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1.
Satoshi Takeuchi Aparna Balachandran Mouhammed Amir Habra Alexandria T. Phan Roland L. Bassett Jr. Homer A. Macapinlac Hubert H. Chuang 《European journal of nuclear medicine and molecular imaging》2014,41(11):2066-2073
Purpose
Adrenocortical carcinoma (ACC) is a rare and aggressive malignancy. Limited data are available about on value of 18F-FDG PET/CT in ACC. We evaluated the impact of PET/CT on the management of ACC.Methods
We performed a retrospective review in patients with ACC who had undergone PET/CT. The impact of PET/CT on the management plan was evaluated by comparing the findings on PET/CT to the findings on contrast-enhanced CT. The sensitivity, specificity, and accuracy of each form of imaging were calculated. The correlations between PET/CT parameters, including maximum standardized uptake value (SUVmax), total lesion glycolysis, and decline in SUVmax after chemotherapy, and clinical outcome were evaluated.Results
Included in the analysis were 106 patients with 180 PET/CT scans. Of the 106 patients, 7 underwent PET/CT only for initial staging, 84 underwent PET/CT only for restaging, and 15 underwent PET/CT for both initial staging and restaging. PET/CT changed the management plan in 1 of 22 patients (5 %) at initial staging and 9 of 99 patients (9 %) at restaging. In 5 of the patients in whom PET/CT changed the management plan, PET/CT showed response to chemotherapy but contrast-enhanced CT showed stable disease. Sensitivity, specificity, and accuracy were 100 %, 100 %, and 100 % for PET/CT at initial staging; 92.6 %, 100 %, and 96.4 % for CT at initial staging; 98.4 %, 100 %, and 99.5 % for PET/CT at restaging; and 96.8 %, 98.6 %, and 98.0 % for CT at restaging, respectively. No PET/CT parameters were associated with survival at either initial diagnosis or recurrence.Conclusion
PET/CT findings could substantially change the management plan in a small proportion of patients with ACC. Although lesion detection was similar between PET/CT and CT, PET/CT may be preferred for chemotherapeutic response assessment because it may predict response before anatomic changes are detected on CT. 相似文献2.
Published data on the diagnosis of bone metastases of prostate cancer are conflicting and heterogeneous. We performed a comprehensive meta-analysis to compare the diagnostic performance of choline-PET/CT, MRI, bone SPECT, and bone scintigraphy (BS) in detecting bone metastases in parents with prostate cancer. Pooled sensitivity, specificity, and diagnostic odds ratios (DOR) were calculated both on a per-patient basis and on a per-lesion basis. Summary receiver operating characteristic (SROC) curves were also drawn to obtain the area under curve (AUC) and Q* value. Sixteen articles consisting of 27 studies were included in the analysis. On a per-patient basis, the pooled sensitivities by using choline PET/CT, MRI, and BS were 0.91 [95 % confidence interval (CI): 0.83–0.96], 0.97 (95 % CI: 0.91–0.99), 0.79 (95 % CI: 0.73–0.83), respectively. The pooled specificities for detection of bone metastases using choline PET/CT, MRI, and BS, were 0.99 (95 % CI: 0.93–1.00), 0.95 (95 % CI: 0.90–0.97), and 0.82 (95 % CI: 0.78–0.85), respectively. On a per-lesion basis, the pooled sensitivities of choline PET/CT, bone SPECT, and BS were 0.84 (95 % CI: 0.81–0.87), 0.90 (95 % CI: 0.86–0.93), 0.59 (95 % CI: 0.55–0.63), respectively. The pooled specificities were 0.93 (95 % CI: 0.89–0.96) for choline PET/CT, 0.85 (95 % CI: 0.80–0.90) for bone SPECT, and 0.75 (95 % CI: 0.71–0.79) for BS. This meta-analysis indicated that MRI was better than choline PET/CT and BS on a per-patient basis. On a per-lesion analysis, choline PET/CT with the highest DOR and Q* was better than bone SPECT and BS for detecting bone metastases from prostate cancer. 相似文献
3.
