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1.
Purpose
The aim of this study was to evaluate whether the acquisition of delayed images could improve the detectability of liver pathological uptakes.Materials and methods
Ninety-five consecutive patients with suspected liver metastases underwent a dual-phase positron emission tomography (PET) scan. All patients underwent a whole-body PET/computed tomography (CT) scan (PET-1) acquired 1 h post [18F]fluorodeoxyglucose (FDG) injection, and a liver PET/CT scan [that is, one or two fields of view (FOV) of the upper abdomen; PET-2] acquired 2 h postinjection. In all cases, image reconstruction was performed as 3D reconstruction algorithm Fourier rebinning (FORE) iterative, FOV 50 cm, image matrix size 128×128. Both studies were evaluated qualitatively and semiquantitatively [background standard uptake values (SUV)mean of the liver, lesion SUVmax and SUVmean and ratio SUVmean lesion/background).Results
Thirty-seven of 95 patients (38.9%) presented liver lesions at both PET-1 and PET-2 exams, whereas there were two (2.2%) only at PET-2. Eighty-one liver lesions were identified at both PET studies, whereas there were nine (11.1%) only at PET-2. Furthermore, at PET-2, we had a statistically significant reduction of SUVmean background values (p<0.001, Wilcoxon test) and a concomitant increase of SUVmean lesion values (p<0.001, Wilcoxon test), ratio lesion to background (p<0.001, Wilcoxon test).Conclusions
Acquisition of delayed images improved the hepatic detection of pathological FDG uptake. 相似文献2.
Ana Mar��a Garc��a Vicente ��ngel Soriano Castrej��n Miguel ��ngel Cruz Mora Ana Gonz��lez Ageitos Mar��a del Mar Mu?oz S��nchez Alberto Le��n Mart��n Ruth Espinosa Auni��n Fernanda Relea Calatayud Vicente Mu?oz Madero Ignacio Chac��n L��pez-Mu?iz Jose Manuel Cordero Garc��a Germ��n Andr��s Jim��nez Londo?o 《European journal of nuclear medicine and molecular imaging》2013,40(1):72-79
Purpose
The aim of this study was to analyse the correlation between dual-time-point 18F-2-deoxy-2-fluoro-D-glucose (FDG) uptakes in lymph nodes assessed by positron emission tomography (PET)/CT and histopathological and immunohistochemical prognostic factors.Methods
Seventy-five women with locally advanced breast cancer were prospectively evaluated. PET/CT was requested in the initial staging previous to adjuvant chemotherapy (multicentre study). All of the patients underwent 18F-FDG PET/CT with a dual-time-point acquisition. Both examinations were evaluated qualitatively and semi-quantitatively with calculation of maximum standardized uptake values (SUVmax) in PET-1 (SUV-1) and in PET-2 (SUV-2) and the percentage variation of the SUV or retention index (RI) between PET-1 and PET-2 in lymph nodes with the greater 18F-FDG uptake. The biological prognostic parameters such as the steroid receptor status, p53 and HER2 expression, proliferation rate (Ki-67) and grading were determined from tissue of the primary tumour. Metabolic and biological parameters were correlated using Spearman??s rank-order correlation coefficient and Mann-Whitney U and Kruskal?CWallis tests.Results
Negative receptor status was correlated with higher SUV-1, SUV-2 and RI in lymph nodes. The results were significant for progesterone receptor status. p53 over-expression and triple-negative status were associated with greater semi-quantitative parameters in lymph nodes. Higher tumoural grades were related with greater semi-quantitative parameters (p?>?0.05).Conclusion
Biological factors of bad prognosis were correlated with higher semi-quantitative metabolic values in lymph nodes. Therefore these results appear to reveal biological significance of lymph node 18F-FDG accumulation. 相似文献3.
Takayoshi Shinya Soichiro Fujii Shoji Asakura Toshitaka Taniguchi Kotaro Yoshio Aierken Alafate Shuhei Sato Tadashi Yoshino Susumu Kanazawa 《Annals of nuclear medicine》2012,26(8):616-621
Objective
The aim of this study was to evaluate the usefulness of F-18 fluorodeoxyglucose (FDG) dual-time-point (DTP) positron emission tomography (PET)/computed tomography (CT) with semiquantitative analyses for the initial staging in patients with malignant lymphoma.Methods
Forty-three patients had DTP PET/CT, with 60-min and 2-h scan [n?=?8, Hodgkin??s lymphoma (HL); n?=?12, indolent non-Hodgkin lymphoma (NHL); n?=?23, aggressive NHL].Results
A total of 524 lesions were evaluated (406 lymph nodes and 118 extra-nodal lesions). The maximum standardized uptake value (SUVmax) on 2-h delayed scan (SUV2) was significantly higher than those on 1-h early scan (SUV1) for all groups (P?<?0.0001 for HL; P?<?0.0001 for indolent NHL; P?<?0.0001 for aggressive NHL). Significant differences were detected between HL and indolent NHL, between indolent NHL and the aggressive NHL for both SUV1 and SUV2 (each P?<?0.0001). No significant differences were detected between HL and aggressive NHL for both SUV1 and SUV2 (P?=?0.6891 for SUV1; P?=?0.8828 for SUV2); however, significant differences were detected for the retention index of SUVmax between these groups (P?=?0.0238).Conclusions
DTP F-18 FDG PET/CT with a semiquantitative technique may have the potential to provide the more accurate diagnoses for the staging of malignant lymphoma and the more important role in predicting the histological grades of malignancy compared with single-time-point F-18 FDG-PET scan. 相似文献4.
