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Sample records for fdg small-animal pet

  1. Optimization of a Model Corrected Blood Input Function from Dynamic FDG-PET Images of Small Animal Heart In Vivo.

    PubMed

    Zhong, Min; Kundu, Bijoy K

    2013-10-01

    Quantitative evaluation of dynamic Positron Emission Tomography (PET) of mouse heart in vivo is challenging due to the small size of the heart and limited intrinsic spatial resolution of the PET scanner. Here, we optimized a compartment model which can simultaneously correct for spill over and partial volume effects for both blood pool and the myocardium, compute kinetic rate parameters and generate model corrected blood input function (MCBIF) from ordered subset expectation maximization - maximum a posteriori (OSEM-MAP) cardiac and respiratory gated (18)F-FDG PET images of mouse heart with attenuation correction in vivo, without any invasive blood sampling. Arterial blood samples were collected from a single mouse to indicate the feasibility of the proposed method. In order to establish statistical significance, venous blood samples from n=6 mice were obtained at 2 late time points, when SP contamination from the tissue to the blood is maximum. We observed that correct bounds and initial guesses for the PV and SP coefficients accurately model the wash-in and wash-out dynamics of the tracer from mouse blood. The residual plot indicated an average difference of about 1.7% between the blood samples and MCBIF. The downstream rate of myocardial FDG influx constant, Ki (0.15±0.03 min(-1)), compared well with Ki obtained from arterial blood samples (P=0.716). In conclusion, the proposed methodology is not only quantitative but also reproducible. PMID:24741130

  2. Noninvasive image derived heart input function for CMRglc measurements in small animal slow infusion FDG PET studies.

    PubMed

    Xiong, Guoming; Paul, Cumming; Todica, Andrei; Hacker, Marcus; Bartenstein, Peter; Böning, Guido

    2012-12-01

    Absolute quantitation of the cerebral metabolic rate for glucose (CMRglc) can be obtained in positron emission tomography (PET) studies when serial measurements of the arterial [(18)F]-fluoro-deoxyglucose (FDG) input are available. Since this is not always practical in PET studies of rodents, there has been considerable interest in defining an image-derived input function (IDIF) by placing a volume of interest (VOI) within the left ventricle of the heart. However, spill-in arising from trapping of FDG in the myocardium often leads to progressive contamination of the IDIF, which propagates to underestimation of the magnitude of CMRglc. We therefore developed a novel, non-invasive method for correcting the IDIF without scaling to a blood sample. To this end, we first obtained serial arterial samples and dynamic FDG-PET data of the head and heart in a group of eight anaesthetized rats. We fitted a bi-exponential function to the serial measurements of the IDIF, and then used the linear graphical Gjedde-Patlak method to describe the accumulation in myocardium. We next estimated the magnitude of myocardial spill-in reaching the left ventricle VOI by assuming a Gaussian point-spread function, and corrected the measured IDIF for this estimated spill-in. Finally, we calculated parametric maps of CMRglc using the corrected IDIF, and for the sake of comparison, relative to serial blood sampling from the femoral artery. The uncorrected IDIF resulted in 20% underestimation of the magnitude of CMRglc relative to the gold standard arterial input method. However, there was no bias with the corrected IDIF, which was robust to the variable extent of myocardial tracer uptake, such that there was a very high correlation between individual CMRglc measurements using the corrected IDIF with gold-standard arterial input results. Based on simulation, we furthermore find that electrocardiogram-gating, i.e. ECG-gating is not necessary for IDIF quantitation using our approach. PMID:23160517

  3. Noninvasive image derived heart input function for CMRglc measurements in small animal slow infusion FDG PET studies

    NASA Astrophysics Data System (ADS)

    Xiong, Guoming; Cumming, Paul; Todica, Andrei; Hacker, Marcus; Bartenstein, Peter; Böning, Guido

    2012-12-01

    Absolute quantitation of the cerebral metabolic rate for glucose (CMRglc) can be obtained in positron emission tomography (PET) studies when serial measurements of the arterial [18F]-fluoro-deoxyglucose (FDG) input are available. Since this is not always practical in PET studies of rodents, there has been considerable interest in defining an image-derived input function (IDIF) by placing a volume of interest (VOI) within the left ventricle of the heart. However, spill-in arising from trapping of FDG in the myocardium often leads to progressive contamination of the IDIF, which propagates to underestimation of the magnitude of CMRglc. We therefore developed a novel, non-invasive method for correcting the IDIF without scaling to a blood sample. To this end, we first obtained serial arterial samples and dynamic FDG-PET data of the head and heart in a group of eight anaesthetized rats. We fitted a bi-exponential function to the serial measurements of the IDIF, and then used the linear graphical Gjedde-Patlak method to describe the accumulation in myocardium. We next estimated the magnitude of myocardial spill-in reaching the left ventricle VOI by assuming a Gaussian point-spread function, and corrected the measured IDIF for this estimated spill-in. Finally, we calculated parametric maps of CMRglc using the corrected IDIF, and for the sake of comparison, relative to serial blood sampling from the femoral artery. The uncorrected IDIF resulted in 20% underestimation of the magnitude of CMRglc relative to the gold standard arterial input method. However, there was no bias with the corrected IDIF, which was robust to the variable extent of myocardial tracer uptake, such that there was a very high correlation between individual CMRglc measurements using the corrected IDIF with gold-standard arterial input results. Based on simulation, we furthermore find that electrocardiogram-gating, i.e. ECG-gating is not necessary for IDIF quantitation using our approach.

  4. Autoradiographic and Small-Animal PET Comparisons Between 18F-FMISO, 18F-FDG, 18F-FLT and the Hypoxic Selective 64Cu-ATSM in a Rodent Model of Cancer

    PubMed Central

    Dence, Carmen S.; Ponde, Datta E.; Welch, Michael J.; Lewis, Jason S.

