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1.
Seok-Ho Yoon Ku Sang Kim Seok Yun Kang Hee-Sung Song Kyung Sook Jo Bong-Hoi Choi Su Jin Lee Joon-Kee Yoon Young-Sil An 《Nuclear Medicine and Molecular Imaging》2013,47(1):27-35
Purpose
Bone metastasis is an important factor for the treatment and prognosis of breast cancer patients. Whole-body bone scintigraphy (WBBS) can evaluate skeletal metastases, and 18F-FDG PET/CT seems to exhibit high specificity and accuracy in detecting bone metastases. However, there is a limitation of 18F-FDG PET in assessing sclerotic bone metastases because some lesions may be undetectable. Recent studies showed that 18F-fluoride PET/CT is more sensitive than WBBS in detecting bone metastases. This study aims to evaluate the usefulness of 18F-fluoride PET/CT by comparing it with WBBS and 18F-FDG PET/CT in breast cancer patients with osteosclerotic skeletal metastases.Materials and Methods
Nine breast cancer patients with suspected bone metastases (9 females; mean age ± SD, 55.6 ± 10.0 years) underwent 99mTc-MDP WBBS, 18F-FDG PET/CT and 18F-fluoride PET/CT. Lesion-based analysis of five regions of the skeletons (skull, vertebral column, thoracic cage, pelvic bones and long bones of extremities) and patient-based analysis were performed.Results
18F-fluoride PET/CT, 18F-FDG PET/CT and WBBS detected 49, 20 and 25 true metastases, respectively. Sensitivity, specificity, positive predictive value and negative predictive value of 18F-fluoride PET/CT were 94.2 %, 46.3 %, 57.7 % and 91.2 %, respectively. Most true metastatic lesions on 18F-fluoride PET/CT had osteosclerotic change (45/49, 91.8 %), and only four lesions showed osteolytic change. Most lesions on 18F-FDG PET/CT also demonstrated osteosclerotic change (17/20, 85.0 %) with three osteolytic lesions. All true metastatic lesions detected on WBBS and 18F-FDG PET/CT were identified on 18F-fluoride PET/CT.Conclusion
18F-fluoride PET/CT is superior to WBBS or 18F-FDG PET/CT in detecting osteosclerotic metastatic lesions. 18F-fluoride PET/CT might be useful in evaluating osteosclerotic metastases in breast cancer patients. 相似文献2.
Karsten Beiderwellen Michael Huebner Philipp Heusch Johannes Grueneisen Verena Ruhlmann Felix Nensa Hilmar Kuehl Lale Umutlu Sandra Rosenbaum-Krumme Thomas C. Lauenstein 《European radiology》2014,24(8):2023-2030
Objectives
To compare [18?F]FDG PET/MRI with PET/CT for the assessment of bone lesions in oncologic patients.Methods
This prospective study included 67 patients with solid tumours scheduled for PET/CT with [18?F]FDG who also underwent a whole-body PET/MRI scan. The datasets (PET/CT, PET/MRI) were rated by two readers regarding lesion conspicuity (four-point scale) and diagnostic confidence (five-point scale). Median scores were compared using the Wilcoxon test.Results
Bone metastases were present in ten patients (15 %), and benign bone lesions in 15 patients (22 %). Bone metastases were predominantly localized in the pelvis (18 lesions, 38 %) and the spine (14 lesions, 29 %). Benign bone lesions were exclusively osteosclerotic and smaller than the metastases (mean size 6 mm vs. 23 mm). While PET/CT allowed identification of 45 of 48 bone metastases (94 %), PET/MRI allowed identification of all bone metastases (100 %). Conspicuity of metastases was high for both modalities with significantly better results using PET/MRI (p?<?0.05). Diagnostic confidence in lesion detection was high for both modalities without a significant difference. In benign lesions, conspicuity and diagnostic confidence were significantly higher with PET/CT (p?<?0.05).Conclusions
[18?F]FDG PET/MRI shows high potential for the assessment of bone metastases by offering superior lesion conspicuity when compared to PET/CT. In hypersclerotic, benign bone lesions PET/CT still sets the reference.Key Points
? PET/MRI and PET/CT are of equal value for the identification of disease-positive patients ? PET/MRI offers higher lesion conspicuity as well as diagnostic confidence ? PET/MRI is an attractive new alternative for the assessment of bone metastases 相似文献3.