Hongzan Sun Jun Xin Shaomin Zhang Qiyong Guo Yueyue Lu Wei Zhai Long Zhao Weiai Peng Baijun Wang 《European journal of nuclear medicine and molecular imaging》2014,41(5):898-905
Purpose
To evaluate the concordance among 18F-FDG PET imaging, MR T2-weighted (T2-W) imaging and apparent diffusion coefficient (ADC) maps with diffusion-weighted (DW) imaging in cervical cancer using hybrid whole-body PET/MR.Methods
This study prospectively included 35 patients with cervical cancer who underwent pretreatment 18F-FDG PET/MR imaging. 18F-FDG PET and MR images were fused using standard software. The percent of the maximum standardized uptake values (SUVmax) was used to contour tumours on PET images, and volumes were calculated automatically. Tumour volumes measured on T2-W and DW images were calculated with standard techniques of tumour area multiplied by the slice profile. Parametric statistics were used for data analysis.Results
FDG PET tumour volumes calculated using SUVmax (14.30?±?4.70) and T2-W imaging volume (33.81?±?27.32 cm3) were similar (P?>?0.05) at 35 % and 40 % of SUVmax (32.91?±?18.90 cm3 and 27.56?±?17.19 cm3 respectively) and significantly correlated (P?<?0.001; r?=?0.735 and 0.766). The mean DW volume was 30.48?±?22.41 cm3. DW volumes were not significantly different from FDG PET volumes at either 35 % SUVmax or 40 % SUVmax or from T2-W imaging volumes (P?>?0.05). PET subvolumes with increasing SUVmax cut-off percentage showed an inverse change in mean ADC values on DW imaging (P?<?0.001, ANOVA).Conclusion
Hybrid PET/MR showed strong volume concordance between FDG PET, and T2-W and DW imaging in cervical cancer. Cut-off at 35 % or 40 % of SUVmax is recommended for 18F-FDG PET/MR SUV-based tumour volume estimation. The linear tumour subvolume concordance between FDG PET and DW imaging demonstrates individual regional concordance of metabolic activity and cell density. 相似文献5.
Asae Nozawa Ali Hosseini Rivandi Santosh Kesari Carl K. Hoh 《European journal of nuclear medicine and molecular imaging》2013,40(7):997-1004
Purpose
To retrospectively assess the utility of 18F fluorodeoxyglucose (FDG) positron emission tomography (PET) images of standardized uptake values corrected for blood glucose (SUVgluc), and to compare this to various quantitative methods to identify the presence or absence of high grade malignancy.Methods
A retrospective review in 42 patients, found 81 central nervous system (CNS) lesions. Fifty one were malignant and 30 were benign or post treatment changes based on pathology (n?=?32) and on clinical outcome (n?=?49). Dynamic FDG PET scans were processed to generate parametric images of SUVgluc, SUV, glucose metabolic rate (GMR), and lesion to cerebellum ratios (SUVRc), and contralateral white matter ratios (SUVRw). The SUVgluc was calculated from $ {{{\mathrm{SU}{{\mathrm{V}}_{\max }}*\mathrm{BG}}} \left/ {{\left[ {100\,\mathrm{mg}/\mathrm{dl}} \right]}} \right.} $ , where SUVmax is the maximum SUV and BG is the blood glucose level (mg/dL).Results
Using a malignant threshold for SUVgluc of 4.5 and GMR of 13.0 μmole/min/100 g, the accuracies were similar for the SUVgluc (80 %) and GMR (81 %) and were higher than the conventional SUVmax (73 %). The area under the receiver operating characteristic (ROC) curve for the SUVgluc (0.8661) was better than that for the SUVmax (0.7955) (p?<?0.02) and was similar to those of the GMR (0.8694), SUVRc (0.8278), and SUVRw (0.8559).Conclusion
These results suggest that the SUVgluc may assist in the interpretation of FDG PET brain images in patients with CNS lesions. The SUVgluc method avoids the complexity of kinetic modeling and the definition of a reference region. 相似文献6.