    2008-01-01

    Introduction Cu-ATSM, a hypoxia imaging agent, has been shown to be predictive of response to traditional cancer therapies in patients with a wide range of tumors. It is known that the environment of the tumor results in a myriad of physiological consequences, including hypoxia, alterations in metabolism and proliferation. In an effort to better characterize the relationships between Cu-ATSM and other prominent radiopharmaceuticals, this current study was undertaken to compare the regional distribution of 64Cu-ATSM with 18F-FMISO, 18F-FDG and 18F-FLT in 9L tumors. Methods Taking advantage of the different half-life of 18F (t½ = 110 min) in comparison to 64Cu (t½ = 12.7 h), we undertook a dual tracer autoradiography study in 9L tumors. Four groups were examined: (a) 18F-FMISO, 2 h p.i. and 64Cu-ATSM 10 min p.i. (b) 18F-FMISO, 2 h p.i. and 64Cu-ATSM 24 h p.i. (c) 18F-FDG, 1 h p.i. and 64Cu-ATSM 10 min p.i., and (d) 18F-FLT, 1 h p.i. and 64Cu-ATSM 10 min p.i‥ Small animal PET imaging was performed in 9L tumor-bearing rats with imaging on concurrent days comparing 64Cu-ATSM with 18F-FMISO and 18F-FLT. Results It was shown that the regional distribution of 18F-FMISO and 64Cu-ATSM showed an excellent correlation when the 64Cu-ATSM had been allowed to distribute for either 10 min (R2 = 0.84) or 24 h (R2 = 0.86). The regional comparisons between 64Cu-ATSM (10 min) and 18F-FDG (1 h) resulted in a very poor correlation (R2 = 0.08) between the regional uptake of the two agents. The comparison between 18F-FLT and 64Cu-ATSM showed a strong relationship (R2 = 0.83) between the two tracers. The small-animal PET images for the distribution comparisons between 64Cu-ATSM and 18F-FMISO and 18F-FLT were in agreement with the data generated from the autoradiography studies. Conclusions The data show that it is important to remember that a number of different metabolic situations can exist when considering the relationship between regions of high glucose uptake, proliferation and

  5. A Very High Spatial Resolution Detector for Small Animal PET

    SciTech Connect

    Kanai Shah, M.S.

    2007-03-06

    Positron Emission Tomography (PET) is an in vivo analog of autoradiography and has the potential to become a powerful new tool in imaging biological processes in small laboratory animals. PET imaging of small animals can provide unique information that can help in advancement of human disease models as well as drug development. Clinical PET scanners used for human imaging are bulky, expensive and do not have adequate spatial resolution for small animal studies. Hence, dedicated, low cost instruments are required for conducting small animal studies with higher spatial resolution than what is currently achieved with clinical as well as dedicated small animal PET scanners. The goal of the proposed project is to investigate a new all solid-state detector design for small animal PET imaging. Exceptionally high spatial resolution, good timing resolution, and excellent energy resolution are expected from the proposed detector design. The Phase I project was aimed at demonstrating the feasibility of producing high performance solid-state detectors that provide high sensitivity, spatial resolution, and timing characteristics. Energy resolution characteristics of the new detector were also investigated. The goal of the Phase II project is to advance the promising solid-state detector technology for small animal PET and determine its full potential. Detectors modules will be built and characterized and finally, a bench-top small animal PET system will be assembled and evaluated.

  6. Small-animal PET: what is it, and why do we need it?

    PubMed

    Yao, Rutao; Lecomte, Roger; Crawford, Elpida S

    2012-09-01

    Small-animal PET refers to imaging of animals such as rats and mice using dedicated PET scanners. Small-animal PET has been used extensively in modern biomedical research. It provides a quantitative measure of the 3-dimensional distribution of a radiopharmaceutical administered to a live subject noninvasively. In this article, we will discuss the operational and technical aspects of small-animal PET; make some comparisons between small-animal PET and human PET systems; identify the challenges of, opportunities for, and ultimate limitations in applying small-animal PET; and discuss some representative small-animal PET applications. Education objectives: After reading this article, the technologist will be able to explain the requirements and benefits of small-animal PET in biomedical research, describe the design and general characteristics of a small-animal PET system, list and describe some of the challenges of imaging small animals, and discuss several small-animal PET applications. PMID:22582006

  7. [Housing situation of small animals in Swiss pet shops].

    PubMed

    Schrickel, B; Gebhardt-Henrich, S; Steiger, A

    2008-07-01

    This study investigates the situation regarding housing of small animals in Swiss pet shops. Data of 92 pet shops were collected with a questionnaire. On average 813 fish, 52.5 invertebrates, 32.2 small mammals, 26.9 birds, 8.9 reptiles and 2.7 amphibians were offered for sale per pet shop. Small mammals, birds and reptiles were mainly obtained from Swiss breeders, while fish and amphibians were almost exclusively purchased from foreign providers. The housing systems which were sold differed from those in which the animals were kept in the shop. This may be misleading to the future pet owners and may lead to faulty husbandry. Animals on reserve were often kept in different housing systems than those in the pet shop. Sick animals were usually treated or killed by the pet shop owners. The killing methods varied between the various species. PMID:18714938

  8. Feasibility study of small animal imaging using clinical PET/CT scanner

    NASA Astrophysics Data System (ADS)

    Hsu, Wen-Lin; Chen, Chia-Lin; Wang, Ze-Jing; Wu, Tung-Hsin; Liu, Dai-Wei; Lee, Jason J. S.

    2007-02-01

    The feasibility of small animal imaging using a clinical positron emission tomography/computed tomography (PET/CT) scanner with [F-18]-fluoro-2-deoxy- D-glucose (FDG) was evaluated. Two protocols in PET/CT system, single-mouse high-resolution mode (SHR) and multi-mouse high throughput mode (MHT) protocol were employed to investigate the ability of the scanner and also explored the performance differences between microPET and clinical PET/CT. In this study, we have found that even the clinical PET/CT scanner could not compete with the microPET scanner, especially in spatial resolution; the high-resolution CT image could advance the anatomical information to sub-millimeter level. Besides, CT-based attenuation correction can improve the image uniformity characteristics and quantification accuracy, and the large bore of a human whole-body scanner broadens the possibility of high throughput studies. Considering all the benefits, clinical PET/CT imaging might be a potential alternative for small animal study.

  9. PET Quantification of Cerebral Oxygen Metabolism in Small Animals

    PubMed Central

    Temma, Takashi; Koshino, Kazuhiro; Moriguchi, Tetsuaki; Enmi, Jun-ichiro; Iida, Hidehiro

    2014-01-01

    Understanding cerebral oxygen metabolism is of great importance in both clinical diagnosis and animal experiments because oxygen is a fundamental source of brain energy and supports brain functional activities. Since small animals such as rats are widely used to study various diseases including cerebral ischemia, cerebrovascular diseases, and neurodegenerative diseases, the development of a noninvasive in vivo measurement method of cerebral oxygen metabolic parameters such as oxygen extraction fraction (OEF) and cerebral metabolic rate of oxygen (CMRO2) as well as cerebral blood flow (CBF) and cerebral blood volume (CBV) has been a priority. Although positron emission tomography (PET) with 15O labeled gas tracers has been recognized as a powerful way to evaluate cerebral oxygen metabolism in humans, this method could not be applied to rats due to technical problems and there were no reports of PET measurement of cerebral oxygen metabolism in rats until an 15O-O2 injection method was developed a decade ago. Herein, we introduce an intravenous administration method using two types of injectable 15O-O2 and an 15O-O2 gas inhalation method through an airway placed in the trachea, which enables oxygen metabolism measurements in rats. PMID:25202714