Punit Sharma Niraj Naswa Sudhir Suman KC Luis Andres Alvarado Alok Kumar Dwivedi Yashwant Yadav Rakesh Kumar Ariachery C. Ammini Chandrasekhar Bal 《European journal of nuclear medicine and molecular imaging》2014,41(12):2194-2202
Purpose
To determine the prognostic value of 68Ga-DOTANOC PET/CT in patients with well-differentiated neuroendocrine tumor (NET), and to compare the prognostic value with that of 18F-FDG PET/CT and other conventional clinicopathological prognostic factors.Methods
Data from 37 consecutive patients (age 46.6?±?13.5 years, 51 % men) with well-differentiated NET who underwent 68Ga-DOTANOC PET/CT and 18F-FDG PET/CT were analyzed. All patients underwent a baseline visit with laboratory and radiological examinations. Clinical and imaging follow-up was performed in all patients. Progression-free survival (PFS) was measured from the date of the first PET/CT scan to the first documentation of progression of disease.Results
68Ga-DOTANOC PET/CT was positive in 37 of the 37 patients and 18F-FDG PET/CT was positive in 21. During follow-up 10 patients (27 %) showed progression of disease and 27 (73 %) showed no progression (24 stable disease, 3 partial response). The median follow-up was 25 months (range 2 – 52 months). Among the variables evaluated none was significantly different between the progressive disease and nonprogressive disease groups, with only SUVmax on 68Ga-DOTANOC PET/CT being borderline significant (P?=?0.073). In the univariate analysis for PFS outcome, SUVmax on 68Ga-DOTANOC PET/CT (HR 0.122, 95 % CI 0.019 – 0.779; P?=?0.026) and histopathological tumor grade (HR 4.238, 95 % CI 1.058 – 16.976; P?=?0.041) were found to be associated with PFS. Other factors including age, sex, primary site, Ki-67 index, TNM stage, 18F-FDG PET/CT status (positive/negative), SUVmax on 18F-FDG PET/CT and type of treatment were not significant. In multivariable analysis, only SUVmax on 68Ga-DOTANOC PET/CT was found to be an independent positive predictor of PFS (HR 0.122, 95 % CI 0.019 – 0.779; P?=?0.026).Conclusion
SUVmax measured on 68Ga-DOTANOC PET/CT is an independent, positive prognostic factor in patients with well-differentiated NET and is superior to SUVmax on 18F-FDG PET/CT and conventional clinicopathological factors for predicting PFS. 相似文献4.
Luka Lezaic Sebastijan Rep Mojca Jensterle Sever Tomaz Kocjan Marko Hocevar Jure Fettich 《European journal of nuclear medicine and molecular imaging》2014,41(11):2083-2089
Purpose
Primary hyperparathyroidism is a common endocrine disorder which is diagnosed biochemically and for which therapy is surgical. A prerequisite for minimally invasive surgery, which minimizes morbidity and cost, is accurate localization of the involved gland(s). The aim of this study was to evaluate the usefulness of 18F-fluorocholine PET/CT for preoperative localization of hyperfunctioning parathyroid tissue.Methods
18F-Fluorocholine PET/CT and conventional parathyroid scintigraphic imaging consisting of 99mTc-sestaMIBI SPECT/CT, 99mTc-sestaMIBI dual-phase imaging and 99mTc-sestaMIBI/pertechnetate subtraction imaging were performed in 24 patients. The diagnostic performance of the imaging methods was compared against histology as the gold standard and postoperative serum Ca2+ and iPTH values.Results
The sensitivity and specificity of 18F-fluorocholine PET/CT were 92 % and 100 %, respectively, in contrast to 49 % and 100 %, 46 % and 100 %, and 44 % and 100 % for 99mTc-sestaMIBI SPECT/CT, 99mTc-sestaMIBI/pertechnetate subtraction imaging and 99mTc-sestaMIBI dual-phase imaging, respectively. Combined conventional scintigraphic imaging had a sensitivity and specificity of 64 % and 100 %, respectively. The performance of 18F-fluorocholine PET/CT was superior particularly in patients with multiple lesions or hyperplasia.Conclusion
18F-Fluorocholine PET/CT appears to be a promising, effective imaging method for localization of hyperfunctioning parathyroid tissue. 相似文献5.
Joyce C. Mhlanga John A. Carrino Martin Lodge Hao Wang Richard L. Wahl 《European journal of nuclear medicine and molecular imaging》2014,41(12):2337-2345
Purpose
The aim of this study was to prospectively determine the feasibility and compare the novel use of a positron emission mammography (PEM) scanner with standard PET/CT for evaluating hand osteoarthritis (OA) with 18F-FDG.Methods
Institutional review board approval and written informed consent were obtained for this HIPAA-compliant prospective study in which 14 adults referred for oncological 18F-FDG PET/CT underwent dedicated hand PET/CT followed by arthro-PET using the PEM device. Hand radiographs were obtained and scored for the presence and severity of OA. Summed qualitative and quantitative joint glycolytic scores for each modality were compared with the findings on plain radiography and clinical features.Results
Eight patients with clinical and/or radiographic evidence of OA comprised the OA group (mean age 73?±?7.7 years). Six patients served as the control group (53.7?±?9.3 years). Arthro-PET quantitative and qualitative joint glycolytic scores were highly correlated with PET/CT findings in the OA patients (r?=?0.86. p??=?0.007; r?=?0.94, p?=?0.001). Qualitative arthro-PET and PET/CT joint scores were significantly higher in the OA patients than in controls (38.7?±?6.6 vs. 32.2?±?0.4, p?=?0.02; 37.5?±?5.4 vs. 32.2?±?0.4, p?=?0.03, respectively). Quantitative arthro-PET and PET/CT maximum SUV-lean joint scores were higher in the OA patients, although they did not reach statistical significance (20.8?±?4.2 vs. 18?±?1.8, p?=?0.13; 22.8?±?5.38 vs. 20.1?±?1.54, p=?0.21). By definition, OA patients had higher radiographic joint scores than controls (30.9?±?31.3 vs. 0, p?=?0.03).Conclusion
Hand imaging using a small field of view PEM system (arthro-PET) with FDG is feasible, performing comparably to PET/CT in assessing metabolic joint activity. Arthro-PET and PET/CT showed higher joint FDG uptake in OA. Further exploration of arthro-PET in arthritis management is warranted. 相似文献6.