Objective
To evaluate the normal variants of the physiological bowel 2-deoxy-2-[18F]fluoro-d-glucose (FDG) uptake in dual-time-point positron emission tomography/computed tomography (PET/CT).Methods
We performed a retrospective review of 206 consecutive asymptomatic subjects who underwent whole-body FDG PET/CT for medical checkup in our institution. The criteria for exclusion of the subjects from this study were as follows: history of abdominal surgeries or endoscopic mucosal resection, history of any malignant tumors, symptoms of diarrhea or constipation, a positive fecal occult blood test, elevated serum carcinoembryonic antigen (CEA) level, and hyperglycemia (more than 110 mg/dl). A total of 39 subjects (32 males, 7 females, mean age 58.1 years old) were enrolled in this retrospective study. Two radiologists evaluated the dual-time-point FDG PET/CT images of these 39 subjects, retrospectively. FDG uptakes in 5 areas (small bowel (SB), cecum and ascending colon (AC), transverse colon (TC), descending colon (DC), and rectosigmoid colon (RS)) were scored visually in comparison with the activity in the liver (0 = no uptake, 1 = activity less than that in the liver, and 2 = activity equal to or greater than that in the liver) in the early and delayed image. The scores decided by two radiologists were averaged and this average score was defined as the bowel uptake score (BUS). For 34 areas with the BUS of 2 in either the early or delayed images, the maximum standardized uptake values (SUVmax) were measured for semiquantitative analysis. Wilcoxon’s signed rank test and paired t test were adopted for the statistical analyses.Results
The average BUS in the early/delayed images was 1.19/1.17 (SB), 0.81/1.23 (AC), 0.10/0.35 (TC), 0.35/0.59 (DC), and 1.17/1.54 (RS), respectively. The average SUVmax of the 34 areas with a score of 2 was 3.11 in the early images and 3.76 in the delayed images. The scores in the AC, TC, DC and RS, and the SUVmax were significantly higher in the delayed images (p < 0.05).Conclusions
Physiological FDG uptake in the colon increases significantly from the early to the delayed phase in dual-time-point PET/CT imaging, which should be carefully taken into consideration in the diagnosis of bowel diseases. 相似文献7.
Hye Ryoung Koo Jeong Seon Park Keon Wook Kang Nariya Cho Jung Min Chang Min Sun Bae Won Hwa Kim Su Hyun Lee Mi Young Kim Jin You Kim Mirinae Seo Woo Kyung Moon 《European radiology》2014,24(3):610-618
Objectives
To determine whether a correlation exists between maximum standardized uptake value (SUVmax) on 18F-fluorodeoxyglucose positron emission tomography (FDG-PET) and the subtypes of breast cancer.Methods
This retrospective study involved 548 patients (mean age 51.6 years, range 21–81 years) with 552 index breast cancers (mean size 2.57 cm, range 1.0–14.5 cm). The correlation between 18F-FDG uptake in PET/CT, expressed as SUVmax, and immunohistochemically defined subtypes (luminal A, luminal B, human epidermal growth factor receptor 2 (HER2) positive and triple negative) was analyzed.Results
The mean SUVmax value of the 552 tumours was 6.07?±?4.63 (range 0.9–32.8). The subtypes of the 552 tumours were 334 (60 %) luminal A, 66 (12 %) luminal B, 60 (11 %) HER2 positive and 92 (17 %) triple negative, for which the mean SUVmax values were 4.69?±?3.45, 6.51?±?4.18, 7.44?±?4.73 and 9.83?±?6.03, respectively. In a multivariate regression analysis, triple-negative and HER2-positive tumours had 1.67-fold (P?<?0.001) and 1.27-fold (P?=?0.009) higher SUVmax values, respectively, than luminal A tumours after adjustment for invasive tumour size, lymph node involvement status and histologic grade.Conclusion
FDG uptake was independently associated with subtypes of invasive breast cancer. Triple-negative and HER2-positive breast cancers showed higher SUVmax values than luminal A tumours.Key Points
? 18 F-FDG PET demonstrates increased tissue glucose metabolism, a hallmark of cancers. ? Immunohistochemically defined subtypes appear significantly associated with FDG uptake (expressed as SUV max ). ? Triple-negative tumours had 1.67-fold higher SUV max values than luminal A tumours. ? HER2-positive tumours had 1.27-fold higher SUV max values than luminal A tumours. 相似文献8.
