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1.
Beuthien-Baumann B Strumpf A Zessin J Bredow J Kotzerke J 《European journal of nuclear medicine and molecular imaging》2007,34(10):1604-1609
Purpose In patients with medullary thyroid carcinoma (MTC), rising levels of the tumour markers calcitonin and CEA after primary surgery
indicate tumour recurrence or metastases. The only chance of cure is the resection of localised tumour tissue. For positron
emission tomography (PET) with 18F-fluorodeoxyglucose (18F-FDG) and 18F-dihydroxyphenylalanine (18F-DOPA), sensitivities of 78% and 63% have been reported, but in a considerable percentage of MTC patients the source of tumour
marker elevation is not detected. The aim of this retrospective data evaluation was to compare the value of PET with 18F-FDG, 18F-DOPA and the amino acid tracer 3-O-methyl-6-[18F]fluoro-DOPA (18F-OMFD) in the detection of MTC recurrence.
Methods Fifteen patients with elevated calcitonin were investigated with PET as part of their individual clinical work-up. All patients
underwent 18F-FDG PET and 18F-DOPA PET, and ten patients underwent 18F-OMFD PET.
Results With 18F-FDG, seven patients showed foci in the neck, mediastinum, upper abdomen or bone. In seven patients, 18F-DOPA revealed suspicious foci; five of these seven patients showed partially corresponding uptake of 18F-FDG in the neck and mediastinum. Two of these patients underwent surgery and metastases were verified. With 18F-OMFD, a small focus in the liver was suspected in one patient without a correlate on 18F-FDG PET, 18F-DOPA PET or conventional imaging.
Conclusion
18F-FDG and 18F-DOPA showed foci that were highly suspicious for local recurrence or metastasis of MTC, although histological verification
in these patients with numerous previous surgical interventions was performed in only two patients. The amino acid tracer
18F-OMFD had no diagnostic impact in these patients. 相似文献
2.
Ruth G. Keijsers Fred J. Verzijlbergen Wim J. Oyen Jules M. van den Bosch Henk J. Ruven Heleen van Velzen-Blad Jan C. Grutters 《European journal of nuclear medicine and molecular imaging》2009,36(7):1131-1137
Purpose Angiotensin-converting enzyme (ACE) and soluble interleukin-2 receptor (sIL-2R) are serological markers, widely used for determining
sarcoidosis activity. 18F-FDG PET has proven to be a sensitive technique in the imaging of sarcoidosis. The aim of this study was to determine sensitivity
of 18F-FDG PET, genotype-corrected ACE and sIL-2R in active sarcoidosis as well as their correlation.
Methods This retrospective study included 36 newly diagnosed, symptomatic sarcoidosis patients. ACE and sIL-2R levels were simultaneously
obtained within 4 weeks of 18F-FDG PET. ACE was corrected for genotype and expressed as Z-score. 18F-FDG PET was visually evaluated and scored as positive or negative. Maximum and average standardized uptake values (SUVmax and SUVavg) were compared with ACE and sIL-2R.
Results
18F-FDG PET was found positive in 34 of 36 patients (94%). Thirteen patients (36%) showed an increased ACE with the highest
sensitivity found in patients with the I/I genotype (67%). Seventeen patients (47%) showed an increased sIL-2R. No correlation
was found between SUV and ACE or sIL-2R. Increased ACE and sIL-2R correlated with a positive 18F-FDG PET in 12 patients (92%) and 16 patients (94%), respectively.
Conclusion
18F-FDG PET is a very sensitive technique to assess active sarcoidosis, in contrast with ACE and sIL-2R, suggesting a pivotal
role for 18F-FDG PET in future sarcoidosis assessment. 相似文献
3.