Carlos Caicedo Maria Jose Garcia-Velloso Maria Dolores Lozano Tania Labiano Carmen Vigil Diaz Jose Maria Lopez-Picazo Alfonso Gurpide Javier Zulueta Jose Angel Richter Echevarria Jose Luis Perez Gracia 《European journal of nuclear medicine and molecular imaging》2014,41(11):2058-2065
Purpose
The tumour molecular profile predicts the activity of epidermal growth factor receptor (EGFR) inhibitors in non-small-cell lung cancer (NSCLC). However, tissue availability and tumour heterogeneity limit its assessment. We evaluated whether [18F]FDG PET might help predict KRAS and EFGR mutation status in NSCLC.Methods
Between January 2005 and October 2011, 340 NSCLC patients were tested for KRAS and EGFR mutation status. We identified patients with stage III and IV disease who had undergone [18F]FDG PET/CT scanning for initial staging. SUVpeak, SUVmax and SUVmean of the single hottest tumour lesions were calculated, and their association with KRAS and EGFR mutation status was assessed. A receiver operator characteristic (ROC) curve analysis and a multivariate analysis (including SUVmean, gender, age and AJCC stage) were performed to identify the potential value of [18F]FDG PET/CT for predicting KRAS mutation.Results
From 102 patients staged using [18F]FDG PET/CT, 28 (27 %) had KRAS mutation (KRAS+), 22 (22 %) had EGFR mutation (EGFR+) and 52 (51 %) had wild-type KRAS and EGFR profiles (WT). KRAS+ patients showed significantly higher [18F]FDG uptake than EGFR+ and WT patients (SUVmean 9.5, 5.7 and 6.6, respectively; p?0.001). No significant differences were observed in [18F]FDG uptake between EGFR+ patients and WT patients. ROC curve analysis for KRAS mutation status discrimination yielded an area under the curve of 0.740 for SUVmean (p?0.001). The multivariate analysis showed a sensitivity and specificity of 78.6 % and 62.2 %, respectively, and the AUC was 0.773.Conclusion
NSCLC patients with tumours harbouring KRAS mutations showed significantly higher [18F]FDG uptake than WT patients, as assessed in terms of SUVpeak, SUVmax and SUVmean. A multivariate model based on age, gender, AJCC stage and SUVmean might be used as a predictive marker of KRAS mutation status in patients with stage III or IV NSCLC. 相似文献7.
Jean François Grellier Laetitia Vercellino Thierry Leblanc Pascal Merlet Catherine Thieblemont Pierre Weinmann Marie-Elisabeth Toubert Nathalie Berenger Josette Brière Pauline Brice 《European journal of nuclear medicine and molecular imaging》2014,41(11):2023-2030
Purpose
Nodular lymphocyte-predominant Hodgkin lymphoma (NLPHL) is a rare Hodgkin lymphoma distinguished from classical Hodgkin lymphoma (cHL) by the nature of the neoplastic cells which express B-cell markers. We wanted to determine the diagnostic performance of FDG PET/CT in initial assessment and its therapeutic impact on staging.Methods
We retrospectively studied a population of 35 patients with NLPHL (8 previously treated for NLHPL, 27 untreated). All patients underwent an initial staging by pretherapeutic FDG PET/CT. The impact on initial stage or relapse stage was assessed by an independent physician.Results
In a per-patient analysis, the sensitivity of the pretherapeutic FDG PET/CT was 100 %. In a per-site analysis, the sensitivity, specificity, positive predictive value, negative predictive value and accuracy of pretherapeutic FDG PET/CT were 100 %, 99 %, 97 %, 100 % and 99 %, respectively. Pretherapeutic FDG PET/CT led to a change in the initial stage/relapse stage in 12 of the 35 patients (34 %). In contrast to previous results established without FDG PET/CT, 20 % of patient had osteomedullary lesions.Conclusion
Pretherapeutic FDG PET/CT has excellent performance for initial staging or relapse staging of NLPHL. 相似文献8.