  10. Use of [18F]fluorodeoxyglucose and the ATLAS small animal PET scanner to examine cerebral functional activation by whisker stimulation in unanesthetized rats

    PubMed Central

    Ravasi, Laura; Shimoji, Kazuaki; Soto-Montenegro, Marisa L.; Esaki, Takanori; Seidel, Jurgen; Sokoloff, Louis; Schmidt, Kathleen

    2011-01-01

    Purpose Stroking the whiskers of a rat is known to increase cerebral blood flow and glucose utilization in the somatosensory cortex. We sought to determine if this activation could be detected with small animal PET and [18F]FDG. Methods Awake rats were co-injected with [18F]FDG and [14C]DG, and during uptake of the tracers, either 5, 10, or 15 whiskers on one side of the face were continuously stimulated. At the end of uptake the animal was killed and imaged with the ATLAS small animal PET scanner. 14C autoradiography was then performed on brain sections obtained from each animal, and increases in tracer uptake in the somatosensory cortex were compared to those determined with PET. Results Both methods showed increases in [18F]FDG and [14C]DG uptake in the somatosensory cortex in response to stimulation of as few as five whiskers. However, the magnitude of activation determined from the PET images was less than that from autoradiography due to the lower spatial resolution of the PET scanner. Conclusions ATLAS small animal PET imaging with [18F]FDG can be used to assess neuronal functional activity in vivo. PMID:21326123

  11. Non-Invasive imaging of small-animal tumors: high-frequency ultrasound vs. MicroPET.

    PubMed

    Liao, Ai-Ho; Li, Chen-Han; Cheng, Weng-Fang; Li, Pai-Chi

    2005-01-01

    Tumor volume measurement on small animals is important but currently invasive. We employ ultrasonic micro-imaging (UMI) in this study and demonstrate its feasibility. In addition, we use small animal positron emission tomography (microPET) as a preliminary effort to develop multi-modality small animal imaging techniques. The tumor growth curve from UMI is also compared to radioactivity from microPET. Both UMI and [18F] FDG microPET imaging were performed on C57BL/6J black mice bearing WF-3 ovary cancer cells at various stages from the second week till up to the eighth week. Segmentation and 3D reconstruction were also done. The growth curve was obtained in vivo noninvasively by UMI. The cell doubling time was 7.46 days according to UMI. This result was compared with vernier caliper measurement and radioactivity counting by microPET. In microPET, we obtained the time-activity curves from the tumor and the tumor-surrounding tissue. The tumor-to-normal-tissues ratios reached maximum at the fifth week after tumor cell implantation. PMID:17281549

  12. Development of a PET Scanner for Simultaneously Imaging Small Animals with MRI and PET

    PubMed Central

    Thompson, Christopher J; Goertzen, Andrew L; Thiessen, Jonathan D; Bishop, Daryl; Stortz, Greg; Kozlowski, Piotr; Retière, Fabrice; Zhang, Xuezhu; Sossi, Vesna

    2014-01-01

    Recently, positron emission tomography (PET) is playing an increasingly important role in the diagnosis and staging of cancer. Combined PET and X-ray computed tomography (PET-CT) scanners are now the modality of choice in cancer treatment planning. More recently, the combination of PET and magnetic resonance imaging (MRI) is being explored in many sites. Combining PET and MRI has presented many challenges since the photo-multiplier tubes (PMT) in PET do not function in high magnetic fields, and conventional PET detectors distort MRI images. Solid state light sensors like avalanche photo-diodes (APDs) and more recently silicon photo-multipliers (SiPMs) are much less sensitive to magnetic fields thus easing the compatibility issues. This paper presents the results of a group of Canadian scientists who are developing a PET detector ring which fits inside a high field small animal MRI scanner with the goal of providing simultaneous PET and MRI images of small rodents used in pre-clinical medical research. We discuss the evolution of both the crystal blocks (which detect annihilation photons from positron decay) and the SiPM array performance in the last four years which together combine to deliver significant system performance in terms of speed, energy and timing resolution. PMID:25120157

  13. Development of a PET scanner for simultaneously imaging small animals with MRI and PET.

    PubMed

    Thompson, Christopher J; Goertzen, Andrew L; Thiessen, Jonathan D; Bishop, Daryl; Stortz, Greg; Kozlowski, Piotr; Retière, Fabrice; Zhang, Xuezhu; Sossi, Vesna

    2014-01-01

    Recently, positron emission tomography (PET) is playing an increasingly important role in the diagnosis and staging of cancer. Combined PET and X-ray computed tomography (PET-CT) scanners are now the modality of choice in cancer treatment planning. More recently, the combination of PET and magnetic resonance imaging (MRI) is being explored in many sites. Combining PET and MRI has presented many challenges since the photo-multiplier tubes (PMT) in PET do not function in high magnetic fields, and conventional PET detectors distort MRI images. Solid state light sensors like avalanche photo-diodes (APDs) and more recently silicon photo-multipliers (SiPMs) are much less sensitive to magnetic fields thus easing the compatibility issues. This paper presents the results of a group of Canadian scientists who are developing a PET detector ring which fits inside a high field small animal MRI scanner with the goal of providing simultaneous PET and MRI images of small rodents used in pre-clinical medical research. We discuss the evolution of both the crystal blocks (which detect annihilation photons from positron decay) and the SiPM array performance in the last four years which together combine to deliver significant system performance in terms of speed, energy and timing resolution. PMID:25120157

  14. Innovations in Small-Animal PET/MR Imaging Instrumentation.

    PubMed

    Tsoumpas, Charalampos; Visvikis, Dimitris; Loudos, George

    2016-04-01

    Multimodal imaging has led to a more detailed exploration of different physiologic processes with integrated PET/MR imaging being the most recent entry. Although the clinical need is still questioned, it is well recognized that it represents one of the most active and promising fields of medical imaging research in terms of software and hardware. The hardware developments have moved from small detector components to high-performance PET inserts and new concepts in full systems. Conversely, the software focuses on the efficient performance of necessary corrections without the use of CT data. The most recent developments in both directions are reviewed. PMID:26952725