Yuji Nishiyama Ukihide Tateishi Kazuya Shizukuishi Ayako Shishikura Etsuko Yamazaki Hiroto Shibata Tomohiro Yoneyama Yoshiaki Ishigatsubo Tomio Inoue 《Annals of nuclear medicine》2013,27(1):78-83
Purpose
The aim of this study was to report our early experience with 18F-fluoride PET/CT for detecting lesions and evaluate the usefulness of this modality in the assessment of multiple myeloma (MM).Materials and methods
18F-fluoride PET/CT and 99mTc-MDP bone scintigraphy (BS) studies from 7 myeloma patients (4 male and 3 female, mean age 55 years) diagnosed according to standard criteria were reviewed retrospectively. Two reviewers visually and quantitatively analyzed the images and recorded their findings after reaching a consensus. Diagnostic certainty regarding the presence or absence of myeloma lesions was evaluated according to the reference standard consisting of whole-body magnetic resonance imaging and whole-body X-ray.Results
A total of 93 affected areas were definite according to the reference standard. Of these, 83 affected areas (89 %) were identified on 18F-fluoride PET/CT, whereas 54 affected areas (58 %) were found on BS. Mean SUVmax in the affected areas was 9.8 ± 3.2 (standard deviation) ranging from 5.0 to 21.2. A total of s17 lesions with bone fracture were also detected by 18F-fluoride PET/CT and 2 lesions (12 %) were negative on BS.Conclusion
Our result showed that 18F-fluoride PET was a possible modality to detect areas of lesions in patients with MM. 相似文献4.
Daniel C. Bortot Bárbara J. Amorim Glaucia C. Oki Sérgio B. Gapski Allan O. Santos Mariana C. L. Lima Elba C. S. C. Etchebehere Marycel F. Barboza Jair Mengatti Celso Dario Ramos 《European journal of nuclear medicine and molecular imaging》2012,39(11):1730-1736
Purpose
Bone scintigraphy (BS) has been used extensively for many years for the diagnosis of bone metastases despite its low specificity and significant rate of equivocal lesions. 18F-Fluoride PET/CT has been proven to have a high sensitivity and specificity in the detection of malignant bone lesions, but its effectiveness in patients with inconclusive lesions on BS is not well documented. This study evaluated the ability of 18F-fluoride PET/CT to exclude bone metastases in patients with various malignant primary tumours and nonspecific findings on BS.Methods
We prospectively studied 42 patients (34–88?years of age, 26 women) with different types of tumour. All patients had BS performed for staging or restaging purposes but with inconclusive findings. All patients underwent 18F-fluoride PET/CT. All abnormalities identified on BS images were visually compared with their appearance on the PET/CT images.Results
All the 96 inconclusive lesions found on BS images of the 42 patients were identified on PET/CT images. 18F-Fluoride PET/CT correctly excluded bone metastases in 23 patients (68 lesions). Of 19 patients (28 lesions) classified by PET/CT as having metastases, 3 (5 lesions) were finally classified as free of bone metastases on follow-up. The sensitivity, specificity, and positive and negative predictive values of 18F-fluoride PET/CT were, respectively, 100?%, 88?%, 84?% and 100?% for the identification of patients with metastases (patient analysis) and 100?%, 82?% and 100?% for the identification of metastatic lesions (lesion analysis).Conclusion
The factors that make BS inconclusive do not affect 18F-fluoride PET/CT which shows a high sensitivity and negative predictive value for excluding bone metastases even in patients with inconclusive conventional BS. 相似文献5.
Yun Jung Choi Hee Sung Hwang Hyun Jeong Kim Yong Hyu Jeong Arthur Cho Jae Hoon Lee Mijin Yun Jong Doo Lee Won Jun Kang 《Annals of nuclear medicine》2014,28(4):304-313
Objective
The purpose of this study was to evaluate the diagnostic performance of 18F-fluoro-2-deoxy-d-glucose positron emission tomography (FDG PET) as a single imaging agent in neuroblastoma in comparison with other imaging modalities.Methods
A total of 30 patients with pathologically proven neuroblastoma who underwent FDG PET for staging were enrolled. Diagnostic performance of FDG PET and abdomen CT was compared in detecting soft tissue lesions. FDG PET and bone scintigraphy (BS) were compared in bone metastases. Maximal standardized uptake value (SUVmax) of primary or recurrent lesions was calculated for quantitative analysis.Results
Tumor FDG uptake was detected in 29 of 30 patients with primary neuroblastoma. On initial FDG PET, SUVmax of primary lesions were lower in early stage (I–II) than in late stage (III–IV) (3.03 vs. 5.45, respectively, p = 0.019). FDG PET was superior to CT scan in detecting distant lymph nodes (23 vs. 18 from 23 lymph nodes). FDG PET showed higher accuracy to identify bone metastases than BS both on patient-based analyses (100 vs. 94.4 % in sensitivity, 100 vs. 77.8 % in specificity), and on lesion-based analyses (FDG PET: 203 lesions, BS: 86 lesions). Sensitivity and specificity of FDG PET to detect recurrence were 87.5 % and 93.8, respectively.Conclusion
FDG PET was superior to CT in detecting distant LN metastasis and to BS in detecting skeletal metastasis in neuroblastoma. BS might be eliminated in the evaluation of neuroblastoma when FDG PET is performed. 相似文献6.