Kai-Hsiung Ko Hsian-He Hsu Tsai-Wang Huang Hong-Wei Gao Daniel H. Y. Shen Wei-Chou Chang Yi-Chih Hsu Tsun-Hou Chang Chi-Ming Chu Ching-Liang Ho Hung Chang 《European journal of nuclear medicine and molecular imaging》2014,41(10):1889-1897
Purpose
The identification of the mutation status of the epidermal growth factor receptor (EGFR) is important for the optimization of treatment in patients with pulmonary adenocarcinoma. The acquisition of adequate tissues for EGFR mutational analysis is sometimes not feasible, especially in advanced-stage patients. The aim of this study was to predict EGFR mutation status in patients with pulmonary adenocarcinoma based on 18F-fluorodeoxyglucose (FDG) uptake and imaging features in positron emission tomography/computed tomography (PET/CT), as well as on the serum carcinoembryonic antigen (CEA) level.Methods
We retrospectively reviewed 132 pulmonary adenocarcinoma patients who underwent EGFR mutation testing, pretreatment FDG PET/CT and serum CEA analysis. The associations between EGFR mutations and patient characteristics, maximal standard uptake value (SUVmax) of primary tumors, serum CEA level and CT imaging features were analyzed. Receiver-operating characteristic (ROC) curve analysis was performed to quantify the predictive value of these factors.Results
EGFR mutations were identified in 69 patients (52.2 %). Patients with SUVmax ≥6 (p?=?0.002) and CEA level ≥5 (p?=?0.013) were more likely to have EGFR mutations. The CT characteristics of larger tumors (≥3 cm) (p?=?0.023) and tumors with a nonspiculated margin (p?=?0.026) were also associated with EGFR mutations. Multivariate analysis showed that higher SUVmax and CEA level, never smoking and a nonspiculated tumor margin were the most significant predictors of EGFR mutation. The combined use of these four criteria yielded a higher area under the ROC curve (0.82), suggesting a good discrimination.Conclusion
The combined evaluation of FDG uptake, CEA level, smoking status and tumor margins may be helpful in predicting EGFR mutation status in patients with pulmonary adenocarcinoma, especially when the tumor sample is inadequate for genetic analysis or genetic testing is not available. Further large-scale prospective studies are needed to validate these results. 相似文献9.
Takeshi Shinozaki Kenichi Utano Hiroyuki Fujii Yuka Utano Takahiro Sasaki Shigeyoshi Kijima Hidenori Kanazawa Yukio Kimura Akifumi Fujita Hideharu Sugimoto 《Japanese journal of radiology》2014,32(8):476-481
Objective
The objective of this study was to compare the diagnostic accuracy of dual-time-point 18F-fluorodeoxyglucose (18F-FDG) positron emission tomography (PET) to single-time-point 18F-FDG PET for staging of preoperative lung cancer.Methods
Between November 2008 and December 2009, 107 patients who were diagnosed as having lung cancer or strongly suspected of having lung cancer were enrolled. They underwent dual-time-point 18F-FDG PET following conventional imaging. Dual-time-point 18F-FDG PET imaging (whole body) was performed at 1-h (early) post-FDG injection and repeated (2 h delayed) after injection. The diagnostic accuracy of pre-PET staging and post-PET staging was retrospectively evaluated, and the diagnostic accuracy of dual-time-point 18F-FDG PET was compared to that of single-time-point 18F-FDG PET.Results
In 100 patients, the early 18F-FDG PET scan resulted in upstaging of the tumor in ten (10 %) and down-staging of the tumor in five (5 %) compared to the conventional scan. The delayed phase of 18F-FDG PET provided no additional information on staging for lung cancer patients. The remaining seven patients were diagnosed as not having lung cancer.Conclusion
This study confirmed that dual-time-point 18F-FDG PET is useful for differential diagnosis between benign and malignant lesions, but has no major impact on staging and therapeutic management of patients with pathologically proven lung cancer. 相似文献10.
Dong Yun Lee Chang Hwan Lee Min Jung Seo Suk Hyun Lee Jin-Sook Ryu Jong Jin Lee 《Annals of nuclear medicine》2014,28(8):789-795
Objective
The purpose of this study was to investigate the diagnostic performance of postoperative fluorine-18 fluoro-2-deoxy-d-glucose (18F-FDG) positron emission tomography/computed tomography (PET/CT) as a surveillance modality for advanced gastric cancer patients who were asymptomatic and negative by conventional follow-up.Methods
We retrospectively collected 46 advanced gastric cancer patients who received approximately 1-year-postoperative 18F-FDG PET/CT surveillance following curative resection (mean age 60.6 ± 11.5 years). 18F-FDG PET/CT was interpreted by nuclear medicine physicians who were blind to the clinical information. Final confirmation was determined by clinical follow-up using tumor markers, conventional CT scan, upper gastrointestinal endoscopy and with/without subsequent histopathologic diagnosis.Results
Four patients developed recurrence (8.7 %; 1 local and 3 distant recurrences). For local recurrence, 18F-FDG PET/CT found four hypermetabolic lesions and one was local recurrence. For distant recurrence, seven hypermetabolic lesions were found in six patients and true-positive was three lesions. False-positive cases were mainly turned out to be physiologic small bowel uptake. Regardless of the recurrence site, the sensitivity, specificity, positive predictive value and negative predictive value of 18F-FDG PET/CT were 100 % (4/4, 95 % confidence interval (CI) 39.6–100 %), 88.1 % (37/42, 95 % CI 73.6–95.5 %), 44.4 % (4/9, 95 % CI 15.3–77.3 %) and 100 % (37/37, 95 % CI 88.3–100 %), respectively in the patient-based analysis.Conclusion
Our study showed good specificity of postoperative surveillance 18F-FDG PET/CT for detecting recurrence. Careful caution should be made for interpreting some false-positive hypermetabolic lesions in postoperative 18F-FDG PET/CT, especially at the local anastomosis site. 相似文献11.