Hai-Jeon Yoon Keon Wook Kang In Kook Chun Nariya Cho Seock-Ah Im Sunjoo Jeong Song Lee Kyeong Cheon Jung Yun-Sang Lee Jae Min Jeong Dong Soo Lee June-Key Chung Woo Kyung Moon 《European journal of nuclear medicine and molecular imaging》2014,41(8):1534-1543
Purpose
Imaging biomarkers from functional imaging modalities were assessed as potential surrogate markers of disease status. Specifically, in this prospective study, we investigated the relationships between functional imaging parameters and histological prognostic factors and breast cancer subtypes.Methods
In total, 43 patients with large or locally advanced invasive ductal carcinoma (IDC) were analyzed (47.6?±?7.5 years old). 68Ga-Labeled arginine-glycine-aspartic acid (RGD) and 18F-fluorodeoxyglucose (FDG) positron emission tomography/computed tomography (PET/CT) were performed. The maximum and average standardized uptake values (SUVmax and SUVavg) from RGD PET/CT and SUVmax and SUVavg from FDG PET/CT were the imaging parameters used. For histological prognostic factors, estrogen receptor (ER), progesterone receptor (PR), and human epidermal growth factor receptor 2 (HER2) expression was identified using immunohistochemistry (IHC) or fluorescent in situ hybridization (FISH). Four breast cancer subtypes, based on ER/PR and HER2 expression (ER/PR+,Her2?, ER/PR+,Her2+, ER/PR?,Her2+, and ER/PR?,Her2?), were considered.Results
Quantitative FDG PET parameters were significantly higher in the ER-negative group (15.88?±?8.73 vs 10.48?±?6.01, p?=?0.02 for SUVmax; 9.40?±?5.19 vs 5.92?±?4.09, p?=?0.02 for SUVavg) and the PR-negative group (8.37?±?4.94 vs 4.79?±?3.93, p?=?0.03 for SUVavg). Quantitative RGD PET parameters were significantly higher in the HER2-positive group (2.42?±?0.59 vs 2.90?±?0.75, p?=?0.04 for SUVmax; 1.60?±?0.38 vs 1.95?±?0.53, p?=?0.04 for SUVavg) and showed a significant positive correlation with the HER2/CEP17 ratio (r?=?0.38, p?=?0.03 for SUVmax and r?=?0.46, p?<?0.01 for SUVavg). FDG PET parameters showed significantly higher values in the ER/PR?,Her2? subgroup versus the ER/PR+,Her2? or ER/PR+,Her2+ subgroups, while RGD PET parameters showed significantly lower values in the ER/PR?,Her2? subgroup versus the other subgroups. There was no correlation between FDG and RGD PET parameters in the overall group. Only the ER/PR?,Her2? subgroup showed a significant positive correlation between FDG and RGD PET parameters (r?=?0.59, p?=?0.03 for SUVmax).Conclusion
68Ga-RGD and 18F-FDG PET/CT are promising functional imaging modalities for predicting biomarkers and molecular phenotypes in breast cancer patients. 相似文献9.
Buvat I Necib H Garcia C Wagner A Vanderlinden B Emonts P Hendlisz A Flamen P 《European journal of nuclear medicine and molecular imaging》2012,39(10):1628-1634
Purpose
Medical oncology needs early identification of patients that are not responding to systemic therapy. 18F-Fluorodeoxyglucose (FDG) positron emission tomography (PET) performed before and early during treatment has been proposed for this purpose. However, the best way to assess the change in FDG uptake between two scans has not been identified. We studied cutoff thresholds to identify responding tumours as a function of the method used to measure tumour uptake.Methods
The study included 28 metastatic colorectal cancer (mCRC) patients who underwent 2 FDG PET/CT scans (baseline and at day 14 of the first course of polychemotherapy). For 78 tumour lesions, 4 standardized uptake value (SUV) indices were measured: maximum SUV (SUVmax) and mean SUV in a region obtained using an isocontour (SUV40?%), with each of these SUV normalized either by the patient body weight (BW) or body surface area (BSA). The per cent change and absolute change in tumour uptake between the baseline and the early PET scans were measured based on these four indices. These changes were correlated to the RECIST 1.0-based response using contrast-enhanced CT at baseline and at 6–8?weeks on treatment.Results
The 78 tumours were classified as non-responding (NRL, n?=?58) and responding lesions (RL, n?=?20). Receiver-operating characteristic (ROC) curves characterizing the performance in NRL/RL classification using early FDG PET uptake had areas under the curve between 0.75 and 0.84, without significant difference between the indices. The cutoff threshold in FDG uptake per cent change to get a 95?% sensitivity of RL detection depended on the way uptake was measured: ?14?% (specificity of 53?%) and ?22?% (specificity of 64?%) for SUVmax and SUV40?%, respectively. Thresholds expressed as absolute SUV decrease instead of per cent change were less sensitive to the SUV definition: an SUV decline by 1.2 yielded a sensitivity of RL detection of 95?% for SUVmax and SUV40?%. For a given cutoff threshold, the sensitivity was the same whatever the normalization (by BSA or BW).Conclusion
A 14?% drop of tumour FDG SUVmax, 22?% drop of SUV40?% or 1.2 drop of SUVmax or SUVmean after one single course of polychemotherapy predicts objective response in mCRC lesions with a high sensitivity, potentially allowing the early identification of non-responding patients. 相似文献10.
