肺部炎性肿块18氟-氟代脱氧葡萄糖正电子发射断层扫描显像特点分析

目的 探讨肺部炎性肿块在18氟-氟代脱氧葡萄糖(18F-FDG)正电子发射断层扫描(PET/CT)中的表现.方法 22例通过病理或者在有效治疗随访后得到证实的肺部炎性肿块患者,分析其18 F-FDG PET/CT的病灶形态与最大标准摄取值(SUVmax).结果 22例肺部炎性肿块患者中球形肺炎6例,SUVmax为(3.54±1.34);慢性肺炎5例,SUVmax为(3.30±2.06);局限性机化性肺炎6例,SUVmax为(1.55±1.47);炎性假瘤5例,SUVmax为(2.90±2.34).结论 肺部炎性肿块也可以出现对18F-FDG的高摄取,但其PET/CT具有炎性病变的影像学特征,在临床诊断及鉴别诊断中具有重要的应用价值.     

The role of 18F-FDG PET/CT imaging in Waldenstrom macroglobulinemia

Disease assessment in WM is dependent on the quantification of the IgM monoclonal protein and percent involvement of the bone marrow. There is a need for imaging studies that objectively measure tumor load in these patients. In this study, we sought to examine the role of combined FDG-PET/CT imaging in the detection of tumor load and in the assessment of response to therapy. Thirty-five patients were enrolled on a prospective study using bortezomib and rituximab therapy and were included in this study because they completed a pre- and post-treatment FDG-PET/CT imaging at one facility (12 newly diagnosed and 23 relapsed/refractory). The use of combined FDG-PET/CT imaging showed positive findings in 83% of patients with WM, unlike prior studies using conventional imaging that indicate that only 20% of patients have lymphadenopathy or hepatosplenomegaly. Moreover, 43% of patients had abnormal bone marrow uptake on FDG-PET imaging that can potentially help in the assessment of their tumor load, especially with heterogenous sampling of the bone marrow. There was no statistical correlation between EORTC response criteria for FDG-PET/CT and response by monoclonal protein. This is the first study to examine the role of FDG-PET/CT imaging in WM. Future studies should examine the role of FDG-PET/CT in conjunction with monoclonal protein response in the assessment of progression-free survival in patients with WM.     

Multi-site abdominal tuberculosis mimics malignancy on 18F-FDG PET/CT: Report of three cases

18 F-fluorodeoxyglucose positron emission/computed tomography( 18 F-FDG PET/CT)imaging,an established procedure for evaluation of malignancy,shows an increased 18 F-FDG uptake in inflammatory conditions.We present three patients with abdominal pain and weight loss.Conventional imaging studies indicated that abdominal neoplasm and 18 F-FDG PET/CT for assessment of malignancy showed multiple lesions with intense 18 FFDG uptake in abdomen of the three cases.However,the three patients were finally diagnosed wit...     

鼻型结外NK/T细胞淋巴瘤PET/CT表现及临床分析

目的:用18F-FDG PET/CT精确揭示鼻型结外NK/T细胞淋巴瘤患者的病灶,探讨病变范围与相关临床指标的关系。方法:22例初诊鼻型结外NK/T细胞淋巴瘤患者治疗前行18F-FDG PET/CT检查,分析鼻、咽部及全身病灶累及范围及播散规律,并分析不同病变范围患者之间ALB、LDH、β2-MG、SUVmax、B症状发生率之间的差异。结果:18F-FDG PET/CT发现每位患者至少有一处病灶,原发病灶在鼻腔、鼻咽、口咽部者分别占81.9%、9.1%、9.1%。病变累及最多的部位为鼻腔(95.5%,21/22)、鼻咽(54.5%,12/22)、左颈部淋巴结(40.9%,9/22)、右颈部淋巴结(40.9%,9/22)、口咽(36.4%,8/22)等。鼻、咽部原发病灶可向邻近部位播散,也可沿淋巴结群依次播散,还可以跳跃方式向远处器官播散。病灶范围较广者组,SUVmax值显著增加,血清β2-MG升高者比例也显著增加。结论:18F-FDG PET/CT能精确发现鼻型结外NK/T细胞淋巴瘤患者鼻、咽部及全身病灶,血清β2-MG水平也能反映病灶的累及范围。     

Comparison of 18F-FDG PET/CT imaging with different dual time 18F-FDG PET/CT with forced diuresis in clinical diagnosis of prostate cancer