Omar Alonso Mónica Rodríguez-Taroco Eduardo Savio Cecilia Bentancourt Juan P. Gambini Henry Engler 《Annals of nuclear medicine》2014,28(7):638-645
Objective
There is little evidence regarding the role of 68Ga-DOTATATE PET/CT for the identification of primary tumors in patients with metastatic neuroendocrine carcinoma of unknown primary. The aim of this study is to assess the value of this technique in the mentioned clinical scenario.Methods
We retrospectively studied twenty-nine patients (mean age 59.5 ± 10.6 years; female 17) with pathologically proven neuroendocrine metastases. In all cases conventional imaging was negative for primary tumor identification. 68Ga-DOTATATE PET/CT was performed with a mean dose of 104.2 ± 18.8 MBq, using a 64-slice PET/CT with time-of-flight correction. A team of an experienced radiologist and a nuclear medicine physician evaluated the images. The maximum SUV (SUVm) was measured in all abnormal foci. Histopathology (when available) and/or clinical follow-up with correlative imaging was considered as reference standard.Results
68Ga-DOTATATE PET/CT identified the primary tumor in 17/29 (59 %) patients in the following locations: pancreas (n = 7), ileum (n = 7), duodenum (n = 1), colon (n = 1) and stomach (n = 1). In this population a significant correlation was found between SUVm of primary tumor and metastases (r = 0.815, P < 0.0001). Furthermore, additional sites of unsuspected metastases were demonstrated in 9 patients of this group and in 6 patients in whom no primary tumor was localized, mainly in lymph nodes and mesentery. Pathology confirmation was obtained in 7 patients who underwent surgery, whereas in the remaining 10 patients, correlative imaging and follow-up confirmed primary tumor localization.Conclusions
68Ga-DOTATATE PET/CT is a clinically useful imaging technique for the localization of primary tumors in patients with neuroendocrine metastatic carcinoma of unknown origin with the potential of having a significant impact in patient management and therapy planning. 相似文献12.
F. Cornelis M. Silk H. Schoder H. Takaki J. C. Durack J. P. Erinjeri C. T. Sofocleous R. H. Siegelbaum M. Maybody S. B. Solomon 《European journal of nuclear medicine and molecular imaging》2014,41(12):2265-2272
Purpose
We sought to evaluate the safety and the diagnostic success rate of percutaneous biopsies performed under intra-procedural 18?F-deoxyglucose (FDG) positron-emission tomography/computed tomography (PET/CT) guidance for lesions difficult to see with conventional cross-sectional imaging.Methods
From 2011 to 2013, consecutive clinically indicated percutaneous PET/CT-guided biopsies of 106 masses (mean size, 3.3 cm; range, 0.7–15.9 cm; SD, 2.9 cm) in bones (n?=?33), liver (n?=?26), soft tissues (n?=?18), lung (n?=?15) and abdomen (n?=?14) were reviewed. The biopsy procedures were performed following injection of a mean of 255 MBq (SD, 74) FDG. Mean maximal standardized uptake value (SUV) of lesions was 8.8 (SD, 6.3). A systematic review of the histopathological results and outcomes was performed.Results
Biopsies were positive for malignancy in 76 cases (71.7 %, 76/106) and for benign tissue in 30 cases (28.3 %, 30/106). Immediate results were considered adequate for 100 PET/CT biopsies (94.3 %, 100/106) requiring no further exploration, and for the six others (5.7 %, 6/106) benign diagnoses were confirmed after surgery (n?=?4) or follow-up (n?=?2). The consequent overall sensitivity and the diagnostic success of biopsy were therefore 100 %. No significant differences in terms of detection of malignancy were observed between the different locations. Lesions > 2 cm or with SUV?>?4 were not significantly more likely to be malignant. Complications occurred after four biopsies (3.7 %, 4/106).Conclusion
Intra-procedural PET/CT guidance appears as a safe and effective method and allows high diagnostic success of percutaneous biopsies for metabolically active lesions. 相似文献13.