Shin Young Jeong Sang-Woo Lee Hui Joong Lee Sungmin Kang Ji-Hyoung Seo Kyung Ah Chun Ihn Ho Cho Kyung Sook Won Seok Kil Zeon Byeong-Cheol Ahn Jaetae Lee 《European journal of nuclear medicine and molecular imaging》2010,37(12):2334-2343
Purpose
The purpose of this study was to determine the incidence of incidental pituitary uptake on whole-body 18F-fluorodeoxyglucose (FDG) positron emission tomography/computed tomography (PET/CT) and to investigate its clinical significance.Methods
The files of 40,967 patients who underwent whole-body FDG PET/CT were retrospectively reviewed. Quantification of pituitary metabolic activity was obtained by using the maximum standardized uptake value (SUVmax). Hormone assays and pituitary MRIs were performed to assess pituitary lesions.Results
Focally increased pituitary FDG uptake on PET/CT was found in 30 of 40,967 patients, accounting for an incidence of 0.073%. The mean SUVmax of 30 patients was 8.9?±?6.6 (range: 3.2–32.6). Histological diagnosis was obtained in three patients and included two growth hormone-secreting adenomas and one non-functioning adenoma. Hormone assays were performed on serum samples from 11 patients, 2 of whom were shown to have hypersecretion of pituitary hormone. MRI was performed on 19 patients. Abnormal MRI findings suggesting a pituitary mass were found in 18 of 19 cases (94.7%). The mean SUVmax calculated without correction for partial volume effect for macroadenomas was significantly higher than the SUVmax for microadenomas (11.5?±?8.4 vs 4.8?±?1.3; p?<?0.05). There were no cases diagnosed with metastasis to the pituitary gland during clinical follow-up.Conclusion
Incidental pituitary FDG uptake was a very rare finding. Cases with incidental pituitary FDG uptake were diagnosed primarily with clinically non-functioning adenomas, and there were also a few functioning adenomas. Further evaluations, including hormone assays and pituitary MRI, are warranted when pituitary uptake is found on FDG PET/CT. 相似文献11.
Byung Hyun Byun Woo Chul Noh Ilhan Lim Seung Sook Lee A. Ra Cho Ji Ae Park Kyeong Min Kim Hyun-Ah Kim Eun-Kyu Kim Byung Il Kim Chang Woon Choi Sang Moo Lim 《Annals of nuclear medicine》2013,27(8):720-728
Objective
The aim of this study was to measure the apparent diffusion coefficient (ADC) value at the region with the highest FDG uptake using sequential 18F-FDG PET and MRI, and to correlate it with the histological grade of invasive ductal carcinoma (IDC) of the breast.Methods
A retrospective study was conducted on 75 untreated patients with IDC. First, a PET/CT scan and subsequent breast MRI were done and the SUVmax of the each breast tumor was recorded. Then, a PET image and ADC map were co-registered. On the axial slice containing the pixel with SUVmax, we drew multiple circular ROIs within the tumor and measured the mean ADC value of each ROI. The average (ADC-mean) and minimum (ADC-min) of the mean ADC values for all ROIs within the tumor were calculated, respectively. Then, a circular ROI was placed at the corresponding location to the pixel with the highest SUV and the mean ADC value of the ROI was denoted as ADC-PET. We compared the averages of the ADC parameters and assessed the correlations among SUVmax and ADC parameters. ROC curve and logistic regression analyses were performed to assess the utility of ADC and SUVmax for detecting histological grade 3.Results
ADC-min was significantly lower than the ADC-mean or ADC-PET. All of the ADC parameters showed a negative correlation with SUVmax. The area under the ROC curve for identifying histological grade 3 using ADC-PET, ADC-min, ADC-mean and SUVmax was 0.684, 0.660, 0.633 and 0.639, respectively. By multivariate analysis, ADC-PET was a significant, independent predictor of histological grade 3 (p = 0.004).Conclusions
We estimated the ADC value at the breast tumor region with the highest FDG uptake using sequential 18F-FDG PET and MRI. This new ADC parameter distinguished high-grade IDC, supporting the feasibility of the combined PET-MRI system in patients with breast cancer. 相似文献12.
B. B. Koolen M. J. T. F. D. Vrancken Peeters J. Wesseling E. H. Lips W. V. Vogel T. S. Aukema E. van Werkhoven K. G. A. Gilhuijs S. Rodenhuis E. J. Th. Rutgers R. A. Valdés Olmos 《European journal of nuclear medicine and molecular imaging》2012,39(12):1830-1838
Purpose
The aim of this study was to evaluate the association of primary tumour 18F-fluorodeoxyglucose (FDG) uptake with clinical, histopathological and molecular characteristics of breast cancer patients scheduled for neoadjuvant chemotherapy. Second, we wished to establish for which patients pretreatment positron emission tomography (PET)/CT could safely be omitted because of low FDG uptake.Methods
PET/CT was performed in 214 primary stage II or III breast cancer patients in the prone position with hanging breasts. Tumour FDG uptake was qualitatively evaluated to determine the possibility of response monitoring with PET/CT and was quantitatively assessed using maximum standardized uptake values (SUVmax). FDG uptake was compared with age, TNM stage, histology, hormone and human epidermal growth factor receptor 2 status, grade, Ki-67 and molecular subtype in univariable and multivariable analyses.Results
In 203 tumours (95?%) FDG uptake was considered sufficient for response monitoring. No subgroup of patients with consistently low tumour FDG uptake could be identified. In a univariable analysis, SUVmax was significantly higher in patients with distant metastases at staging examination, non-lobular carcinomas, tumours with negative hormone receptors, triple negative tumours, grade 3 tumours, and in tumours with a high proliferation index (Ki-67 expression). After multiple linear regression analysis, triple negative and grade 3 tumours were significantly associated with a higher SUVmax.Conclusion
Primary tumour FDG uptake in breast cancer patients scheduled for neoadjuvant chemotherapy is significantly higher in tumours with prognostically unfavourable characteristics. Based on tumour characteristics associated with low tumour FDG uptake, this study was unable to identify a subgroup of patients unlikely to benefit from pretreatment PET/CT. 相似文献13.