Jeong Won Lee Sang Mi Lee Ho Sung Lee Yong Hoon Kim Won Kyoung Bae 《Annals of nuclear medicine》2012,26(8):627-633
Objective
The aim of this study was to compare the diagnostic ability of 18F-fluorodeoxyglucose (18F-FDG) positron emission tomography/computed tomography (PET/CT) with that of 99mTc-methylene diphosphonate (99mTc-MDP) bone scan for bone metastasis in staging patients with small cell lung cancer (SCLC).Methods
Ninety-five patients with SCLC who underwent both 18F-FDG PET/CT and 99mTc-MDP bone scan for initial staging work-up were retrospectively enrolled. All 18F-FDG PET/CT and bone scan images were visually assessed. Bone metastasis was confirmed by histopathological results and all available clinical information.Results
Of 95 patients with SCLC, metastatic bone lesions were found in 30 patients, and 84 metastatic lesions were evaluated on a lesion-basis analysis. The sensitivity of 18F-FDG PET/CT was 100?% on a per-patient basis and 87?% on a per-lesion basis, and there was no false-positive lesion on PET/CT images. In contrast, the sensitivity of the bone scan was 37?% on a per-patient basis and 29?% on a per-lesion basis. The bone scan showed 11 false-positive lesions. The bone scan detected two metastatic lesions that were not detected by PET/CT, which were outside the region scanned by PET/CT. On follow-up bone scan, 21 lesions that were not detected by the initial bone scan but were detected by PET/CT were newly detected.Conclusions
In patients with SCLC, 18F-FDG PET/CT showed higher detection rate of bone metastasis than 99mTc-MDP bone scan. Thus, 18F-FDG PET/CT can replace bone scan in staging patients with SCLC. 相似文献7.
Hugo J. A. Adams Thomas C. Kwee Bart de Keizer Rob Fijnheer John M. H. de Klerk Rutger A. J. Nievelstein 《European journal of nuclear medicine and molecular imaging》2014,41(3):565-574
Purpose
To systematically review and meta-analyse published data on the diagnostic performance of 18F-FDG PET/CT in detecting bone marrow involvement in patients with newly diagnosed diffuse large B-cell lymphoma (DLBCL).Methods
PubMed/MEDLINE and Embase were systematically searched for relevant studies. The methodological quality of each study was assessed. Sensitivities and specificities of FDG PET/CT in individual studies were calculated and meta-analysed with a random effects model. A summary receiver operating characteristic curve (sROC) was constructed with the Moses-Shapiro-Littenberg method. Weighted summary proportions of discrepancies between the FDG PET/CT and (blind) bone marrow biopsy (BMB) results among all patients were calculated.Results
Seven studies, with a total of 654 patients with newly diagnosed DLBCL, were included. Overall, the quality of the included studies was moderate. The sensitivity and specificity of FDG PET/CT for detecting bone marrow involvement ranged from 70.8 % to 95.8 % and from 99.0 % to 100 %, with pooled estimates of 88.7 % (95 % confidence interval, CI, 82.5 – 93.3 %) and 99.8 % (95 % CI 98.8 – 100 %), respectively. The area under the sROC curve was 0.9983. The weighted summary proportion of FDG PET/CT-negative patients with positive BMB findings among all patients was 3.1 % (95 % CI 1.8 – 5.0 %) and the weighted summary proportion of FDG PET/CT-positive patients with negative BMB findings among all patients was 12.5 % (95 % CI 8.4 – 17.3 %).Conclusion
FDG PET/CT is accurate and complementary to BMB for detecting bone marrow involvement in patients with newly diagnosed DLBCL. A negative FDG PET/CT scan cannot rule out the presence of bone marrow involvement, but positive FDG PET/CT findings obviate the need for BMB for the detection of bone marrow involvement in these patients. 相似文献8.
K. Kubiessa S. Purz M. Gawlitza A. Kühn J. Fuchs K. G. Steinhoff A. Boehm O. Sabri R. Kluge T. Kahn P. Stumpp 《European journal of nuclear medicine and molecular imaging》2014,41(4):639-648
Purpose
The aim of this study was to evaluate the diagnostic capability of simultaneous 18F-fluorodeoxyglucose (FDG) positron emission tomography (PET)/MRI compared to 18F-FDG PET/CT as well as their single components in head and neck cancer patients.Methods
In a prospective study 17 patients underwent 18F-FDG PET/CT for staging or follow-up and an additional 18F-FDG PET/MRI scan with whole-body imaging and dedicated examination of the neck. MRI, CT and PET images as well as PET/MRI and PET/CT examinations were evaluated independently and in a blinded fashion by two reader groups. Results were compared with the reference standard (final diagnosis determined in consensus using all available data including histology and follow-up). Sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) were calculated.Results
A total of 23 malignant tumours were found with the reference standard. PET/CT showed a sensitivity of 82.7 %, a specificity of 87.3 %, a PPV of 73.2 % and a NPV of 92.4 %. Corresponding values for PET/MRI were 80.5, 88.2, 75.6 and 92.5 %. No statistically significant difference in diagnostic capability could be found between PET/CT and PET/MRI. Evaluation of the PET part from PET/CT revealed highest sensitivity of 95.7 %, and MRI showed best specificity of 96.4 %. There was a high inter-rater agreement in all modalities (Cohen’s kappa 0.61–0.82).Conclusion
PET/MRI of patients with head and neck cancer yielded good diagnostic capability, similar to PET/CT. Further studies on larger cohorts to prove these first results seem justified. 相似文献9.