Comparison of parametric FBP and OS-EM reconstruction algorithm images for PET dynamic study 总被引:1,自引:0,他引:1
Keiichi Oda Hinako Toyama Koji Uemura Yoko Ikoma Yuichi Kimura Michio Senda 《Annals of nuclear medicine》2001,15(5):417-423
An ordered subsets expectation maximization (OS-EM) algorithm is used for image reconstruction to suppress image noise and to make non-negative value images. We have applied OS-EM to a digital brain phantom and to human brain 18F-FDG PET kinetic studies to generate parametric images. A 45 min dynamic scan was performed starting injection of FDG with a 2D PET scanner. The images were reconstructed with OS-EM (6 iterations, 16 subsets) and with filtered backprojection (FBP), and K1, k2 and k3 images were created by the Marquardt non-linear least squares method based on the 3-parameter kinetic model. Although the OS-EM activity images correlated fairly well with those obtained by FBP, the pixel correlations were poor for the k2 and k3 parametric images, but the plots were scattered along the line of identity and the mean values for K1, k2 and k3 obtained by OS-EM were almost equal to those by FBP. The kinetic fitting error for OS-EM was no smaller than that for FBP. The results suggest that OS-EM is not necessarily superior to FBP for creating parametric images. 相似文献
4.
Ho KC Lai CH Wu TI Ng KK Yen TC Lin G Chang TC Wang CC Hsueh S Huang HJ 《European journal of nuclear medicine and molecular imaging》2008,35(3):484-492
Purpose Uterine carcinosarcomas clinically confined to the uterus usually harbor occult metastases. We conducted a pilot study to
evaluate the value of 18F-fluorodeoxyglucose (FDG) positron emission tomography (PET) in uterine carcinosarcoma.
Methods Patients with histologically confirmed uterine carcinosarcoma were enrolled. Abdominal and pelvic magnetic resonance imaging
(MRI)/whole-body computed tomography (CT) scan, and whole-body 18F-FDG PET or PET/CT were undertaken for primary staging, evaluating response, and restaging/post-therapy surveillance. The
clinical impact of 18F-FDG PET was determined on a scan basis.
Results A total of 19 patients were recruited and 31 18F-FDG PET scans (including 8 scans performed on a PET/CT scanner) were performed. Positive impacts of scans were found in
36.8% (7/19) for primary staging, 66.7% (2/3) for monitoring response, and 11.1% (1/9) for restaging/post-therapy surveillance.
PET excluded falsely inoperable disease defined by MRI in two patients. Aggressive treatment applying to three patients with
PET-defined resectable stage IVB disease seemed futile. Two patients died of disease shortly after salvage therapy restaged
by PET. With PET monitoring, one stage IVB patient treated by targeted therapy only was alive with good performance. Using
PET did not lead to improvement of overall survival of this series compared with the historical control (n = 35) (P = 0.779).
Conclusions The preliminary results suggest that 18F-FDG PET is beneficial in excluding falsely inoperable disease for curative therapy and in making a decision on palliation
for better quality of life instead of aggressive treatment under the guidance of PET. PET seems to have limited value in post-therapy
surveillance or restaging after failure. 相似文献
5.
Krug B Van Zanten A Pirson AS Crott R Vander Borght T 《European journal of nuclear medicine and molecular imaging》2008,35(1):80-88
Introduction As healthcare expenses are escalating in many countries, the sector faces a new challenge of becoming more cost efficient.
There is an urgent need for more accurate data on the costs of healthcare procedures. The cost of Positron Emission Tomography
(PET) with [18F]-fludeoxyglucose (18F-FDG) studies is mainly influenced by the price of the radiopharmaceutical, which may vary throughout Europe from 300 to
500 Euro per patient dose (370 MBq). The aim of the current study is to conduct an activity-based costing (ABC) estimation
of 18F-FDG production in Europe to better identify the different cost components and to analyse their relative contribution to
the total cost.
Materials and methods Financial data were collected on capital expense and global operating costs through interviews with industry experts, PET
centre managers, evaluation of prior studies, and review of expenses incurred at the University Medical Centre in Groningen
(The Netherlands). After mapping the activities, we divided the cost in five categories: wage, equipment, consumables, overhead
and space costs. A sensitivity analysis was performed for key cost components, including the compliance with regulatory requirements.
Results The critical factor for profitability was throughput. Including the European regulation procedure, the cost for 370 MBq 18F-FDG patient dose, 3 h EOS without delivery cost, ranges between 155 and 177 Euro/dose for two production runs and between
210 and 237 Euro/dose for one production run. These costs are predominantly determined by personnel and equipment costs, although
the cost for quality assurance increases steadily.
Conclusion The ABC analysis provides significant insight into the production cost components of 18F-FDG through different operating configurations. Reductions in equipment prices, increased availability of radiopharmaceuticals,
growth in demand, and improvements in reimbursement will all contribute to the financial viability of this imaging technique. 相似文献
6.