  15. FDG-PET imaging in hematological malignancies.

    PubMed

    Valls, L; Badve, C; Avril, S; Herrmann, K; Faulhaber, P; O'Donnell, J; Avril, N

    2016-07-01

    The majority of aggressive lymphomas is characterized by an up regulated glycolytic activity, which enables the visualization by F-18 FDG-PET/CT. One-stop hybrid FDG-PET/CT combines the functional and morphologic information, outperforming both, CT and FDG-PET as separate imaging modalities. This has resulted in several recommendations using FDG-PET/CT for staging, restaging, monitoring during therapy, and assessment of treatment response as well as identification of malignant transformation. FDG-PET/CT may obviate the need for a bone marrow biopsy in patients with Hodgkin's lymphoma and diffuse large B cell lymphoma. FDG-PET/CT response assessment is recommended for FDG-avid lymphomas, whereas CT-based response evaluation remains important in lymphomas with low or variable FDG avidity. The treatment induced change in metabolic activity allows for assessment of response after completion of therapy as well as prediction of outcome early during therapy. The five-point scale Deauville Criteria allows the assessment of treatment response based on visual FDG-PET analysis. Although the use of FDG-PET/CT for prediction of therapeutic response is promising it should only be conducted in the context of clinical trials. Surveillance FDG-PET/CT after complete remission is discouraged due to the relative high number of false-positive findings, which in turn may result in further unnecessary investigations. Future directions include the use of new PET tracers such as F-18 fluorothymidine (FLT), a surrogate biomarker of cellular proliferation and Ga-68 CXCR4, a chemokine receptor imaging biomarker as well as innovative digital PET/CT and PET/MRI techniques. PMID:27090170

  16. Neuroimaging in Animal Seizure Models with 18FDG-PET

    PubMed Central

    Mirrione, Martine M.; Tsirka, Stella E.

    2011-01-01

    Small animal neuroimaging has become increasingly available to researchers, expanding the breadth of questions studied with these methods. Applying these noninvasive techniques to the open questions underlying epileptogenesis is no exception. A major advantage of small animal neuroimaging is its translational appeal. Studies can be well controlled and manipulated, examining the living brain in the animal before, during, and after the disease onset or disease treatment. The results can also be compared to data collected on human patients. Over the past decade, we and others have explored metabolic patterns in animal models of epilepsy to gain insight into the circuitry underlying development of the disease. In this paper, we provide technical details on how metabolic imaging that uses 2-deoxy-2[18F]fluoro-D-glucose (18FDG) and positron emission tomography (PET) is performed and explain the strengths and limitations of these studies. We will also highlight recent advances toward understanding epileptogenesis through small animal imaging. PMID:22937232

  17. FDG PET/CT of Intercostal Schwannoma.

    PubMed

    Wang, Si-Yun; Luo, Dong-Lan; Chen, Gang; Liu, En-Tao; Wang, Shu-Xia

    2016-06-01

    Intercostal schwannoma is rare. We report FDG PET/CT findings of intercostal schwannoma in a 66-year-old woman. The tumor contains both solid and cystic components with intense FDG activity in the solid component. Postsurgical pathology diagnosis revealed schwannoma. PMID:26859215

  18. Full 3-D cluster-based iterative image reconstruction tool for a small animal PET camera

    NASA Astrophysics Data System (ADS)

    Valastyán, I.; Imrek, J.; Molnár, J.; Novák, D.; Balkay, L.; Emri, M.; Trón, L.; Bükki, T.; Kerek, A.

    2007-02-01

    Iterative reconstruction methods are commonly used to obtain images with high resolution and good signal-to-noise ratio in nuclear imaging. The aim of this work was to develop a scalable, fast, cluster based, fully 3-D iterative image reconstruction package for our small animal PET camera, the miniPET. The reconstruction package is developed to determine the 3-D radioactivity distribution from list mode type of data sets and it can also simulate noise-free projections of digital phantoms. We separated the system matrix generation and the fully 3-D iterative reconstruction process. As the detector geometry is fixed for a given camera, the system matrix describing this geometry is calculated only once and used for every image reconstruction, making the process much faster. The Poisson and the random noise sensitivity of the ML-EM iterative algorithm were studied for our small animal PET system with the help of the simulation and reconstruction tool. The reconstruction tool has also been tested with data collected by the miniPET from a line and a cylinder shaped phantom and also a rat.

  19. Efficient system modeling for a small animal PET scanner with tapered DOI detectors

    NASA Astrophysics Data System (ADS)

    Zhang, Mengxi; Zhou, Jian; Yang, Yongfeng; Rodríguez-Villafuerte, Mercedes; Qi, Jinyi

    2016-01-01

    A prototype small animal positron emission tomography (PET) scanner for mouse brain imaging has been developed at UC Davis. The new scanner uses tapered detector arrays with depth of interaction (DOI) measurement. In this paper, we present an efficient system model for the tapered PET scanner using matrix factorization and a virtual scanner geometry. The factored system matrix mainly consists of two components: a sinogram blurring matrix and a geometrical matrix. The geometric matrix is based on a virtual scanner geometry. The sinogram blurring matrix is estimated by matrix factorization. We investigate the performance of different virtual scanner geometries. Both simulation study and real data experiments are performed in the fully 3D mode to study the image quality under different system models. The results indicate that the proposed matrix factorization can maintain image quality while substantially reduce the image reconstruction time and system matrix storage cost. The proposed method can be also applied to other PET scanners with DOI measurement.

  20. A small animal PET based on GAPDs and charge signal transmission approach for hybrid PET-MR imaging

    NASA Astrophysics Data System (ADS)

    Kang, Jihoon; Choi, Yong; Hong, Key Jo; Hu, Wei; Jung, Jin Ho; Huh, Yoonsuk; Kim, Byung-Tae

    2011-08-01

    Positron emission tomography (PET) employing Geiger-mode avalanche photodiodes (GAPDs) and charge signal transmission approach was developed for small animal imaging. Animal PET contained 16 LYSO and GAPD detector modules that were arranged in a 70 mm diameter ring with an axial field of view of 13 mm. The GAPDs charge output signals were transmitted to a preamplifier located remotely using 300 cm flexible flat cables. The position decoder circuits (PDCs) were used to multiplex the PET signals from 256 to 4 channels. The outputs of the PDCs were digitized and further-processed in the data acquisition unit. The cross-compatibilities of the PET detectors and MRI were assessed outside and inside the MRI. Experimental studies of the developed full ring PET were performed to examine the spatial resolution and sensitivity. Phantom and mouse images were acquired to examine the imaging performance. The mean energy and time resolution of the PET detector were 17.6% and 1.5 ns, respectively. No obvious degradation on PET and MRI was observed during simultaneous PET-MRI data acquisition. The measured spatial resolution and sensitivity at the CFOV were 2.8 mm and 0.7%, respectively. In addition, a 3 mm diameter line source was clearly resolved in the hot-sphere phantom images. The reconstructed transaxial PET images of the mouse brain and tumor displaying the glucose metabolism patterns were imaged well. These results demonstrate GAPD and the charge signal transmission approach can allow the development of high performance small animal PET with improved MR compatibility.