Alexandre Cochet Inna Dygai-Cochet Jean-Marc Riedinger Olivier Humbert Alina Berriolo-Riedinger Michel Toubeau Séverine Guiu Charles Coutant Bruno Coudert Pierre Fumoleau François Brunotte 《European journal of nuclear medicine and molecular imaging》2014,41(3):428-437
Purpose
The objective of this study was to assess the impact on management and the prognostic value of 18F-fluorodeoxyglucose (FDG) positron emission tomography (PET)/CT for initial staging of newly diagnosed large breast cancer (BC) when compared with conventional staging.Methods
We prospectively included 142 patients with newly diagnosed BC and at least grade T2 tumour. All patients were evaluated with complete conventional imaging (CI) procedures (mammogram and/or breast ultrasound, bone scan, abdominal ultrasound and/or CT, X-rays and/or CT of the chest), followed by FDG PET/CT exploration, prior to treatment. The treatment plan based on CI staging was compared with that based on PET/CT findings. CI and PET/CT findings were confirmed by imaging and clinical follow-up and/or pathology when assessable. Progression-free survival (PFS) was analysed using the Cox proportional hazards regression model.Results
According to CI staging, 79 patients (56 %) were stage II, 46 (32 %) stage III and 17 (12 %) stage IV (distant metastases). Of the patients, 30 (21 %) were upstaged by PET/CT, including 12 (8 %) from stage II or III to stage IV. On the other hand, 23 patients (16 %) were downstaged by PET/CT, including 4 (3 %) from stage IV to stage II or III. PET/CT had a high or medium impact on management planning for 18 patients (13 %). Median follow-up was 30 months (range 9–59 months); 37 patients (26 %) experienced recurrence or progression of disease during follow-up and 17 patients (12 %) died. The Cox model indicated that CI staging was significantly associated with PFS (p?=?0.01), but PET/CT staging provided stronger prognostic stratification (p?<?0.0001). Moreover, Cox regression multivariate analysis showed that only PET/CT staging remained associated with PFS (p?<?0.0001).Conclusion
FDG PET/CT provides staging information that more accurately stratifies prognostic risk in newly diagnosed large BC when compared with conventional explorations alone. 相似文献10.
Seiji Kurata Ukihide Tateishi Kazuya Shizukuishi Tomohiro Yoneyama Ayako Hino Hayato Kaida Kiminori Fujimoto Masatoshi Ishibashi Tomio Inoue 《Annals of nuclear medicine》2013,27(5):481-486
Objectives
The purpose of this study was to evaluate the prevalence, distribution, and relationship of 18F-fluoride uptake and arterial calcification in oncologic patients using 18F-fluoride PET/CT.Methods
Image data obtained from 29 oncologic patients undergoing whole-body 18F-fluoride PET/CT were evaluated retrospectively. Arterial wall 18F-fluoride uptake and calcification were analyzed both quantitatively and semiquantitatively in 8 patients with arterial 18F-fluoride uptake.Results
Arterial 18F-fluoride uptake was observed at 35 lesions in 8 (28 %) of the 29 patients, and calcification was observed at 345 lesions in the same patients. Five of the 8 patients had prostate cancer, and the remaining patients had hepatocellular carcinoma or malignant melanoma. In these 8 patients, the prevalence of both 18F-fluoride uptake and calcification was highest in the abdominal aorta, followed by the descending thoracic aorta and the aortic arch. Colocalization of radiotracer accumulation and calcification could be observed in the 32 lesions (91 %) with arterial 18F-fluoride uptake, and only the 3 lesions (9 %) with arterial 18F-fluoride uptake were not colocalized with arterial calcification. The presence of both arterial radiotracer uptake and calcification was significantly associated with advancing age (P < 0.01).Conclusion
Our results suggest that 18F-fluoride PET/CT might be a useful modality for detecting active mineral deposition sites of atherosclerosis in oncologic patients. 相似文献11.