The role of <Superscript>18</Superscript>F-FDG PET in characterising disease activity in Takayasu arteritis 总被引:2,自引:0,他引:2
Webb M Chambers A AL-Nahhas A Mason JC Maudlin L Rahman L Frank J 《European journal of nuclear medicine and molecular imaging》2004,31(5):627-634
Takayasu arteritis (TA) is a rare, sporadic and chronic inflammatory arteritis, which predominantly affects the aorta and its branches. Diagnosis can be difficult and there are limitations to the current diagnostic work-up. By detecting areas of active glucose metabolism present in active vasculitis, imaging with fluorine-18 fluorodeoxyglucose positron emission tomography (18F-FDG PET) could potentially have a role in the management of TA. Our aim was to assess this role by reviewing 28 18F-FDG PET scans performed on 18 patients suspected of having TA. All patients had full clinical and laboratory assessment, cross-sectional imaging and angiography, and 16/18 satisfied the American College of Rheumatologists criteria for TA. 18F-FDG PET achieved a sensitivity of 92%, a specificity of 100%, and negative and positive predictive values of 85% and 100% respectively in the initial assessment of active vasculitis in TA. We conclude that 18F-FDG PET can be used to diagnose early disease, to detect active disease (even within chronic changes) and to monitor the effectiveness of treatment. 相似文献
7.
Hyo Jung Seo Byung Wook Min Jae Seon Eo Sun Il Lee Sang Hee Kang Sung Yup Jung Sang Chul Oh Jae Gol Choe 《Nuclear Medicine and Molecular Imaging》2016,50(1):85-89
Metastatic mucinous adenocarcinoma in an inguinal hernia is a rare disease and the image findings of 18F-fluorodeoxyglucose (18F-FDG) positron emission tomography (PET)/computed tomography (CT) are little known. Here, we introduce a 57-year-old man with metastatic mucinous adenocarcinoma in an inguinal hernia. On initial 18F-FDG PET/CT, hypermetabolism was observed in mucinous adenocarcinoma of the cecum, and adenocarcinomas of the transverse and ascending colon, respectively. Follow-up 18F-FDG PET/CT revealed newly developed multiple hypermetabolism in peritoneal seeding masses and nodules in the pelvic cavity and scrotum. Peritoneal carcinomatosis in the right pelvic side wall was extended to the incarcerated peritoneum and mesentery in the right inguinoscrotal hernia.18F-FDG PET/CT was useful to reveal unexpected peritoneal seeding within the inguinal hernia. Also, this case demonstrated that metastatic mucinous adenocarcinomas had variably intense FDG uptake. 相似文献
8.
Optimal dose of <Superscript>18</Superscript>F-FDG required for whole-body PET using an LSO PET camera 总被引:2,自引:0,他引:2
Everaert H Vanhove C Lahoutte T Muylle K Caveliers V Bossuyt A Franken PR 《European journal of nuclear medicine and molecular imaging》2003,30(12):1615-1619
Reducing the acquisition time of whole-body fluorine-18 fluorodeoxyglucose positron emission tomography (18F-FDG PET) (corrected for attenuation) is of major importance in clinical practice. With the introduction of lutetium oxyorthosilicate (LSO), the acquisition time can be dramatically reduced, provided that patients are injected with larger amounts of tracer and/or the system is operated in 3D mode. The aim of this study was to determine the optimal dose of 18F-FDG required in order to achieve good-to-excellent image quality when a "3-min emission, 2-min transmission/bed position" protocol is used for an LSO PET camera. A total of 218 consecutive whole-body 18F-FDG PET studies were evaluated retrospectively. After excluding patients with liver metastases, hyperglycaemia and paravenous injections, the final study population consisted of 186 subjects (112 men, 74 women, age 59±15 years). Patients were injected with an activity of 18F-FDG ranging from 2.23 to 15.21 MBq/kg. Whole-body images corrected for attenuation (3 min emission, 2 min transmission/bed position) were acquired with an LSO PET camera (Ecat Accel,Siemens) 60 min after tracer administration. Patients were positioned with their arms along the body. Image reconstruction was done iteratively and a post-reconstruction filter was applied. Image quality was scored visually by two independent observers using a five-point scoring scale (poor, reasonable, good, very good, excellent). In addition, the coefficient of variability (COV) was measured in a region of interest over the liver in order to quantify noise. Of the images obtained in 118 patients injected with 8 MBq/kg 18F-FDG, 92% and 90% were classified as good, very good or excellent by observer 1 and observer 2, respectively. The COV averaged 10.63%±3.19% for doses 8 MBq/kg and 16.46%±5.14% for doses <8 MBq/kg. Administration of an 18F-FDG dose of 8 MBq/kg results in images of good to excellent quality in the vast majority of patients when using an LSO PET camera and applying a 3-min emission, 2-min transmission/bed position acquisition protocol. At lower doses, a rapid decline in image quality and increasing noise are observed. Alternative protocols should be adopted in order to compensate for the loss in image quality when doses <8 MBq/kg are used. 相似文献
9.