Objectives
Physiological myocardial uptake of 18F-FDG during positron emission tomography can mask adjacent abnormal uptake in mediastinal malignancy and inflammatory cardiac diseases. Myocardial uptake is unpredictable and variable. This study evaluates the impact of a low-carbohydrate diet in reducing myocardial FDG uptake.Method
Patients attending for clinically indicated oncological FDG PET were asked to have an “Atkins-style” low-carbohydrate diet (less than 3 g) the day before examination and an overnight fast. A total of 120 patients following low-carbohydrate diet plus overnight fast were compared with 120 patients prepared by overnight fast alone. Patients having an Atkins-style diet also completed a diet compliance questionnaire. SUVmax and SUVmean for myocardium, blood pool and liver were measured in both groups.Results
Myocardial SUVmax fell from 3.53?±?2.91 in controls to 1.77?±?0.91 in the diet-compliant group. 98 % of diet-compliant patients had a myocardial SUVmax less than 3.6 compared with 67 % of controls. Liver and blood pool SUVmax rose from 2.68?±?0.49 and 1.82?±?0.30 in the control group to 3.14?±?0.57 and 2.06?±?0.30.Conclusion
An Atkins-style diet the day before PET, together with an overnight fast, effectively suppresses myocardial FDG uptake.Key Points
? Low-carbohydrate diet (LCD) the day before PET suppresses myocardial FDG uptake. ? LCD before PET increases liver and blood pool SUV max and SUV mean . ? Suppression of myocardial uptake may improve PET imaging of thoracic disease. ? Suppression of myocardial uptake may help imaging cardiac inflammatory disease with PET. 相似文献14.
Johannes Salamon Thorsten Derlin Peter Bannas Jasmin D. Busch Jochen Herrmann Maximilian Bockhorn Christian Hagel Reinhard E. Friedrich Gerhard Adam Victor F. Mautner 《European journal of nuclear medicine and molecular imaging》2013,40(5):685-692
Purpose
The aim of the study was to evaluate the potential usefulness of intratumoural tracer uptake heterogeneity on 18F-fluorodeoxyglucose (FDG) positron emission tomography (PET)/CT as compared to a cut-off maximum standardized uptake value (SUVmax) for characterization of peripheral nerve sheath tumours (PNSTs) in neurofibromatosis type 1 (NF1).Methods
Fifty patients suffering from NF1 were examined by 18F-FDG PET/CT. Intralesional tracer uptake was analysed qualitatively and semi-quantitatively by measuring the mean and maximum SUV. Uptake heterogeneity was graded qualitatively using a three-point scale and semi-quantitatively by calculating an SUV-based heterogeneity index (HISUV). Cohen’s κ was used to determine inter- and intra-rater agreement. Histopathological evaluation and clinical as well as radiological follow-up examinations served as the reference standards.Results
A highly significant correlation between the degree of intratumoural uptake heterogeneity on 18F-FDG PET and malignant transformation of PNSTs was observed (p?<?0.0001). Semi-quantitative HISUV was significantly higher in malignant PNSTs (MPNSTs) than in benign tumours (p?=?0.0002). Both intralesional heterogeneity and SUVmax could be used to identify malignant tumours with a sensitivity of 100 %. Cohen’s κ was 0.86 for inter-rater agreement and 0.88 for intra-rater agreement on heterogeneity.Conclusion
MPNSTs in patients with NF1 demonstrate considerable intratumoural uptake heterogeneity on 18F-FDG PET/CT. Assessment of tumour heterogeneity is highly reproducible. Both tumour heterogeneity and a cut-off SUVmax may be used to sensitively identify malignant PNSTs, but the specificity is higher for the latter. A combination of both methods leads to a non-significant improvement in diagnostic performance. 相似文献15.