  1. Raytest ClearPET™, a new generation small animal PET scanner

    NASA Astrophysics Data System (ADS)

    Sempere Roldan, P.; Chereul, E.; Dietzel, O.; Magnier, L.; Pautrot, C.; Rbah, L.; Sappey-Marinier, D.; Wagner, A.; Zimmer, L.; Janier, M.; Tarazona, V.; Dietzel, G.

    2007-02-01

    The ClearPET is a high-performance small animal PET scanner that has been developed by the Crystal Clear Collaboration (CCC) and is now commercially available to customers worldwide through the Raytest group. Its high sensitivity and spatial resolution are achieved, thanks to a patented phoswich configuration made of two types of scintillating crystals: L(Y)SO and LuYAP:Ce, thus providing depth of interaction information. The ClearPET presents a modular design and it allows for 360° rotation of the detector modules around the field of view (FOV). The ClearPET also presents the unique feature of having an adjustable FOV diameter, thus being suitable for small and medium size animal PET studies. This paper shows the performances of the commercial ClearPET in terms of its spatial resolution, sensitivity and quality of phantoms and preclinical images obtained. It also describes the updated situation of the first commercial unit sold to the Animage platform in Lyon.

  2. A rat head holder for simultaneous scanning of two rats in small animal PET scanners: Design, construction, feasibility testing and kinetic validation

    PubMed Central

    Cheng, Tee Ean; Yoder, Karmen K.; Normandin, Marc D.; Risacher, Shannon L.; Converse, Alexander K.; Hampel, Joseph A.; Miller, Michael A.; Morris, Evan D.

    2013-01-01

    To reduce imaging costs, we designed a head holder for scanning two rats simultaneously in small animal PET scanners. Our goals were (i) to maintain high sensitivity and (ii) to minimize repositioning error between scans. Methods A semi-stereotaxic dual rat head holder was designed and constructed for dual rat scanning in our IndyPET-II scanner and the commercial microPET P4. It was also used for single rat scanning in a small-bore, high-resolution animal scanner (“ISAP”). Positional repeatability was validated via multiple [11C]Raclopride scans of a single rat on different days. Accuracy of repositioning was determined by visual comparison of images, and by metrics derived through image alignment. Kinetic validation was assessed via analysis of [18F]Fluorodeoxyglucose ([18F]FDG) dynamic PET studies of six rats. Each rat was scanned twice: once individually, with brain positioned at the center of field of view (CFOV), and once with a partner, with brain away from CFOV. Both rats were injected with FDG during each dual rat session. Patlak uptake constants (Ki) were calculated from whole brain images. Effects of attenuation and scatter correction on single versus dual scan images were explored. Results Image comparison and alignment metrics indicated excellent repositioning of rats. Scaled time-activity-curves from single and dual rat scans were indistinguishable. Average single and dual scan Ki values differed by only 6.3 ± 7.5%. Conclusion Dual rat scanning in a semi-sterotaxic holder is practical for economical small animal scanning and does not compromise kinetic accuracy of [18F]FDG dynamic scan data. PMID:18824025

  3. Practical method for radioactivity distribution analysis in small-animal PET cancer studies

    PubMed Central

    Slavine, Nikolai V.; Antich, Peter P.

    2008-01-01

    We present a practical method for radioactivity distribution analysis in small-animal tumors and organs using positron emission tomography imaging with a calibrated source of known activity and size in the field of view. We reconstruct the imaged mouse together with a source under the same conditions, using an iterative method, Maximum Likelihood Expectation-Maximization with System Modeling, capable of delivering high resolution images. Corrections for the ratios of geometrical efficiencies, radioisotope decay in time and photon attenuation are included in the algorithm. We demonstrate reconstruction results for the amount of radioactivity within the scanned mouse in a sample study of osteolytic and osteoblastic bone metastasis from prostate cancer xenografts. Data acquisition was performed on the small-animal PET system which was tested with different radioactive sources, phantoms and animals to achieve high sensitivity and spatial resolution. Our method uses high resolution images to determine the volume of organ or tumor and the amount of their radioactivity, has the possibility of saving time, effort and the necessity to sacrifice animals. This method has utility for prognosis and quantitative analysis in small-animal cancer studies, and will enhance the assessment of characteristics of tumor growth, identifying metastases, and potentially determining the effectiveness of cancer treatment. The possible application for this technique could be useful for the organ radioactivity dosimetry studies. PMID:18667322

  4. A method for small-animal PET/CT alignment calibration

    NASA Astrophysics Data System (ADS)

    Pascau, J.; Vaquero, J. J.; Chamorro-Servent, J.; Rodríguez-Ruano, A.; Desco, M.

    2012-06-01

    Small-animal positron-emission tomography/computed tomography (PET/CT) scanners provide anatomical and molecular imaging, which enables the joint visualization and analysis of both types of data. A proper alignment calibration procedure is essential for small-animal imaging since resolution is much higher than that in human devices. This work presents an alignment phantom and two different calibration methods that provide a reliable and repeatable measurement of the spatial geometrical alignment between the PET and the CT subsystems of a hybrid scanner. The phantom can be built using laboratory materials, and it is meant to estimate the rigid spatial transformation that aligns both modalities. It consists of three glass capillaries filled with a positron-emitter solution and positioned in a non-coplanar triangular geometry inside the system field of view. The calibration methods proposed are both based on automatic line detection, but with different approaches to calculate the transformation of the lines between both modalities. Our results show an average accuracy of the alignment estimation of 0.39 mm over the whole field of view.