Gontier E Fourme E Wartski M Blondet C Bonardel G Le Stanc E Mantzarides M Foehrenbach H Pecking AP Alberini JL 《European journal of nuclear medicine and molecular imaging》2008,35(1):95-99
Purpose This prospective and bi-centric study was conducted in order to determine the impact of antidiabetic treatments (AD) on 18F-FDG bowel uptake in type 2 diabetic patients.
Methods Fifty-five patients with previously diagnosed and treated type 2 diabetes mellitus (group 1) were divided in two subgroups:
AD treatment including metformin (n=32; group 1a) and AD treatment excluding metformin (n=23; group 1b). The 95 patients without
diabetes mellitus made up controls (group 2). 18F-FDG uptake in small intestine and colon was visually graded and semi-quantitatively measured using the maximum standardized
uptake value.
Results
18F-FDG bowel uptake was significantly increased in AD patients (group 1) as compared to controls (group 2) (p<0.001). Bowel
uptake was significantly higher in AD patients including metformin (group 1a) as compared to AD patients excluding metformin
(group 1b) (p<0.01), whose bowel uptake was not significantly different from controls (group 2). A metformin treatment was
predictive of an increased bowel uptake in the small intestine (odds ratio OR=16.9, p<0.0001) and in the colon (OR=95.3, p<0.0001),
independently of the other factors considered in the multivariate analysis. Bowel uptake pattern in the patients treated with
metformin was typically intense, diffuse and continuous along the bowel, strongly predominant in the colon, in both the digestive
wall and lumen.
Conclusion This study emphasizes that metformin significantly increases 18F-FDG uptake in colon and, to a lesser extent, in small intestine. It raises the question of stopping metformin treatment
before an 18F-FDG PET/CT scan is performed for intra-abdominal neoplasic lesion assessment. 相似文献
10.
Hartmann A Eid K Dora C Trentz O von Schulthess GK Stumpe KD 《European journal of nuclear medicine and molecular imaging》2007,34(5):704-714
Purpose To retrospectively evaluate the diagnostic value of 18F-FDG PET/CT in trauma patients with suspected chronic osteomyelitis.
Methods Thirty-three partial body 18F-FDG PET/CT scans were performed in 33 patients with trauma suspected of having chronic osteomyelitis. In 10 and 23 patients,
infection was suspected in the axial and appendicular skeleton, respectively. In 18 patients, PET/CT was performed in the
presence of metallic implants. Histopathology or bacteriological culture was used as the standard of reference. For statistical
analysis, sensitivity, specificity and accuracy were calculated in relation to findings of the reference standard.
Results Of 33 PET/CT scans, 17 were true positive, 13 true negative, two false positive and one false negative. Eighteen patients
had chronic osteomyelitis and 15 had no osseous infection according to the reference standard. Sensitivity, specificity and
accuracy for 18F-FDG PET/CT was 94%, 87% and 91% for the whole group, 88%, 100% and 90% for the axial skeleton and 100%, 85% and 91% for
the appendicular skeleton, respectively.
Conclusion
18F-FDG PET/CT is a highly sensitive and specific method for the evaluation of chronic infection in the axial and appendicular
skeleton in patients with trauma. PET/CT allows precise anatomical localisation and characterisation of the infectious focus
and demonstrates the extent of chronic osteomyelitis with a high degree of accuracy. 相似文献
11.