The aim of this study was to compare the capability of different dual time (interval 1, 2, 3, or 4 hours) 18F-fluorodeoxyglucose (¹⁸F-FDG) positron emission tomography/computed tomography (PET/CT) with forced diuresis to diagnose prostate cancer (PCa). A retrospective review of 273 male patients from March 2009 to June 2019, with any focal ¹⁸F-FDG uptake in the prostate gland during PET/CT imaging. Early PET/CT imaging was performed 60 minutes after FDG injection. Delayed imaging was performed 1 to 4 hours after diuretic injection. For prostate lesions with increased ¹⁸F-FDG uptake, a spheroid-shaped volume of interest was drawn, including the entire lesion, and the maximum standard uptake value (SUVmax) of the lesion was measured. The SUVmax > 2.5 after delayed imaging and the retention index > 15% were used as the diagnostic criteria for PET/CT in the diagnosis of PCa. Otherwise, it was diagnosed as the benign prostate disease. The final diagnosis was based on histological examination, associated imaging studies, or/and clinical follow-up. The results of inter-group comparison showed that the SUVmax of 1-, 2-, 3-, and 4-hour delayed imaging after diuresis in PCa group was significantly higher than that in control group (P < .05), but there was no statistical difference in SUVmax of early imaging between PCa and control group (P > .05). And the retention index of PCa group that delayed 1, 2, 3, and 4 hours after diuresis were significantly higher than those of control group, respectively (P < .05). The diagnostic sensitivity of imaging delayed 1, 2, 3, and 4 hours after diuresis was 68.8%, 81.2%, 85.7 %, and 71.4%, the specificity was 52.5%, 74.5%, 70.6%, and 65.0%, and the accuracy was respectively 58.2%, 77.4%, 76.4%, and 67.6%, the positive predictive values were 44.0%, 68.9%, 64.3%, and 58.8%, and the negative predictive value were 75.6%, 85.4%, 88.9%, and 76.5%, respectively. ¹⁸F-FDG PET/CT imaging as an imaging tool lacks certain specificity in the diagnosis of PCa, regardless of whether the imaging is delayed. The main advantage of delayed diuretic imaging in PCa is that it can significantly improve the sensitivity, especially the diagnostic effect delayed 2 hours after diuresis is better.     

18F-FDG PET/CT in the diagnosis of prosthetic valve endocarditis

Prosthetic valve endocarditis is a major diagnostic challenge in clinical practice, due to the lower sensitivity of the modified Duke criteria and a higher percentage of cases with negative or inconclusive echocardiography results. The delay in establishing medical and surgical treatment increases the morbidity/mortality rate. New imaging techniques and 18F-FDG PET/CT in particular have meant a significant advance in cases of high clinical suspicion and negative or inconclusive echocardiography, increasing the overall sensitivity of the modified Duke criteria.We report the case of a male patient with prosthetic valve endocarditis, where 18F-FDG PET/CT provided the diagnostic key, determining the origin of the endocarditis and avoiding treatment delay.     

18F-FDG PET/CT in bone sarcoidosis: an observational study

Clinical Rheumatology - Bone sarcoidosis is usually rare. Imaging procedures such as fluorine-18 fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG PET/CT) can reveal bone...     

51例胶质瘤患者18F-FDG PET显像特征及分析

目的探讨胶质瘤18F-氟代脱氧葡萄糖（18F—FDG）PET显像特征,以提高其术前诊断、分级的准确性。方法对经病理证实的51例胶质瘤患者的18F-FDGPET显像特征进行总结,分析其目测法和半定量方法诊断结果与病理诊断的符合率。结果目测法与病理诊断的符合率星形细胞起源肿瘤为97．4％,少突胶质细胞起源肿瘤为66．7％（4／6）,混合性细胞瘤为83．3％（5／6）;半定量法与病理诊断的符合率为86．3％,诊断灵敏性为93．1％、特异性为88．9％。结论不同类型、级别的胶质瘤在18F-FDGPET显像上有其特征性表现,此有利于术前鉴别肿瘤性质及进行分级诊断。     