  5. Noise reduction in small-animal PET images using a multiresolution transform.

    PubMed

    Mejia, Jose M; Ochoa Domínguez, Humberto de Jesús; Vergara Villegas, Osslan Osiris; Ortega Máynez, Leticia; Mederos, Boris

    2014-10-01

    In this paper, we address the problem of denoising reconstructed small animal positron emission tomography (PET) images, based on a multiresolution approach which can be implemented with any transform such as contourlet, shearlet, curvelet, and wavelet. The PET images are analyzed and processed in the transform domain by modeling each subband as a set of different regions separated by boundaries. Homogeneous and heterogeneous regions are considered. Each region is independently processed using different filters: a linear estimator for homogeneous regions and a surface polynomial estimator for the heterogeneous region. The boundaries between the different regions are estimated using a modified edge focusing filter. The proposed approach was validated by a series of experiments. Our method achieved an overall reduction of up to 26% in the %STD of the reconstructed image of a small animal NEMA phantom. Additionally, a test on a simulated lesion showed that our method yields better contrast preservation than other state-of-the art techniques used for noise reduction. Thus, the proposed method provides a significant reduction of noise while at the same time preserving contrast and important structures such as lesions. PMID:24951682

  6. Correction of MRI-induced geometric distortions in whole-body small animal PET-MRI

    SciTech Connect

    Frohwein, Lynn J. Schäfers, Klaus P.; Hoerr, Verena; Faber, Cornelius

    2015-07-15

    Purpose: The fusion of positron emission tomography (PET) and magnetic resonance imaging (MRI) data can be a challenging task in whole-body PET-MRI. The quality of the registration between these two modalities in large field-of-views (FOV) is often degraded by geometric distortions of the MRI data. The distortions at the edges of large FOVs mainly originate from MRI gradient nonlinearities. This work describes a method to measure and correct for these kind of geometric distortions in small animal MRI scanners to improve the registration accuracy of PET and MRI data. Methods: The authors have developed a geometric phantom which allows the measurement of geometric distortions in all spatial axes via control points. These control points are detected semiautomatically in both PET and MRI data with a subpixel accuracy. The spatial transformation between PET and MRI data is determined with these control points via 3D thin-plate splines (3D TPS). The transformation derived from the 3D TPS is finally applied to real MRI mouse data, which were acquired with the same scan parameters used in the phantom data acquisitions. Additionally, the influence of the phantom material on the homogeneity of the magnetic field is determined via field mapping. Results: The spatial shift according to the magnetic field homogeneity caused by the phantom material was determined to a mean of 0.1 mm. The results of the correction show that distortion with a maximum error of 4 mm could be reduced to less than 1 mm with the proposed correction method. Furthermore, the control point-based registration of PET and MRI data showed improved congruence after correction. Conclusions: The developed phantom has been shown to have no considerable negative effect on the homogeneity of the magnetic field. The proposed method yields an appropriate correction of the measured MRI distortion and is able to improve the PET and MRI registration. Furthermore, the method is applicable to whole-body small animal

  7. Evaluation of Matrix9 silicon photomultiplier array for small-animal PET

    PubMed Central

    Du, Junwei; Schmall, Jeffrey P.; Yang, Yongfeng; Di, Kun; Roncali, Emilie; Mitchell, Gregory S.; Buckley, Steve; Jackson, Carl; Cherry, Simon R.

    2015-01-01

    Purpose: The MatrixSL-9-30035-OEM (Matrix9) from SensL is a large-area silicon photomultiplier (SiPM) photodetector module consisting of a 3 × 3 array of 4 × 4 element SiPM arrays (total of 144 SiPM pixels) and incorporates SensL’s front-end electronics board and coincidence board. Each SiPM pixel measures 3.16 × 3.16 mm2 and the total size of the detector head is 47.8 × 46.3 mm2. Using 8 × 8 polished LSO/LYSO arrays (pitch 1.5 mm) the performance of this detector system (SiPM array and readout electronics) was evaluated with a view for its eventual use in small-animal positron emission tomography (PET). Methods: Measurements of noise, signal, signal-to-noise ratio, energy resolution, flood histogram quality, timing resolution, and array trigger error were obtained at different bias voltages (28.0–32.5 V in 0.5 V intervals) and at different temperatures (5 °C–25 °C in 5 °C degree steps) to find the optimal operating conditions. Results: The best measured signal-to-noise ratio and flood histogram quality for 511 keV gamma photons were obtained at a bias voltage of 30.0 V and a temperature of 5 °C. The energy resolution and timing resolution under these conditions were 14.2% ± 0.1% and 4.2 ± 0.1 ns, respectively. The flood histograms show that all the crystals in the 1.5 mm pitch LSO array can be clearly identified and that smaller crystal pitches can also be resolved. Flood histogram quality was also calculated using different center of gravity based positioning algorithms. Improved and more robust results were achieved using the local 9 pixels for positioning along with an energy offset calibration. To evaluate the front-end detector readout, and multiplexing efficiency, an array trigger error metric is introduced and measured at different lower energy thresholds. Using a lower energy threshold greater than 150 keV effectively eliminates any mispositioning between SiPM arrays. Conclusions: In summary, the Matrix9 detector system can resolve

  8. First results in the application of silicon photomultiplier matrices to small animal PET

    NASA Astrophysics Data System (ADS)

    Llosá, G.; Belcari, N.; Bisogni, M. G.; Collazuol, G.; Marcatili, S.; Boscardin, M.; Melchiorri, M.; Tarolli, A.; Piemonte, C.; Zorzi, N.; Barrillon, P.; Bondil-Blin, S.; Chaumat, V.; de La Taille, C.; Dinu, N.; Puill, V.; Vagnucci, J.-F.; Del Guerra, A.

    2009-10-01

    A very high resolution small animal PET scanner that employs matrices of silicon photomultipliers as photodetectors is under development at the University of Pisa and INFN Pisa. The first SiPM matrices composed of 16 (4×4)1 mm×1 mm pixel elements on a common substrate have been produced at FBK-irst, and are being evaluated for this application. The MAROC2 ASIC developed at LAL-Orsay has been employed for the readout of the SiPM matrices. The devices have been tested with pixelated and continuous LYSO crystals. The results show the good performance of the matrices and lead to the fabrication of matrices with 64 SiPM elements.

  9. A detector head design for small-animal PET with silicon photomultipliers (SiPM)

    NASA Astrophysics Data System (ADS)

    Moehrs, Sascha; DelGuerra, Alberto; Herbert, Deborah J.; Mandelkern, Mark A.

    2006-03-01

    Small-animal PET systems are now striving for sub-millimetre resolution. Current systems based upon PSPMTs and finely pixellated scintillators can be pushed to higher resolution, but at the expense of other performance parameters and a rapidly escalating cost. Moreover, depth of interaction (DOI) information is usually difficult to assess in such systems, even though this information is highly desirable to reduce the parallax error, which is often the dominant error for such high-resolution systems. In this study we propose a high-resolution detector head for a small-animal PET imaging system with intrinsic DOI information. Instead of a pixellated scintillator, our design is based upon the classic Anger camera principle, i.e. the head is constructed of modular layers each consisting of a continuous slab of scintillator, viewed by a new type of compact silicon photodetector. The photodetector is the recently developed silicon photomultiplier (SiPM) that as well as being very compact has many other attractive properties: high gain at low bias voltage, excellent single-photoelectron resolution and fast timing. A detector head of about 4 × 4 cm2 in area is proposed, constructed from three modular layers of the type described above. We perform a simulation study, using the Monte Carlo simulation package Geant4. The simulation results are used to optimize the geometry of the detector head and characterize its performance. Additionally, hit estimation algorithms are studied to determine the interaction position of annihilation photons correctly over the whole detector surface. The resulting detector has a nearly uniform efficiency for 511 keV photons of ~70% and an intrinsic spatial resolution of less than ~0.4 mm full width at half maximum (fwhm).