Yoshiki Demura Tatsuro Tsuchida Daisuke Uesaka Yukihiro Umeda Miwa Morikawa Shingo Ameshima Takeshi Ishizaki Yasuhisa Fujibayashi Hidehiko Okazawa 《European journal of nuclear medicine and molecular imaging》2009,36(4):632-639
Purpose To evaluate the usefulness of 18F-FDG PET in the imaging of pulmonary lesions related to disease activity and in monitoring responses to treatment in patients
with pulmonary mycobacteriosis (PM).
Materials and methods We used high-resolution computed tomography (HRCT) and 18F-FDG PET to evaluate 47 consecutive untreated patients with PM, 25 with tuberculosis (TB) and 22 with Mycobacterium avium-intracellulare complex (MAC), who presented with small peripheral pulmonary nodules ≤3 cm, and compared the findings. The diagnosis of mycobacteriosis
was confirmed by bacteriological examinations of bronchoscopic or surgically resected specimens. PET scans were visually and
quantitatively analysed using SUVmax. In addition, 14 patients with PM underwent repeat PET scanning during antimycobacterial
therapy, and changes in 18F-FDG uptake were clinically evaluated (6 during treatment and 12 after treatment).
Results Of all the lesions, 87.2% had SUVmax levels ranging from 3 to 7 (5.05 ± 1.56, range 2.5–7.6, n = 47). Further, SUV levels in patients with PM reflected disease activity as estimated by HRCT, but did not differ significantly
between those with TB (4.96 ± 1.61, n = 25) and MAC (5.15 ± 1.53, n = 22). 18F-FDG uptake was significantly decreased in all 14 patients who received chemotherapy, indicating a positive response to treatment.
Conclusion
18F-FDG PET is considered to be useful for the diagnosis and evaluation of disease activity along with HRCT findings, and in
monitoring response to chemotherapy in patients with PM. 相似文献
12.
Alexander Haug Christoph J. Auernhammer Björn Wängler Reinhold Tiling Gerwin Schmidt Burkhard Göke Peter Bartenstein Gabriele Pöpperl 《European journal of nuclear medicine and molecular imaging》2009,36(5):765-770
Aim To compare the diagnostic impact of 68Ga-DOTA-TATE and 18F-DOPA PET in the diagnosis of well-differentiated metastatic neuroendocrine tumours (NET).
Methods PET/CT using both 68Ga-DOTA-TATE and 18F-DOPA was performed in 25 patients with histologically proven metastatic NET (nine gut, five pancreas, six lung, one paranasal
sinus, four with unknown primary). Analyses of PET examinations were patient-based (pathological uptake: yes/no), and based
on tumour regions (primary tumour if present and metastases of liver, lung, bones and lymph nodes). The results were compared
with the results of contrast enhanced CT, and with plasma serotonin levels, which were available in 24 of the 25 patients.
Results Patient-based sensitivities were 96% for 68Ga-DOTA-TATE PET and 56% for 18F-DOPA PET. 68Ga-DOTA-TATE PET delineated metastases in 54 of 55 positive metastatic tumour regions in contrast to 29 of 55 delineated by
18F-DOPA PET. Overall, 68Ga-DOTA-TATE was superior to 18F-DOPA in 13 patients (two patients showed fewer positive tumour regions with 18F-DOPA PET). The results were comparable in 12 patients. In 13 of 24 patients, plasma serotonin levels were elevated, and
11 of these 13 patients showed pathological uptake of 18F-DOPA. Of the 11 patients with normal levels of serotonin, 3 also showed positive 18F-DOPA uptake. In patients positive for 18F-DOPA uptake the maximum tumour SUVs were correlated with the levels of serotonin (r=0.66, p=0.01).
Conclusion In this study 68Ga-DOTA-TATE PET proved clearly superior to 18F-DOPA PET for detection and staging of NET. 18F-DOPA uptake tended to be increased in those patients with elevated plasma serotonin. We conclude that 18F-DOPA PET should be employed in patients with NET with negative 68Ga-DOTA-TATE PET and elevated plasma serotonin. 相似文献
13.