Metabolic restaging of hepatocellular carcinoma using whole-body 18F-FDG PET/CT

AIM: To evaluate the ability of ¹⁸F-fluorodeoxyglucose positron emission and computed tomography (¹⁸F-FDG PET/CT) in restaging of hepatocellular carcinoma (HCC) after treatment.METHODS: We reviewed a database of the diagnostic performance of ¹⁸F-FDG PET/CT scan for patients with HCC following local or regional treatment. The database consisted of ¹⁸F-FDG PET/CT information of 21 male and 4 female (age range, 27-81 years; mean age, 51.6 years) patients who had received surgical resection and/or interventional treatments and then underwent ¹⁸F-FDG PET/CT scan. All patients had received enhanced CT scan of the liver two weeks before or after the ¹⁸F-FDG PET/CT scan. Intrahepatic recurrence and/or extrahepatic metastases were confirmed by histological analysis or clinical and imaging follow-up. The accuracy of ¹⁸F-FDG PET/CT study was determined by histopathological results or by clinical and imaging follow-up.RESULTS: ¹⁸F-FDG PET/CT was abnormal in 19 of the 25 (76.0%) patients. In detecting HCC recurrence, ¹⁸F-FDG PET/CT scored 17 true positives, 5 true negatives, 2 false positives and 1 false negative. The sensitivity, specificity and accuracy of ¹⁸F-FDG PET/CT in detecting HCC recurrence was 89.5%, 83.3% and 88%, respectively. ¹⁸F-FDG PET/CT had an impact on management of these patients by settling the problem of an unexplained increase in alpha-fetoprotein after treatment (14 patients), by monitoring response to the treatment and guiding additional regional therapy (12 patients), by identifying extrahepatic metastases (10 patients), by identifying tumor growth or thrombosis in the portal vein (6 patients), or by guiding surgical resection of extrahepatic metastases (2 patients).CONCLUSION: Our results suggest that whole body ¹⁸F-FDG PET/CT may be useful in the early evaluation of residual, intrahepatic recurrent or extrahepatic metastatic lesions and able to provide valuable information for the management of HCC recurrence.     

不典型肺结核32例临床分析

探讨不典型肺结核的临床诊治。方法对我院32例不典型肺结核病人的临床病情进行分析。结果 32例患者临床表现,多种改变,最后通过痰TBB塗片培养,胸部CT定位下穿刺,纤维支气管镜等检查后确诊。结论临床医生应熟悉结核病的特殊情况,对可疑结核病患者应加强各方面检查,减少误诊。     

Early colon cancer detected by 18F-FDG PET

Positron emission tomography (PET) is a noninvasive functional imaging modality that can disclose the presence of a malignant disease. It has recently been reported that PET may be useful to detect primary colorectal cancer (CRC). We present the case of a 47-yr-old man with early colon cancer detected by ¹⁸F-fluorodeoxyglucose (FDG) PET. The patient consulted us because of a positive fecal occult blood test and focal FDG uptake in the pelvic cavity detected at a physical check-up. After the usual work up, he was diagnosed as having a sigmoid polyp, 16 mm in diameter. Subsequently, colonoscopic polypectomy was carried out. The surgical specimen was histologically diagnosed as a well-differentiated adenocarcinoma, invading the submucosal layer with lymphatic invasion. Therefore, the involved portion of the sigmoid colon was laparoscopically resected. The FDG PET carried out 1 yr after the operation, showed no abnormal FDG uptake. PET can noninvasively detect an early colon cancer as small as in our patient, as well as other cancers in the whole body. Therefore, we consider it suitable as a screening examination.     

^18F-FDGPET／CT评价肝癌预后的价值

准确评估肝细胞癌（HCC）患者预后是临床的重要问题。18F-FDGPET／CT是一种功能成像与解剖定位成像相融合的影像技术,广泛应用于肿瘤疾病的诊断与预后评价。既往研究证实PET／CT检查所得的SUVmax、SUVratio评价传统化疗、放疗、手术切除、肝动脉化疗栓塞及分子靶向药物索拉非尼治疗的预后均具有良好的价值。现就相关文献进行综述。     

Imaging features of 18F-FDG PET/CT in different types of systemic vasculitis

Clinical Rheumatology - To analyze 18F-fluorodeoxyglucose (FDG) positron emission tomography (PET)/computed tomography (CT) image features in different types of systemic vasculitis and explore its...     

Cardiac Malignant Peripheral Nerve Sheath Tumor Accessed By 18F-FDG PET/CT

This is a case report of a patient presenting an extremely rare cardiac malignancy: malignant peripheral nerve sheath tumour. The ¹⁸F-fluorodeoxyglucosis positron emission tomography associated to computed tomography (¹⁸F-FDG PET/CT) accesses the tumour anatomy and metabolic activity, thereby making it possible to characterize a malignant neoplasm noninvasively. The diagnostic approach with ¹⁸F-FDG PET/CT spared the heart from a likely futile invasive procedure when detecting a distant metastasis and changed the biopsy site and therapeutic planning.