Sampath Santhosh MD Bhagwant Rai Mittal MD DNB Shankaramurthy Gayana MD Anish Bhattacharya DNB Aman Sharma MD Sanjay Jain MD DM 《Journal of nuclear cardiology》2014,21(5):993-1000
Objective
To evaluate the performance parameters of FDG PET/CT in patients with Takayasu arteritis at diagnosis and during immunosuppression.Methods
Retrospective analysis of 60 FDG PET/CT studies in 51 patients was performed (17 scans at diagnosis out of which 4 had follow-up scans also and 43 scans on immunosuppression). The degree of FDG uptake in the vessels was assessed visually using a 4-point scale and maximum standardized uptake value (SUVmax), SUVratio, extent of vasculitis and association with ESR were calculated.Results
PET/CT was positive for active vasculitis in all 17 patients at diagnosis. The mean SUVmax and mean SUV ratio of the active areas were 5.1 ± 3.0 and 3.2 ± 1.9, respectively. On immunosuppression, PET scan was positive for active vasculitis in 14/43 (32.5%) scans. The mean SUVmax and mean SUVratio of the active areas were 1.7 ± 2.1 and 0.95 ± 1.2, respectively. There was significant difference between the mean SUVmax and mean SUVratio at diagnosis and on immunosuppression, respectively (P < .01). The median number of vascular segments in each uptake grade group was also statistically different (P < .01) between scans at diagnosis and on immunosuppression. The median ESR level in PET positive scans was 29 mm/hour (2-53), whereas in PET negative scans was 35.5 mm/hour (6-50) and the difference was not statistically significant.Conclusion
FDG PET/CT showed good sensitivity to detect active vasculitis at diagnosis and during immunosuppression. The change in SUVmax between the successive FDG PET/CT scans may give an objective assessment of response to immunosuppression. 相似文献14.
Francesco Ceci Ken Herrmann Paolo Castellucci Tiziano Graziani Christina Bluemel Riccardo Schiavina Christian Vollmer Sabine Droll Eugenio Brunocilla Renzo Mazzarotto Andreas K. Buck Stefano Fanti 《European journal of nuclear medicine and molecular imaging》2014,41(12):2222-2231
Purpose
The aim of this retrospective two-centre study was to investigate the clinical impact of 11C-choline PET/CT on treatment management decisions in patients with recurrent prostate cancer (rPCa) after radical therapy.Methods
Enrolled in this retrospective study were 150 patients (95 from Bologna, 55 from Würzburg) with rPCa and biochemical relapse (PSA mean?±?SD 4.3?±?5.5 ng/mL, range 0.2–39.4 ng/mL) after radical therapy. The intended treatment before PET/CT was salvage radiotherapy of the prostatic bed in 95 patients and palliative androgen deprivation therapy (ADT) in 55 patients. The effective clinical impact of 11C-choline PET/CT was rated as major (change in therapeutic approach), minor (same treatment, but modified therapeutic strategy) or none. Multivariate binary logistic regression analysis included PSA level, PSA kinetics, ongoing ADT, Gleason score, TNM, age and time to relapse.Results
Changes in therapy after 11C-choline PET/CT were implemented in 70 of the 150 patients (46.7 %). A major clinical impact was observed in 27 patients (18 %) and a minor clinical impact in 43 (28.7 %). 11C-choline PET/CT was positive in 109 patients (72.7 %) detecting local relapse (prostate bed and/or iliac lymph nodes and/or pararectal lymph nodes) in 64 patients (42.7 %). Distant relapse (paraaortic and/or retroperitoneal lymph nodes and/or bone lesions) was seen in 31 patients (20.7 %), and both local and distant relapse in 14 (9.3 %). A significant difference was observed in PSA level and PSA kinetics between PET-positive and PET-negative patients (p?0.05). In multivariate analysis, PSA level, PSA doubling time and ongoing ADT were significant predictors of a positive scan (p?0.05). In statistical analysis no significant differences were observed between the Bologna and Würzburg patients (p?>?0.05). In both centres the same criteria to validate PET-positive findings were used: in 17.3 % of patients by histology and in 82.7 % of patients by correlative imaging and/or clinical follow-up (follow-up mean 20.5 months, median 18.3 months, range 6.2–60 months).Conclusion
11C-Choline PET/CT had a significant impact on therapeutic management in rPCa patients. It led to an overall change in 46.7 % of patients, with a major clinical change implemented in 18 % of patients. Further prospective studies are needed to evaluate the effect of such treatment changes on patient survival. 相似文献15.