Soyeon Park Eunsub Lee Seunghong Rhee Jaehyuk Cho Sunju Choi Sinae Lee Jae Seon Eo Kisoo Pahk Jae Gol Choe Sungeun Kim 《Nuclear Medicine and Molecular Imaging》2016,50(1):24-30
Purpose
The aim of this study was to evaluate the relationship between semiquantitative parameters on 18F-FDG PET/CT including maximum standardized uptake value (SUVmax), mean standardized uptake value (SUVmean), metabolic tumor volume (MTV), and total lesion glycolysis (TLG) and the expression level of Ki-67 in small-cell lung cancer (SCLC).Methods
Ninety-four consecutive patients with SCLC were enrolled in this study. They underwent 18F-FDG PET/CT for initial evaluation of SCLC, and we measured SUVmax, avgSUVmean, MTVsum, and TLGtotal on 18F-FDG PET/CT images. The protein expression of Ki-67 was examined by immunohistochemical staining.Results
Significant correlations were found between the MTVsum and Ki-67 labeling index (r = 0.254, p = 0.014) and the TLGtotal and Ki-67 labeling index (r = 0.239, p = 0.020). No correlation was found between the SUVmax and Ki-67 labeling index (r = 0.116, p = 0.264) and the avgSUVmean and Ki-67 labeling index (r = 0.031, p = 0.770). Dividing the Ki-67 expression level into three categories, it was suggested that increasing Ki-67 expression level caused a stepwise increase in the MTVsum and TLGtotal. (p = 0.028 and 0.039, respectively), but not the SUVmax and avgSUVmean (p = 0.526 and 0.729, respectively).Conclusion
In conclusion, the volume-based parameters of 18F-FDG PET/CT correlate with immunohistochemical staining of Ki-67 in SCLC. Measurement of the MTVsum and TLGtotal by 18F-FDG PET/CT might be a simple, noninvasive, and useful method to determine the proliferative potential of cancer cells. 相似文献14.
Curtet C Carlier T Mirallié E Bodet-Milin C Rousseau C Barbet J Kraeber-Bodéré F 《European journal of nuclear medicine and molecular imaging》2007,34(10):1556-1562
Purpose This study was aimed at evaluating the spatial resolution and sensitivity of two hand-held gamma probes. Radioguided surgery
was tested in seven patients with iodine-negative differentiated thyroid cancer (DTC) recurrence using 18F-FDG PET.
Methods Two gamma probes were evaluated: Clerad’s GammaSup with a collimated CsI(Tl) scintillator and Novelec’s Modelo2 with a BGO
scintillator. Five measurement tests were performed following the NEMA guidelines (NU3-2004). Radioguided surgery was performed
in patients with recurrent DTC and abnormal 18F-FDG uptake on preoperative 18F-FDG PET images. Patients were injected with rTSH 2 days before surgery. A mean activity of 211 MBq of 18F-FDG was injected 60 min before surgery. In vivo and ex vivo counts were recorded for suspected tumours and normal tissue.
Results Spatial resolution was higher with the CsI(Tl) than with the BGO detector: 20.2–40.6 mm vs 20.6–55.3 mm from 0 to 20 mm depth.
Sensitivity in air and water and through side shielding was higher for BGO but the signal-to-noise ratio was 88 and 22 with
the BGO compared to 131 and 76 with the CsI(Tl) at 10 and 30 mm depth. Median in vivo SNR (tumour/non-tumour ratio) was 1.8
with both the BGO and the CsI(Tl) detector, while ex vivo ratios of 2.3 and 2.1, respectively, were obtained. Radioguided
surgery allowed detection of all of the tumours identified by 18F-FDG PET images.
Conclusion This study demonstrated the feasibility of high-energy photon detection with a conventional scintillator equipped with a collimator.
The CsI(TI) probe detected more true events from background than did the BGO detector during surgery. 相似文献
15.
Yukishige Kyoto Mitsuru Momose Chisato Kondo Michio Itabashi Shingo Kameoka Kiyoko Kusakabe 《Annals of nuclear medicine》2010,24(5):395-401
Objective
Elevated levels of serum carcinoembryonic antigen (CEA) in patients with colorectal cancer (CRC) during follow-up suggest recurrence, which can be visualized by 18F-FDG PET/CT. Since the magnitude of CEA elevation reflects cancer volume, the ability of PET/CT to detect recurrence in patients with only mildly elevated CEA might be limited. However, the accuracy of PET/CT in detecting recurrence associated with elevated CEA has not been fully assessed. We retrospectively evaluated the diagnostic performance of 18F-FDG PET/CT postoperatively relative to CEA levels among patients with CRC. 相似文献16.