Naotoshi Ota Katsuhiko Kato Shingo Iwano Shinji Ito Shinji Abe Naotoshi Fujita Keiichi Yamashiro Seiichi Yamamoto Shinji Naganawa 《The British journal of radiology》2014,87(1034)
Objective:
We compared the efficacies of 18F-fluoride positron emission tomography (18F-fluoride PET)/CT, 18F-fludeoxyglucose PET (18F-FDG PET)/CT, and 99mTc bone scintigraphy [planar and single photon emission CT (SPECT)] for the detection of bone metastases in patients with differentiated thyroid carcinoma (DTC).Methods:
We examined 11 patients (8 females and 3 males; mean age ± standard deviation, 61.9 ± 8.7 years) with DTC who had been suspected of having bone metastases after total thyroidectomy and were hospitalized to be given 131I therapy. Bone metastases were verified either when positive findings were obtained on both 131I scintigraphy and CT or when MRI findings were positive if MRI was performed.Results:
Metastases were confirmed in 24 (13.6%) of 176 bone segments in 9 (81.8%) of the 11 patients. The sensitivities of 18F-fluoride PET/CT and 99mTc bone scintigraphy (SPECT) were significantly higher than those of 18F-FDG PET/CT and 99mTc bone scintigraphy (planar) (p < 0.05). The accuracies of 18F-fluoride PET/CT and 99mTc bone scintigraphy (SPECT) were significantly higher than that of 99mTc bone scintigraphy (planar) (p < 0.05).Conclusion:
The sensitivity and accuracy of 18F-fluoride PET/CT for the detection of bone metastases of DTC are significantly higher than those of 99mTc bone scintigraphy (planar). However, the sensitivity and accuracy of 99mTc bone scintigraphy (planar) are improved near to those of 18F-fluoride PET/CT when SPECT is added to a planar scan. The sensitivity of 18F-FDG PET/CT is significantly lower than that of 18F-fluoride PET/CT or 99mTc bone scintigraphy (SPECT).Advances in knowledge:
This article has demonstrated first the high efficacy of 18F-fluoride PET/CT for the detection of bone metastases of DTC.Differentiated thyroid carcinoma (DTC) shows a relatively good prognosis compared with carcinomas of other organs, and the 10-year survival rate of DTC is >80% because of treatments such as total thyroidectomy and ablation of remnants with radioiodine.1 However, metastases of DTC develop in 7–23% of patients; the distant metastases occur commonly in the lungs, bones and brain, and the bones are the second most common site of metastases of DTC.2 Bone scintigraphy using 99mTc-labelled phosphate compounds [99mTc-methylene diphosphonate (99mTc-MDP) or 99mTc-hydroxymethylene diphosphonate (99mTc-HMDP)] has been widely used for detecting and evaluating bone metastases of various kinds of carcinomas because of its overall high sensitivity and the easy evaluation of the entire skeleton.3 However, there were often false-positive cases in 99mTc bone scintigraphy, because degenerative or inflammatory foci were often confused with metastatic lesions. The addition of single photon emission CT (SPECT) to planar acquisition of 99mTc bone scintigraphy has been shown to exhibit a beneficial effect on the detection and evaluation of bone metastases.4–6 Skeletal imaging by 18F-fludeoxyglucose positron emission tomography (18F-FDG PET)/CT has been shown to be useful in the detection of bone metastases of various carcinomas including DTC.7Previously, we compared the efficacies of 18F-FDG PET and planar 99mTc bone scintigraphy for the detection of bone metastases in patients with DTC.8 We found that the specificity and the overall accuracy of 18F-FDG PET for the detection of bone metastases in patients with DTC were higher than those of planar 99mTc bone scintigraphy, whereas the difference in the sensitivity of both examinations was not statistically significant, and concluded that 18F-FDG PET is superior to planar 99mTc bone scintigraphy because of its lower incidence of false-positive results in the detection of bone metastases of DTC.818F-fluoride is a positron-emitting bone-seeking radiotracer, which has a similar uptake mechanism to 99mTc-MDP and 99mTc-HMDP. As the availability of PET systems was increasing, 18F-fluoride has been used for skeletal PET imaging since 1990s. PET or PET/CT with 18F-fluoride have been shown to be more sensitive than planar 99mTc bone scintigraphy for the detection of bone metastases of lung,9 breast,10,11 hepatocellular,12 prostate,11,13,14 colon and bladder11 cancers. However, to the best of our knowledge, there have been no systematic comparative studies on the efficacies of 18F-fluoride PET/CT, 18F-FDG PET/CT and 99mTc bone scintigraphy (planar and SPECT) for the detection of bone metastases of DTC. This study was conducted to compare 18F-fluoride PET/CT, 18F-FDG PET/CT and 99mTc bone scintigraphy (planar and SPECT) in the detection of bone metastases of DTC. 相似文献12.
Till A. Heusner Sherko Kuemmel Steffen Hahn Angela Koeninger Friedrich Otterbach Monia E. Hamami Klaus R. Kimmig Michael Forsting Andreas Bockisch Gerald Antoch Alexander Stahl 《European journal of nuclear medicine and molecular imaging》2009,36(10):1543-1550
Purpose
The aims of this study were (1) to evaluate FDG PET/CT and CT for the detection of axillary lymph node metastases in breast cancer (BC) patients and (2) to evaluate FDG PET/CT as a pre-test for the triage to sentinel lymph node biopsy (SLNB) versus axillary lymph node dissection (ALND).Methods
The sensitivity, specificity, positive and negative predictive value (PPV, NPV), and accuracy of FDG PET/CT and CT for axillary lymph node metastases were determined in 61 patients (gold standard: histopathology). According to the equation “NPV = specificity ? (1-prevalence) / [specificity ? (1-prevalence) + (1-sensitivity) ? prevalence]” FDG PET/CT was evaluated as a triage tool for SLNB versus ALND.Results
The sensitivity, specificity, PPV, NPV and accuracy of FDG PET/CT was 58, 92, 82, 77 and 79% and of CT 46, 89, 72, 71 and 72%, respectively. Patients with an up to ~60% risk for axillary lymph node metastases appear to be candidates for SLNB provided that the axilla is unremarkable on FDG PET/CT.Conclusion
FDG PET/CT cannot replace invasive approaches for axillary staging but may extend the indication for SLNB. 相似文献13.