Alexander W. Sauter Daniel Spira Maximilian Schulze Christina Pfannenberg Jürgen Hetzel Matthias Reimold Ernst Klotz Claus D. Claussen Marius S. Horger 《European journal of nuclear medicine and molecular imaging》2013,40(5):677-684
Purpose
The aim of this study was to investigate correlations between glucose metabolism as determined by [18F]FDG PET/CT and tumour perfusion as quantified by volume perfusion CT in primary tumours and mediastinal lymph nodes (MLN) of patients with non-small-cell lung cancer (NSCLC).Methods
Enrolled in the study were 17 patients with NSCLC. [18F]FDG uptake was quantified in terms of SUVmax and SUVavg. Blood flow (BF), blood volume (BV) and flow extraction product (Ktrans) were determined as perfusion parameters. The correlations between the perfusion parameters and [18F]FDG uptake values were subsequently evaluated.Results
For the primary tumours, no correlations were found between perfusion parameters and [18F]FDG uptake. In MLN, there were negative correlations between BF and SUVavg (r?=??0.383), BV and SUVavg (r?=??0.406), and BV and SUVmax (r?=??0.377), but not between BF and SUVmax, Ktrans and SUVavg, or Ktrans and SUVmax. Additionally, in MLN with SUVmax >2.5 there were negative correlations between BF and SUVavg (r?=??0.510), BV and SUVavg (r?=??0.390), BF and SUVmax (r?=??0.536), as well as BV and SUVmax (r?=??0.346).Conclusion
Perfusion and glucose metabolism seemed to be uncoupled in large primary tumours, but an inverse correlation was observed in MLN. This information may help improve therapy planning and response evaluation. 相似文献16.
Kobe C Scheffler M Holstein A Zander T Nogova L Lammertsma AA Boellaard R Neumaier B Ullrich RT Dietlein M Wolf J Kahraman D 《European journal of nuclear medicine and molecular imaging》2012,39(7):1117-1127
Purpose
To evaluate the predictive value of early and late residual 18F-fluorodeoxyglucose (FDG) and 18F-fluorothymidine (FLT) uptake using different SUV measurements in PET in patients with advanced non-small-cell lung cancer (NSCLC) treated with erlotinib.Methods
We retrospectively reviewed data from 30 patients with untreated stage IV NSCLC who had undergone a combined FDG PET and FLT PET scan at 1?week (early) and 6?weeks (late) after the start of erlotinib treatment. Early and late residual FDG and FLT uptake were measured in up to five lesions per scan with different quantitative standardized uptake values (SUVmax, SUV2Dpeak, SUV3Dpeak, SUV50, SUVA50, SUVA41) and compared with short-term outcome (progression vs. nonprogression after 6?weeks of erlotinib treatment). Receiver-operating characteristics (ROC) curve analysis was used to determine the optimal cut-off value for detecting nonprogression after 6?weeks. Kaplan-Meier analysis and the log-rank test were used to evaluate the association between residual uptake and progression-free survival (PFS).Results
Nonprogression after 6?weeks was associated with a significantly lower early and late residual FDG uptake, measured with different quantitative parameters. In contrast, nonprogression after 6?weeks was not associated with early and late residual FLT uptake. Furthermore, patients with a lower early residual FDG uptake measured in terms of SUVmax and SUV2Dpeak had a significantly prolonged PFS (282?days vs. 118?days; p?=?0.022) than patients with higher values. Similarly, lower late residual FDG uptake and early residual FLT uptake measured in terms of SUV3Dpeak, SUVA50 and SUVA41, and late FLT uptake measured in terms of SUV3Dpeak and SUVA50 was associated with an improved PFS.Conclusion
Early and late residual FDG uptake, measured using different quantitative SUV parameters, are predictive factors for short-term outcome in patients with advanced NSCLC treated with erlotinib. Additionally, low residual FDG and FLT uptake early and late in the course of erlotinib treatment is associated with improved PFS. 相似文献17.
Axel Wetter Christine Lipponer Felix Nensa Philipp Heusch Herbert Rübben Jens-Christian Altenbernd Thomas Schlosser Andreas Bockisch Thorsten Pöppel Thomas Lauenstein James Nagarajah 《European journal of nuclear medicine and molecular imaging》2014,41(1):79-88
Purpose
The aim of this study was to evaluate the positron emission tomography (PET) component of [18F]choline PET/MRI and compare it with the PET component of [18F]choline PET/CT in patients with histologically proven prostate cancer and suspected recurrent prostate cancer.Methods
Thirty-six patients were examined with simultaneous [18F]choline PET/MRI following combined [18F]choline PET/CT. Fifty-eight PET-positive lesions in PET/CT and PET/MRI were evaluated by measuring the maximum and mean standardized uptake values (SUVmax and SUVmean) using volume of interest (VOI) analysis. A scoring system was applied to determine the quality of the PET images of both PET/CT and PET/MRI. Agreement between PET/CT and PET/MRI regarding SUVmax and SUVmean was tested using Pearson’s product-moment correlation and Bland-Altman analysis.Results
All PET-positive lesions that were visible on PET/CT were also detectable on PET/MRI. The quality of the PET images was comparable in both groups. Median SUVmax and SUVmean of all lesions were significantly lower in PET/MRI than in PET/CT (5.2 vs 6.1, p?<?0.05 and 2.0 vs 2.6, p?<?0.001, respectively). Pearson’s product-moment correlation indicated highly significant correlations between SUVmax of PET/CT and PET/MRI (R?=?0.86, p?<?0.001) as well as between SUVmean of PET/CT and PET/MRI (R?=?0.81, p?<?0.001). Bland-Altman analysis revealed lower and upper limits of agreement of ?2.77 to 3.64 between SUVmax of PET/CT vs PET/MRI and ?1.12 to +2.23 between SUVmean of PET/CT vs PET/MRI.Conclusion
PET image quality of PET/MRI was comparable to that of PET/CT. A highly significant correlation between SUVmax and SUVmean was found. Both SUVmax and SUVmean were significantly lower in [18F]choline PET/MRI than in [18F]choline PET/CT. Differences of SUVmax and SUVmean might be caused by different techniques of attenuation correction. Furthermore, differences in biodistribution and biokinetics of [18F]choline between the subsequent examinations and in the respective organ systems have to be taken into account. 相似文献18.