Anca-Ligia Grosu Gregor Weirich Christina Wendl Vesna Prokic Simon Kirste Hans Geinitz Michael Souvatzoglou Juergen E. Gschwend Markus Schwaiger Michael Molls Wolfgang A. Weber Uwe Treiber Bernd Joachim Krause 《European journal of nuclear medicine and molecular imaging》2014,41(12):2242-2248
Purpose
The aim of this study was to develop a methodology for the comparison of pathology specimens after prostatectomy (post-S) with PET images obtained before surgery (pre-S). This method was used to evaluate the merit of 11C-choline PET/CT for delineation of gross tumour volume (GTV) in prostate cancer (PC).Methods
In 28 PC patients, 11C-choline PET/CT was performed before surgery. PET/CT data were coregistered with the pathology specimens. GTV on PET images (GTV-PET) was outlined automatically and corrected manually. Tumour volume in the prostate (TVP) was delineated manually on the pathology specimens. Based on the coregistered PET/pathology images, the following parameters were assessed: SUVmax and SUVmean in the tumoral and nontumoral prostate (NP), GTV-PET (millilitres) and TVP (millilitres).Results
PET/pathology image coregistration was satisfactory. Mean SUVmax in the TVP was lower than in the NP: 5.0 and 5.5, respectively (p?=?0.093). Considering the entire prostate, SUVmax was located in the TVP in two patients, in the TVP and NP in 12 patients and exclusively in NP in 14 patients. Partial overlap the TVP and GTV-PET was seen in 71 % of patients, and complete overlap in 4 %.Conclusion
PET/pathology image coregistration can be used for evaluation of different imaging modalities. 11C-Choline PET failed to distinguish tumour from nontumour tissue. 相似文献16.
Naoto Sassa Katsuhiko Kato Shinji Abe Shingo Iwano Shinji Ito Mitsuru Ikeda Kazuhiro Shimamoto Seiichi Yamamoto Tokunori Yamamoto Momokazu Gotoh Shinji Naganawa 《European journal of nuclear medicine and molecular imaging》2014,41(12):2232-2241
Purpose
We conducted a pilot study to prospectively evaluate the efficacy of PET/CT with 11C-choline (choline PET/CT) for primary diagnosis and staging of urothelial carcinoma of the upper urinary tract (UUT-UC).Methods
Enrolled in this study were 16 patients (9 men, 7 women; age range 51 – 83 years, mean?±?SD 69?±?10.8 years) with suspected UUT-UC. The patients were examined by choline PET/CT, and 13 underwent laparoscopic nephroureterectomy and partial cystectomy. Lymphadenectomy and chemotherapy were also performed as necessary in some of the patients. Of the 16 patients, 12 were confirmed to have UUT-UC (7 renal pelvis carcinoma and 5 ureteral carcinoma), 1 had malignant lymphoma (ureter), 1 had IgG4-related disease (ureter), and 2 had other benign diseases (ureter).Results
Of the 16 study patients, 13 showed definite choline uptake in urothelial lesions, and of these, 11 had UUT-UC, 1 had malignant lymphoma, and 1 had IgG4-related disease. Three patients without choline uptake comprised one with UUT-UC and two with benign diseases. Of the 12 patients with UUT-UC, 3 had distant metastases, 2 had metastases only in the regional lymph nodes, and 7 had no metastases. Distant metastases and metastases in the regional lymph nodes showed definite choline uptake. The outcome in patients with UUT-UC, which was evaluated 592 – 1,530 days after surgery, corresponded to the patient classification based on the presence or absence of metastases and locoregional or distant metastases. Choline uptake determined as SUVmax 10 min after administration was significantly higher than at 20 min in metastatic tumours of UUT-UC (p?0.05), whereas there was no statistically significant difference between the SUVmax values at 10 and those at 20 min in primary tumours of UUT-UC.Conclusion
This study suggests that choline PET/CT is a promising tool for the primary diagnosis and staging of UUT-UC. 相似文献17.
Objective
Our objective was to evaluate ultrafast cone-beam computed tomography (u-CBCT) image data using cross-sectional images, perfusion blood volume (PBV), and image fusion during tumour detection at the course of transarterial chemoembolization.Methods
One hundred and fifty patients (63?±?20 years; 33–82) were examined from February to October 2013 with u-CBCT. Tumour delineation and conspicuity were determined using u-CBCT cross-sectional PBV and u-CBCT-magnetic resonance imaging (MRI) fused data sets for hyperenhanced (HYET), heterogeneously enhanced (HEET), and unenhanced (UET) tumour categories. Catheter localisation and tumour feeding vessels were assessed using all data sets. Quantitative and qualitative analyses were performed using appropriate statistical tests.Result
Qualitative and quantitative tumour delineation showed significant difference (all P?0.05) among tumour categories. Mean tumour–liver–contrast was higher in HYET than in HEET, and UET; moreover, differences between tumour categories were statistically significant (all P?0.0001). Fused data showed higher value with statistical significance (P?0.05) compared with other data sets during catheter localisation and feeding-vessel identification.Conclusion
Tumour delineation was clearly possible using u-CBCT cross sections with contrast material. PBV uses color-coded images to increase detection and produces good tumour differentiation. Image fusion helps accurately identify tumour and feeding vessels and locate contrast material injection sites and catheter tips without additional data acquisition.Key points
? Ultrafast CBCT cross-sectional data provide good tumour delineation with contrast material ? Postprocessed PBV using u-CBCT increased detectability and tumour differentiation ? u-CBCT cross-sectional PBV and u-CBCT-MRI data helps image guidance during chemoembolization ? u-CBCT-MRI can identify tumours and feeding vessels and locate catheter tip accurately 相似文献18.