Byung Hyun Byun Chang-Bae Kong Ilhan Lim Byung Il Kim Chang Woon Choi Won Seok Song Wan Hyeong Cho Dae-Geun Jeon Jae-Soo Koh Soo-Yong Lee Sang Moo Lim 《Skeletal radiology》2013,42(12):1673-1681
Objective
We compared the diagnostic performance of (18)F-fluorodeoxyglucose positron emission tomography/computed tomography (PET/CT) and (99 m)Tc-methylene diphosphonate bone scintigraphy (BS) for the detection of bone metastasis in osteosarcoma.Materials and methods
We retrospectively reviewed 206 patients with stage II–IV osteosarcoma treated with surgery and chemotherapy as well as at least one paired PET/CT and BS scan (defined as an examination). PET/CT and BS images were interpreted separately. When analyzing the diagnostic yield of a combination of PET/CT and BS (PET/CT+BS), an examination was considered positive if either PET/CT or BS scored positive. The final diagnosis was obtained from histological findings or clinical follow-up with imaging studies for at least 6 months. Diagnostic performances of PET/CT, BS, and their combinations were calculated.Results
Out of 833 examinations in 206 patients, 55 with 101 lesions in 38 patients were confirmed as bone metastases. The sensitivity, specificity, and diagnostic accuracy were 95, 98, and 98 %, respectively, for PET/CT; 76, 97, and 96 %, respectively, for BS; and 100, 96, and 97 %, respectively, for PET/CT+BS in an examination-based analysis. Lesion-based analysis demonstrated that the sensitivity of PET/CT+BS (100 %) was significantly higher than that of PET/CT (92 %) or BS (74 %) alone. BS detected significantly less bone metastases in the growth plate region than outside the growth plate region (22 vs. 77 %).Conclusions
PET/CT is more sensitive and accurate than BS for diagnosing bone metastases in osteosarcoma. The combined use of PET/CT and BS improves sensitivity. 相似文献14.
Hyun Jeong Kim Arthur Cho Mijin Yun Young Tae Kim Won Jun Kang 《Annals of nuclear medicine》2016,30(2):104-113
Objective
Endometrial cancer is the most frequent cancer occurring in the female genital tract in the Western countries. Because surgical staging is currently the standard, noninvasive techniques that accurately identify lymph node (LN) metastases would be beneficial by reducing costs and complications. The purpose of our study is to compare the diagnostic accuracy of 2-[18F]fluoro-2-deoxy-d-glucose (18F-FDG) positron emission tomography/computed tomography (PET/CT) with that of magnetic resonance imaging (MRI) for detecting LN metastases in the preoperative staging of endometrial cancer.Methods
Two hundred eighty-seven consecutive patients with endometrial cancer underwent preoperative PET/CT and MRI for staging. The malignancy criteria for LNs were a short diameter of 1 cm or more by MRI and focally increased 18F-FDG uptake by PET/CT. After evaluating PET/CT and MRI separately, morphologic and functional image findings were compared with the histological findings regarding LN metastasis for all patients. PET/CT and MRI images were classified on the basis of histological findings as true-positive, true-negative, false-positive, or false-negative. Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy were calculated.Results
Histologic examination revealed LN metastases in 51 patients (17.8 %). The maximal standardized uptake values (SUVmax) of the primary lesions by PET/CT ranged from 1.4 to 37.7, with a mean value of 9.3, whereas those of the metastatic LNs ranged from 2.0 to 22.5 with a mean of 7.3. On a per-patient basis, node staging resulted in sensitivities of 70.0 % with 18F-FDG PET/CT and 34.0 % with MRI, and specificities of 95.4 % with PET/CT and 95.0 % with MRI. The NPV of PET/CT was 94.3 %, and that of MRI was 87.2 %. On a lesion base analysis, sensitivity of PET/CT was 79.4 % while that of MRI was 51.6 %. In detecting distant metastasis, the sensitivity, specificity, accuracy, PPV, and NPV of PET/CT were 92.9, 98.9, 98.6, 81.3, and 99.6 %, respectively.Conclusion
Diagnostic performance of FDG PET/CT was better than MRI for detecting metastatic lymph nodes in patients with endometrial cancer both by patient basis and lesion basis analyses. Due to high NPV, FDG PET-CT could aid in selecting candidates for lymphadenectomy.15.