Braun JJ Kessler R Constantinesco A Imperiale A 《European journal of nuclear medicine and molecular imaging》2008,35(8):1537-1543
PURPOSE: To evaluate the interest of (18)F-fluoro-2-deoxy-D: -glucose positron emission tomography/computed tomography ((18)F-FDG PET/CT) for diagnosis and therapeutic follow-up of patients with sarcoidosis. METHODS: Twenty consecutive patients with biopsy-proven sarcoidosis were retrospectively included, in particular, 13 and seven cases of thoracic and extra-thoracic sarcoidosis, respectively. All patients underwent (18)F-FDG PET/CT, and 12 of them also (67)Ga scintigraphy. Five patients were re-examined by (18)F-FDG PET/CT to assess response to corticosteroid (CS) treatment. RESULTS: Sensitivity of (18)F-FDG PET/CT in detecting active sarcoidosis localizations was determined considering only biopsy-proven sites. For thoracic, sinonasal, and pharyngo-laryngeal localizations, (18)F-FDG PET/CT sensitivity was 100%, 100%, and 80%, respectively. Overall sensitivity for all 36 biopsy-proven localizations improved from 78% to 87% after excluding skin involvement. Considering only the 12 patients who underwent both scintigraphic examinations, overall sensitivity of (67)Ga scintigraphy and (18)F-FDG PET/CT was 58% and 79%, respectively and improved to 67% and 86% after excluding all sites of skin involvement. To evaluate the efficacy of CS treatment, five enrolled patients underwent second (18)F-FDG PET/CT. Complete regression of all foci of pathological tracer uptake was showed in two cases, permitting CS withdrawal after 2 and 6 months. Improvement but incomplete regression of mediastino-pulmonary disease occurred in two patients treated with CS for 19 and 21 months. Disease progression was assessed in one patient treated with decreasing doses of CS during 16 months. CONCLUSION: (18)F-FDG PET/CT allows to obtain a complete morpho-functional cartography of inflammatory active localizations and to follow treatment efficacy in patients with sarcoidosis, particularly in atypical, complex, and multisystemic forms. 相似文献
17.
Alkhawaldeh K Bural G Kumar R Alavi A 《European journal of nuclear medicine and molecular imaging》2008,35(2):246-252
Purpose Our aim was to assess the diagnostic potential of 18F-FDG PET using partial volume correction and dual-time-point imaging in the assessment of solitary pulmonary nodules.
Methods We included 265 patients in this retrospective study (171 men; 94 women; age range, 41–92 years). All had pulmonary nodules
on CT, and diagnosis was confirmed by biopsy or follow-up CT. All underwent whole body FDG PET, 60 min after FDG injection.
Of the 265 patients, 255 underwent second FDG PET for chest 100 min after injection. Maximum SUVs for nodules were calculated
from both scans. Partial volume correction for first time SUVs was applied, using coefficient factor. Malignancy was defined
using the following criteria: (1) Visual assessment; (2) First time SUV ≥ 2.5; (3) Partial volume corrected first time SUV ≥ 2.5;
(4) second time SUV ≥ 2.5; (5) Increase in SUV over time; (6) Increase or no change in SUV; (7) First time SUV ≥ 2.5 and/or
increase or no change in SUV.
Results Biopsy and follow-up revealed 72 malignant lung nodules and 193 benign nodules. Sensitivity, specificity and accuracy for
the five criteria were as follows: (1) 97, 58 and 68%; (2) 65, 92 and 85%; (3) 84, 91 and 89%; (4) 90, 80 and 83%; (5) 84,
95 and 92%; (6) 92, 92, and 92%; (7) 95, 90 and 91%, respectively.
Conclusion Dual-time-point 18F-FDG PET has potential impact on improving the diagnostic accuracy for malignant lung nodules. Dual-time-point 18F-FDG PET imaging should be included in the clinical work-up of patients with pulmonary nodule. 相似文献
18.