Teik Hin Tan Boon Nang Lee Siti Zarina Amir Hassan 《Nuclear Medicine and Molecular Imaging》2014,48(3):212-215
Purpose
In neuroendocrine liver metastases of unknown primary, a multimodality approach is usually adopted and consists of transabdominal ultrasound, endoscopic ultrasound (EUS), computed tomography (CT), magnetic resonance imaging (MRI), nuclear medicine techniques, endoscopy and exploratory surgery. The purpose of the study is to evaluate the diagnostic value of 68Ga-DOTATATE positron emission tomography (PET)/CT as part of a multimodality approach in neuroendocrine liver metastases of unknown primary.Materials and Methods
Six patients (M:F?=?5:1, age range 28–56 years) with immunohistochemically proven neuroendocrine liver metastases but inconclusive initial CT work-up were retrospectively analysed. Clinical finding, histopathology, comparative imaging and follow-up were used to validate the results when ethically justified.Results
68Ga-DOTATATE PET/CT identified the primary tumour in five out of six (83.3 %) patients: pancreas (n?=?4) and stomach (n?=?1). Out of three patients with indeterminate primary on initial CT, two patients were confirmed by 68Ga-DOTATATE PET/CT. Absence of uptake in indeterminate primary of one patient was later confirmed negative by histopathology. In another three patients with undetected primary on initial CT, primary site was demonstrated in all patients with unsuspected metastases in two patients on 68Ga-DOTATATE PET/ CT. No further work-up was done to confirm the primary in patients with distant metastases. Change of management was observed in three out of six (50 %) patients.Conclusion
Our small study indicates that 68Ga-DOTATATE PET/CT is a promising diagnostic option in the multimodality approach to neuroendocrine liver metastases of unknown primary origin. 相似文献19.
Yoriko Horiguchi Tomohiro Ueda Tomofumi Shiomori Masahiko Kanna Hirooki Matsushita Tomoko Kawaminami Yuta Sudo Shinnosuke Kikuchi Ryo Sasaki Jun Hoshimiya Yukiko Morita 《Annals of nuclear medicine》2014,28(8):707-715
Objective
IQ-SPECT (Siemens AG, Munich, Germany) is a highly sensitive single-photon-emission computed tomography (SPECT) myocardial perfusion imaging (MPI) system that uses a multifocal collimator. We searched for a suitable protocol for short-time imaging by IQ-SPECT in thallium-201 (Tl-201) MPI by evaluating phantom images and also by comparing human IQ-SPECT images with conventional SPECT images as reference standards.Methods
We assessed the image quality using the normalized mean square error (NMSE) and drew up count profiles in Tl-201 SPECT images acquired with IQ-SPECT in a phantom study. We also performed Tl-201 stress myocardial SPECT/CT in 21 patients and compared delayed images acquired by using IQ-SPECT with 36 or 17 views per head with images obtained by using conventional SPECT.Results
The NMSE of SPECT images from IQ-SPECT with 36 views was approximately one-fifth of that with 17 views. The myocardial count profile of images with 17 views was lower than those of images with 36 or 104 views in some regions. Defect scores were significantly lower, and image quality scores higher, in images from conventional SPECT than in those from IQ-SPECT with 17 views. Defect scores and image quality scores were equivalent in images from conventional SPECT and those from IQ-SPECT with 36 views. Agreement with the results of conventional SPECT in terms of coronary artery territory-based defect judgment was the best in IQ-SPECT with 36 views with computed tomography-derived attenuation correction (CTAC): the kappa values for IQ-SPECT with 36 views were 0.76 (without CTAC) and 0.83 (with CTAC), and those for IQ-SPECT with 17 views were 0.62 (without CTAC) and 0.59 (with CTAC). The difference in quantitative tracer uptake between conventional SPECT images and IQ-SPECT images was significantly greater for IQ-SPECT images with 17 views than for those with 36 views.Conclusions
Scanning with 36 views per head with CTAC may be appropriate for Tl-201 MPI using IQ-SPECT, because it provides images equivalent to those using conventional SPECT. 相似文献20.
Keiichiro Yoshinaga Yuuki Tomiyama Osamu Manabe Katsuhiko Kasai Chietsugu Katoh Kenichi Magota Eriko Suzuki Ken-ichi Nishijima Yuji Kuge Yoichi M. Ito Nagara Tamaki 《Annals of nuclear medicine》2014,28(8):761-769