  10. A detector head design for small-animal PET with silicon photomultipliers (SiPM).

    PubMed

    Moehrs, Sascha; Del Guerra, Alberto; Herbert, Deborah J; Mandelkern, Mark A

    2006-03-01

    Small-animal PET systems are now striving for sub-millimetre resolution. Current systems based upon PSPMTs and finely pixellated scintillators can be pushed to higher resolution, but at the expense of other performance parameters and a rapidly escalating cost. Moreover, depth of interaction (DOI) information is usually difficult to assess in such systems, even though this information is highly desirable to reduce the parallax error, which is often the dominant error for such high-resolution systems. In this study we propose a high-resolution detector head for a small-animal PET imaging system with intrinsic DOI information. Instead of a pixellated scintillator, our design is based upon the classic Anger camera principle, i.e. the head is constructed of modular layers each consisting of a continuous slab of scintillator, viewed by a new type of compact silicon photodetector. The photodetector is the recently developed silicon photomultiplier (SiPM) that as well as being very compact has many other attractive properties: high gain at low bias voltage, excellent single-photoelectron resolution and fast timing. A detector head of about 4 x 4 cm2 in area is proposed, constructed from three modular layers of the type described above. We perform a simulation study, using the Monte Carlo simulation package Geant4. The simulation results are used to optimize the geometry of the detector head and characterize its performance. Additionally, hit estimation algorithms are studied to determine the interaction position of annihilation photons correctly over the whole detector surface. The resulting detector has a nearly uniform efficiency for 511 keV photons of approximately 70% and an intrinsic spatial resolution of less than approximately 0.4 mm full width at half maximum (fwhm). PMID:16481681

  11. [2D imaging simulations of a small animal PET scanner with DOI measurement: jPET-RD.].

    PubMed

    Yamaya, Taiga; Kitamura, Keishi; Hagiwara, Naoki; Obi, Takashi; Hasegawa, Tomoyuki; Yoshida, Eiji; Tsuda, Tomoaki; Inadama, Naoko; Wada, Yasuhiro; Murayama, Hideo

    2005-01-01

    We present a preliminary study on the design of a high sensitivity small animal DOI-PET scanner: jPET-RD (for Rodents with DOI detectors), which will contribute to molecular imaging. The 4-layer DOI block detector for the jPET-RD that consists of scintillation crystals (1.4 mm x 1.4 mm x 4.5 mm) and a flat panel position-sensitive photomultiplier tube (52 mm x 52 mm) was previously proposed. In this paper, we investigate imaging performance of the jPET-RD through numerical simulations. The scanner has a hexagonal geometry with a small diameter and a large axial aperture. Therefore DOI information is expected to improve resolution uniformity in the whole field of view (FOV). We simulate the scanner for various parameters of the number of DOI channels and the crystal length. Simulated data are reconstructed using the maximum likelihood expectation maximization with accurate system modeling. The trade-off results between background noise and spatial resolution show that only shortening the length of crystal does not improve the trade-off at all, and that 4-layer DOI information improves uniformity of spatial resolution in the whole FOV. Excellent performance of the jPET-RD can be expected based on the numerical simulation results. PMID:15961924

  12. Denoising of high resolution small animal 3D PET data using the non-subsampled Haar wavelet transform

    NASA Astrophysics Data System (ADS)

    Ochoa Domínguez, Humberto de Jesús; Máynez, Leticia O.; Vergara Villegas, Osslan O.; Mederos, Boris; Mejía, José M.; Cruz Sánchez, Vianey G.

    2015-06-01

    PET allows functional imaging of the living tissue. However, one of the most serious technical problems affecting the reconstructed data is the noise, particularly in images of small animals. In this paper, a method for high-resolution small animal 3D PET data is proposed with the aim to reduce the noise and preserve details. The method is based on the estimation of the non-subsampled Haar wavelet coefficients by using a linear estimator. The procedure is applied to the volumetric images, reconstructed without correction factors (plane reconstruction). Results show that the method preserves the structures and drastically reduces the noise that contaminates the image.

  13. Evaluation of Matrix9 silicon photomultiplier array for small-animal PET

    SciTech Connect

    Du, Junwei Schmall, Jeffrey P.; Yang, Yongfeng; Di, Kun; Roncali, Emilie; Mitchell, Gregory S.; Buckley, Steve; Jackson, Carl; Cherry, Simon R.

    2015-02-15

    Purpose: The MatrixSL-9-30035-OEM (Matrix9) from SensL is a large-area silicon photomultiplier (SiPM) photodetector module consisting of a 3 × 3 array of 4 × 4 element SiPM arrays (total of 144 SiPM pixels) and incorporates SensL’s front-end electronics board and coincidence board. Each SiPM pixel measures 3.16 × 3.16 mm{sup 2} and the total size of the detector head is 47.8 × 46.3 mm{sup 2}. Using 8 × 8 polished LSO/LYSO arrays (pitch 1.5 mm) the performance of this detector system (SiPM array and readout electronics) was evaluated with a view for its eventual use in small-animal positron emission tomography (PET). Methods: Measurements of noise, signal, signal-to-noise ratio, energy resolution, flood histogram quality, timing resolution, and array trigger error were obtained at different bias voltages (28.0–32.5 V in 0.5 V intervals) and at different temperatures (5 °C–25 °C in 5 °C degree steps) to find the optimal operating conditions. Results: The best measured signal-to-noise ratio and flood histogram quality for 511 keV gamma photons were obtained at a bias voltage of 30.0 V and a temperature of 5 °C. The energy resolution and timing resolution under these conditions were 14.2% ± 0.1% and 4.2 ± 0.1 ns, respectively. The flood histograms show that all the crystals in the 1.5 mm pitch LSO array can be clearly identified and that smaller crystal pitches can also be resolved. Flood histogram quality was also calculated using different center of gravity based positioning algorithms. Improved and more robust results were achieved using the local 9 pixels for positioning along with an energy offset calibration. To evaluate the front-end detector readout, and multiplexing efficiency, an array trigger error metric is introduced and measured at different lower energy thresholds. Using a lower energy threshold greater than 150 keV effectively eliminates any mispositioning between SiPM arrays. Conclusions: In summary, the Matrix9 detector system