Kenta Miwa Masayuki Inubushi Kei Wagatsuma Michinobu Nagao Taisuke Murata Masamichi Koyama Mitsuru Koizumi Masayuki Sasaki 《European journal of radiology》2014
Purpose
The present study aimed to determine whether fractal analysis of morphological complexity and intratumoral heterogeneity of FDG uptake can help to differentiate malignant from benign pulmonary nodules.Materials and methods
We retrospectively analyzed data from 54 patients with suspected non-small cell lung cancer (NSCLC) who were examined by FDG PET/CT. Pathological assessments of biopsy specimens confirmed 35 and 19 nodules as NSCLC and inflammatory lesions, respectively. The morphological fractal dimension (m-FD), maximum standardized uptake value (SUVmax) and density fractal dimension (d-FD) of target nodules were calculated from CT and PET images. Fractal dimension is a quantitative index of morphological complexity and tracer uptake heterogeneity; higher values indicate increased complexity and heterogeneity.Results
The m-FD, SUVmax and d-FD significantly differed between malignant and benign pulmonary nodules (p < 0.05). Although the diagnostic ability was better for d-FD than m-FD and SUVmax, the difference did not reach statistical significance. Tumor size correlated significantly with SUVmax (r = 0.51, p < 0.05), but not with either m-FD or d-FD. Furthermore, m-FD combined with either SUVmax or d-FD improved diagnostic accuracy to 92.6% and 94.4%, respectively.Conclusion
The d-FD of intratumoral heterogeneity of FDG uptake can help to differentially diagnose malignant and benign pulmonary nodules. The SUVmax and d-FD obtained from FDG-PET images provide different types of information that are equally useful for differential diagnoses. Furthermore, the morphological complexity determined by CT combined with heterogeneous FDG uptake determined by PET improved diagnostic accuracy. 相似文献19.
Punit Sharma Varun Singh Dhull Saurabh Arora Poonam Gupta Rajeev Kumar Prashant Durgapal Arun Malhotra Sunil Chumber Ariachery C. Ammini Rakesh Kumar Chandrasekhar Bal 《European journal of nuclear medicine and molecular imaging》2014,41(3):494-504
Purpose
The purpose of the present study was to evaluate the diagnostic accuracy of 68Ga-DOTANOC positron emission tomography (PET)/CT in patients with suspicion of pheochromocytoma.Methods
Data of 62 patients [age 34.3?±?16.1 years, 14 with multiple endocrine neoplasia type 2 (MEN2)] with clinical/biochemical suspicion of pheochromocytoma and suspicious adrenal lesion on contrast CT (n?=?70), who had undergone 68Ga-DOTANOC PET/CT, were retrospectively analyzed. PET/CT images were analyzed visually as well as semiquantitatively, with measurement of maximum standardized uptake value (SUVmax), SUVmean, SUVmax/SUVliver, and SUVmean/SUVliver. Results of PET/CT were compared with 131I-metaiodobenzylguanidine (MIBG) imaging, which was available in 40 patients (45 lesions). Histopathology and/or imaging/clinical/biochemical follow-up (minimum 6 months) was used as reference standard.Results
The sensitivity, specificity, and accuracy of 68Ga-DOTANOC PET/CT was 90.4, 85, and 88.7 %, respectively, on patient-based analysis and 92, 85, and 90 %, respectively, on lesion-based analysis. 68Ga-DOTANOC PET/CT showed 100 % accuracy in patients with MEN2 syndrome and malignant pheochromocytoma. On direct comparison, lesion-based accuracy of 68Ga-DOTANOC PET/CT for pheochromocytoma was significantly higher than 131I-MIBG imaging (91.1 vs 66.6 %, p?=?0.035). SUVmax was higher for pheochromocytomas than other adrenal lesions (p?=?0.005), MEN2-associated vs sporadic pheochromocytoma (p?=?0.012), but no difference was seen between benign vs malignant pheochromocytoma (p?=?0.269).Conclusion
68Ga-DOTANOC PET/CT shows high diagnostic accuracy in patients with suspicion of pheochromocytoma and is superior to 131I-MIBG imaging for this purpose. Best results of 68Ga-DOTANOC PET/CT are seen in patients with MEN2-associated and malignant pheochromocytoma. 相似文献20.
Byun BH Jeong UG Hong SP Min JJ Chong A Song HC Bom HS 《Annals of nuclear medicine》2012,26(6):471-477