Balasubramanian Venkitaraman Sellam Karunanithi Arvind Kumar G. C. Khilnani Rakesh Kumar 《European journal of nuclear medicine and molecular imaging》2014,41(5):856-864
Purpose
The objective of this study was to evaluate the role of 68Ga-DOTATOC positron emission tomography (PET)/CT scan in patients with suspected pulmonary carcinoid tumour and to compare its results with 18F-fluorodeoxyglucose (FDG) PET/CT scan.Methods
In this prospective study, 32 patients (age 34.22?±?12.03 years; 53.1 % female) with clinical suspicion of bronchopulmonary carcinoid were evaluated with 68Ga-DOTATOC PET/CT and 18F-FDG PET/CT. The two imaging modalities were compared, considering the tissue diagnosis as the reference standard.Results
Based on the reference standard 26 cases were carcinoid tumours [21 typical carcinoids (TC) and 5 atypical carcinoids (AC)] and 6 cases were non-carcinoid tumours. The sensitivity, specificity and accuracy of 68Ga-DOTATOC PET/CT in the diagnosis of pulmonary carcinoid tumour were 96.15, 100 and 96.87 % respectively, whereas those of 18F-FDG PET/CT were 78.26, 11.1 and 59.37 % respectively. The maximum standardised uptake value (SUVmax) of TC on 68Ga-DOTATOC PET/CT scan ranged from 3.58 to 55, while that of AC ranged from 1.1 to 32.5. 18F-FDG PET/CT was true-positive in all cases of AC and false-negative in eight cases of TC (sensitivity for TC 61.9 % and for AC 100 %).Conclusion
68Ga-DOTATOC PET/CT is a useful imaging investigation for the evaluation of pulmonary carcinoids. 18F-FDG PET/CT scan suffers from low sensitivity and specificity in differentiating the pulmonary carcinoids from other tumours. 相似文献16.
Diagnostic value of diffusion-weighted magnetic resonance imaging (DWI) compared to FDG PET/CT for whole-body breast cancer staging 总被引:1,自引:0,他引:1
Till-Alexander Heusner Sherko Kuemmel Angela Koeninger Monia E. Hamami Steffen Hahn Anton Quinsten Andreas Bockisch Michael Forsting Thomas Lauenstein Gerald Antoch Alexander Stahl 《European journal of nuclear medicine and molecular imaging》2010,37(6):1077-1086
Purpose
The aim of the study was to prospectively compare the diagnostic value of whole-body diffusion-weighted imaging (DWI) and FDG PET/CT for breast cancer (BC) staging.Methods
Twenty BC patients underwent whole-body FDG PET/CT and 1.5-T DWI. Lesions with qualitatively elevated signal intensity on DW images (b?=?800 s/mm2) were rated as suspicious for tumour and mapped to individual lesions and different compartments (overall 552 lesions). The apparent diffusion coefficient (ADC) value was determined for quantitative evaluation. Histopathology, MRI findings, bone scan findings, concordant findings between FDG PET/CT and DWI, CT follow-up scans and plausibility served as the standards of reference defining malignancy.Results
According to the standards of reference, breasts harboured malignancy in 11, regional lymph nodes in 4, M1 lymph nodes in 3, bone in 7, lung in 2, liver in 3 and other tissues in 3 patients. On a compartment basis, the sensitivity, specificity, accuracy, positive predictive value (PPV) and negative predictive value (NPV) for the detection of malignancies were 94, 99, 98, 97 and 98% for FDG PET/CT and 91, 72, 76, 50 and 96% for DWI, respectively. Of the lesions seen on DWI only, 348 (82%) turned out to be false-positive compared to 23 (11%) on FDG PET/CT. The average lesion ADC was 820?±?300 with true-positive lesions having 929?±?252 vs 713?±?305 in false-positive lesions (p?<?0.0001).Conclusion
Based on these initial data DWI seems to be a sensitive but unspecific modality for the detection of locoregional or metastatic BC disease. There was no possibility to quantitatively distinguish lesions using ADC. DWI alone may not be recommended as a whole-body staging alternative to FDG PET(/CT). Further studies are necessary addressing the question of whether full-body MRI including DWI may become an alternative to FDG PET/CT for whole-body breast cancer staging. 相似文献17.
