glucose positron emission tomography/computed tomography (18F-FDG PET/CT) for benign and malignant testicular lesions.MethodsThe PET/CT scans of 53 patients with testicular lesions confirmed by biopsy or surgical pathology were retrospectively analyzed. There were 32 cases of malignant tumors and 21 cases of benign lesions. Differences in the maximum standardized uptake value (SUVmax) measurements and the SUVmax lesion/background ratios between benign and malignant lesions were analyzed. The diagnostic value of this PET/CT modality for the differential diagnosis of benign versus malignant testicular lesions was calculated.ResultsThe differences in the SUVmax measurements and the SUVmax lesion/background ratios between benign and malignant lesions were statistically significant (SUVmax: Z = −4.295, p = 0.000; SUVmax lesion/background ratio: Z = −5.219, p = 0.000); specifically, both of these indicators were higher in malignant lesions compared to benign lesions. An SUVmax of 3.75 was the optimal cutoff value to differentiate between benign and malignant testicular lesions. The diagnostic sensitivity, specificity, accuracy, positive predictive value, and negative predictive value of this PET/CT modality in the differential diagnosis of benign versus malignant testicular lesions were 90.6%, 80.9%, 86.8%, 87.9%, and 85.0%, respectively.Conclusions18F-FDG PET/CT can accurately identify benign and malignant testicular lesions.  相似文献   

20.
目的探讨18F-FDG(18F-脱氧葡萄糖)PET/CT全身显像在原发灶不明淋巴结转移癌诊断中的应用。方法回顾性分析2007年1月~2008年12月208例有完整随访资料常规检查难以发现原发灶的淋巴结转移癌患者的18F-FDGPET/CT扫描报告,通过分析病历记录、病理结果及临床随访确定最终原发灶诊断。结果 208例原发灶不明淋巴结转移癌患者中,107例成功检测到原发灶,检出率为51.44%;77例病理证实,30例为临床诊断。其中肺癌占54.21%(58/107),鼻咽癌占14.95%(16/107),乳腺癌占10.28%(11/107),结直肠癌8例,喉癌5例,扁桃体癌、甲状腺癌、前列腺癌各3例。其余101例患者未检测到原发灶。结论 18F-FDGPET/CT全身显像是一种寻找淋巴结转移原发灶较灵敏的方法 。  相似文献   

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