Nakagawa M Kuwabara Y Sasaki M Koga H Chen T Kaneko O Hayashi K Morioka T Masuda K 《Annals of nuclear medicine》2002,16(3):207-211
OBJECTIVES: Carbon-11-L-methyl-methionine (11C-methionine) has been reported to be useful for evaluating brain tumors, but several other brain disorders have also shown signs of high methionine uptake. We retrospectively evaluated the significance of 11C-methionine uptake in cerebrovascular diseases, and also compared our results with those for 18F-FDG PET and 99mTc-HMPAO SPECT. METHODS: Seven patients, including 3 patients with a cerebral hematoma and 4 patients with a cerebral infarction, were examined. All 7 patients underwent both 11C-methionine PET and 99mTc-HMPAO SPECT, and 6 of them underwent 18F-FDG PET. RESULTS: A high 11C-methionine uptake was observed in all 3 patients with cerebral hematoma. Increased 99mTc-HMPAO uptake was observed in 2 out of 3 patients, and all 3 patients had decreased 18F-FDG uptake. Of 4 patients with a cerebral infarction, high 11C-methionine uptake was observed in 3. Increased 99mTc-HMPAO uptake was also observed in one patient, whereas 3 patients had decreased 18F-FDG uptake. CONCLUSIONS: We should keep in mind that high 11C-methionine uptake is frequently observed in cerebrovascular diseases. CVD should therefore be included in the differential diagnosis when encounting patients with a high 11C-methionine uptake. 相似文献
19.
Aim
The aim of this study was to assess the combined use of the radiotracers 18F-FDG and 18F-NaF in treatment response evaluation of a group of multiple myeloma (MM) patients undergoing high-dose chemotherapy (HDT) followed by autologous stem cell transplantation (ASCT) by means of static (whole-body) and dynamic PET/CT (dPET/CT).Patients and methods
Thirty-four patients with primary, previously untreated MM scheduled for treatment with HDT followed by ASCT were enrolled in the study. All patients underwent PET/CT scanning with 18F-FDG and 18F-NaF before and after therapy. Treatment response by means of PET/CT was assessed according to the European Organization for Research and Treatment of Cancer (EORTC) 1999 criteria. The evaluation of dPET/CT studies was based on qualitative evaluation, semi-quantitative (SUV) calculation, and quantitative analysis based on two-tissue compartment modelling and a non-compartmental approach leading to the extraction of fractal dimension (FD).Results
An analysis was possible in 29 patients: three with clinical complete response (CR) and 26 with non-CR (13 patients near complete response-nCR, four patients very good partial response-VGPR, nine patients partial response-PR). After treatment, 18F-FDG PET/CT was negative in 14/29 patients and positive in 15/29 patients, showing a sensitivity of 57.5 % and a specificity of 100 %. According to the EORTC 1999 criteria, 18F-FDG PET/CT-based treatment response revealed CR in 14 patients (18F-FDG PET/CT CR), PR in 11 patients (18F-FDG PET/CT PR) and progressive disease in four patients (18F-FDG PET/CT PD). In terms of 18F-NaF PET/CT, 4/29 patients (13.8 %) had a negative baseline scan, thus failed to depict MM. Regarding the patients for which a direct lesion-to-lesion comparison was feasible, 18F-NaF PET/CT depicted 56 of the 129 18F-FDG positive lesions (43 %). Follow-up 18F-NaF PET/CT showed persistence of 81.5 % of the baseline 18F-NaF positive MM lesions after treatment, despite the fact that 64.7 % of them had turned to 18F-FDG negative. Treatment response according to 18F-NaF PET/CT revealed CR in one patient (18F-NaF PET/CT CR), PR in five patients (18F-NaF PET/CT PR), SD in 12 patients (18F-NaF PET/CT SD), and PD in seven patients (18F-NaF PET/CT PD). Dynamic 18F-FDG and 18F-NaF PET/CT studies showed that SUVaverage, SUVmax, as well as the kinetic parameters K1, influx and FD from reference bone marrow and skeleton responded to therapy with a significant decrease (p?<?0.001).Conclusion
F-FDG PET/CT demonstrated a sensitivity of 57.7 % and a specificity of 100 % in treatment response evaluation of MM. Despite its limited sensitivity, the performance of 18F-FDG PET/CT was satisfactory, given that 6/9 false negative patients in follow-up scans (66.7 %) were clinically characterized as nCR, a disease stage with very low tumor mass. On the other hand, 18F-NaF PET/CT does not seem to add significantly to 18F-FDG PET/CT in treatment response evaluation of MM patients undergoing HDT and ASCT, at least shortly after therapy.20.
Suk Hyun Lee Sangwon Han Hyo Sang Lee Sun Young Chae Jong Jin Lee Dong Eun Song Jin-Sook Ryu 《Nuclear Medicine and Molecular Imaging》2016,50(1):38-45