Franz Buchegger Valentina Garibotto Thomas Zilli Laurent Allainmat Sandra Jorcano Hansjörg Vees Olivier Rager Charles Steiner Habib Zaidi Yann Seimbille Osman Ratib Raymond Miralbell 《European journal of nuclear medicine and molecular imaging》2014,41(1):68-78
Purpose
18F-Fluorocholine (FCH) and 11C-acetate (ACE) PET are widely used for detection of recurrent prostate cancer (PC). We present the first results of a comparative, prospective PET/CT study of both tracers evaluated in the same patients presenting with recurrence and low PSA to compare the diagnostic information provided by the two tracers.Methods
The study group comprised 23 patients studied for a rising PSA level after radical prostatectomy (RP, 7 patients, PSA ≤3 ng/ml), curative radiotherapy (RT, 7 patients, PSA ≤5 ng/ml) or RP and salvage RT (9 patients, PSA ≤5 ng/ml). Both FCH and ACE PET/CT scans were performed in a random sequence a median of 4 days (range 0 to 11 days) apart. FCH PET/CT was started at injection (307?±?16 MBq) with a 10-min dynamic acquisition of the prostate bed, followed by a whole-body PET scan and late (45 min) imaging of the pelvis. ACE PET/CT was performed as a double whole-body PET scan starting 5 and 22 min after injection (994?±?72 MBq), and a late view (45 min) of the prostate bed. PET/CT scans were blindly reviewed by two independent pairs of two experienced nuclear medicine physicians, discordant subgroup results being discussed to reach a consensus for positive, negative end equivocal results.Results
PET results were concordant in 88 out of 92 local, regional and distant findings (Cohen’s kappa 0.929). In particular, results were concordant in all patients concerning local status, bone metastases and distant findings. Lymph-node results were concordant in 19 patients and different in 4 patients. On a per-patient basis results were concordant in 22 of 23 patients (14 positive, 5 negative and 3 equivocal). In only one patient was ACE PET/CT positive for nodal metastases while FCH PET/CT was overall negative; interestingly, the ACE-positive and FCH-negative lymph nodes became positive in a second FCH PET/CT scan performed a few months later.Conclusion
Overall, ACE and FCH PET/CT showed excellent concordance, on both a per-lesion and a per-patient basis, suggesting that both tracers perform equally for recurrent prostate cancer staging. 相似文献18.
The role of fluorodeoxyglucose, 18F-dihydroxyphenylalanine, 18F-choline, and 18F-fluoride in bone imaging with emphasis on prostate and breast 总被引:1,自引:0,他引:1
Diagnostic imaging has played a major role in the evaluation of patients with bone metastases. The imaging modalities have included bone scintigraphy, computed tomography, magnetic resonance imaging, and most recently PET/CT, which can be performed with different tracers, including fluorodeoxyglucose (FDG), 18F-fluoride, 18F-choline (FCH), and 18F-DOPA (dihydroxyphenylalanine). For most tumors the sensitivity of FDG in detecting bone metastases is similar to bone scintigraphy; additionally it can be used to monitor the response to chemotherapy and hormonal therapy. 18F-Fluoride may provide a more sensitive "conventional" bone scan and is superior for FDG nonavid tumors, but, nevertheless, FDG in "early disease" often has clear advantages over 18F-fluoride. Although more data need to be obtained, it appears that FCH is highly efficient in preoperative management regarding N and M staging of prostate cancer once metastatic disease is strongly suspected or documented. For neuroendocrine tumors and in particular in medullary thyroid cancer, DOPA is similar to 18F-fluoride in providing high quality information regarding the skeleton. Nevertheless, prospective studies with large patient groups will be essential to define the exact diagnostic role of FCH and DOPA PET in different clinical settings. 相似文献
19.
Min Jung Seo Jong Jin Lee Hye Ok Kim Sun-Young Chae Seol Hoon Park Jin-Sook Ryu Sei Hyun Ahn Jong Won Lee Byung Ho Son Gyung-Yub Gong Dae Hyuk Moon 《European journal of nuclear medicine and molecular imaging》2014,41(3):438-445
Purpose
The present study assessed the positive predictive value (PPV) of 18F-fluorodeoxyglucose (FDG) positron emission tomography/computed tomography (PET/CT) for the detection of internal mammary node (IMN) metastasis in patients with clinical stage III breast cancer.Methods
Patients who were diagnosed with clinical stage III breast cancer and underwent pretreatment 18F-FDG PET/CT were retrospectively analyzed. The 18F-FDG PET/CT scans were prospectively reviewed by two board-certified nuclear medicine physicians in a blinded manner. The intensities of IMNs were graded into four categories (no activity and lower, similar, and higher activities than that of the mediastinal blood pool). IMNs were measured from the combined CT (largest diameter of the short axis). Histologic data of the IMNs were obtained by ultrasonography-guided fine-needle aspiration biopsy or surgical excision. The PPV was calculated for pathologically confirmed IMNs. Visual grade, maximum standardized uptake values (SUVmax), and sizes were analyzed according to the pathology results.Results
There were 249 clinical stage III breast cancer patients (age 48.0?±?10.1 years, range 26–79 years) who had undergone initial 18F-FDG PET/CT prior to treatment. Excluding 33 cases of stage IV breast cancer, 62 of 216 patients had visible IMNs on 18F-FDG PET/CT, and histologic confirmation was obtained in 31 patients. There were 27 metastatic and four nonmetastatic nodes (PPV 87.1 %). Metastatic nodes mostly presented with visual grade 3 (83.9 %), and SUVmax and size were 3.5?±?4.3 and 5.6?±?2.0 mm, respectively.Conclusion
18F-FDG PET/CT has a high PPV for IMN metastasis in clinical stage III breast cancer, indicating the possibility of metastasis in IMNs with FDG uptake similar to/lower than that of the blood pool or small-sized nodes. 相似文献20.
Takashi Katayama Kazunori Kubota Youichi Machida Akira Toriihara Hitoshi Shibuya 《Annals of nuclear medicine》2012,26(5):426-435