  14. FDG PET in Intracranial Carcinomatous Meningitis.

    PubMed

    Heimburger, Céline; Bund, Caroline; Namer, Izzie Jacques

    2016-01-01

    A 63-year-old white man, diagnosed with pT3N2 squamous cell lung carcinoma, underwent right upper lobectomy with adjuvant radiochemotherapy. After a partial epileptic seizure, MRI revealed a solitary right frontal metastasis that was treated with surgical resection followed by stereotaxic radiotherapy. Three months later, the patient presented weight loss, weakness, and headache. He underwent a whole-body FDG PET/CT for restaging. It showed intense FDG uptakes on the brain periphery corresponding to nodular meningeal contrast enhancement on MRI leading to the diagnosis of carcinomatous meningitis, despite negative cerebrospinal fluid cytology. PMID:26447391

  15. Validation of a small-animal PET simulation using GAMOS: a GEANT4-based framework

    NASA Astrophysics Data System (ADS)

    Cañadas, M.; Arce, P.; Rato Mendes, P.

    2011-01-01

    Monte Carlo-based modelling is a powerful tool to help in the design and optimization of positron emission tomography (PET) systems. The performance of these systems depends on several parameters, such as detector physical characteristics, shielding or electronics, whose effects can be studied on the basis of realistic simulated data. The aim of this paper is to validate a comprehensive study of the Raytest ClearPET small-animal PET scanner using a new Monte Carlo simulation platform which has been developed at CIEMAT (Madrid, Spain), called GAMOS (GEANT4-based Architecture for Medicine-Oriented Simulations). This toolkit, based on the GEANT4 code, was originally designed to cover multiple applications in the field of medical physics from radiotherapy to nuclear medicine, but has since been applied by some of its users in other fields of physics, such as neutron shielding, space physics, high energy physics, etc. Our simulation model includes the relevant characteristics of the ClearPET system, namely, the double layer of scintillator crystals in phoswich configuration, the rotating gantry, the presence of intrinsic radioactivity in the crystals or the storage of single events for an off-line coincidence sorting. Simulated results are contrasted with experimental acquisitions including studies of spatial resolution, sensitivity, scatter fraction and count rates in accordance with the National Electrical Manufacturers Association (NEMA) NU 4-2008 protocol. Spatial resolution results showed a discrepancy between simulated and measured values equal to 8.4% (with a maximum FWHM difference over all measurement directions of 0.5 mm). Sensitivity results differ less than 1% for a 250-750 keV energy window. Simulated and measured count rates agree well within a wide range of activities, including under electronic saturation of the system (the measured peak of total coincidences, for the mouse-sized phantom, was 250.8 kcps reached at 0.95 MBq mL-1 and the simulated peak was

  16. DigiPET: sub-millimeter spatial resolution small-animal PET imaging using thin monolithic scintillators.

    PubMed

    España, Samuel; Marcinkowski, Radoslaw; Keereman, Vincent; Vandenberghe, Stefaan; Van Holen, Roel

    2014-07-01

    A new preclinical PET system based on dSiPMs, called DigiPET, is presented. The system is based on thin monolithic scintillation crystals and exhibits superior spatial resolution at low-cost compared to systems based on pixelated crystals. Current dedicated small-rodent PET scanners have a spatial resolution in the order of 1 mm. Most of them have a large footprint, requiring considerable laboratory space. For rodent brain imaging, a PET scanner with sub-millimeter resolution is desired. To achieve this, crystals with a pixel pitch down to 0.5 mm have been used. However, fine pixels are difficult to produce and will render systems expensive. In this work, we present the first results with a high-resolution preclinical PET scanner based on thin monolithic scintillators and a large solid angle. The design is dedicated to rat-brain imaging and therefore has a very compact geometry. Four detectors were placed in a square arrangement with a distance of 34.5 mm between two opposing detector modules, defining a field of view (FOV) of 32 × 32 × 32 mm(3). Each detector consists of a thin monolithic LYSO crystal of 32 × 32 × 2 mm(3) optically coupled to a digital silicon photomultiplier (dSiPM). Event positioning within each detector was obtained using the maximum likelihood estimation (MLE) method. To evaluate the system performance, we measured the energy resolution, coincidence resolving time (CRT), sensitivity and spatial resolution. The image quality was evaluated by acquiring a hot-rod phantom filled with (18)F-FDG and a rat head one hour after an (18)F-FDG injection. The MLE yielded an average intrinsic spatial resolution on the detector of 0.54 mm FWHM. We obtained a CRT of 680 ps and an energy resolution of 18% FWHM at 511 keV. The sensitivity and spatial resolution obtained at the center of the FOV were 6.0 cps kBq(-1) and 0.7 mm, respectively. In the reconstructed images of the hot-rod phantom, hot rods down to 0.7 mm can be discriminated

  17. In Vivo Biodistribution and Small Animal PET of 64Cu Labeled Antimicrobial Peptoids

    PubMed Central

    Seo, Jiwon; Ren, Gang; Liu, Hongguang; Miao, Zheng; Park, Minyoung; Wang, Yihong; Miller, Tyler M.; Barron, Annelise E.; Cheng, Zhen

    2012-01-01

    Peptoids are a rapidly developing class of biomimetic polymers based on oligo-N-substituted glycine backbones, designed to mimic peptides and proteins. Inspired by natural antimicrobial peptides, a group of cationic amphipathic peptoids has been successfully discovered with a potent and broad-spectrum activity against pathogenic bacteria; however, there are limited studies to address the in vivo pharmacokinetics of the peptoids. Herein, 64Cu labeled DOTA conjugates of three different peptoids and two control peptides were synthesized and assayed in vivo by both biodistribution studies and small animal positron emission tomography (PET). The study was designed in a way to assess how structural differences of the peptidomimetics affect in vivo pharmacokinetics. As amphipathic molecules, major uptake of the peptoids occurred at the liver. Increased kidney uptake was observed by deleting one hydrophobic residue in the peptoid, and 64Cu-3 achieved the highest kidney uptake of all the conjugates tested in this study. In comparison to peptides, our data indicated that peptoids had general in vivo properties of higher tissue accumulation, slower elimination, and higher in vivo stability. Different administration routes (intravenous, intraperitoneal, and oral) were investigated with peptoids. When administered orally, the peptoids showed poor bioavailability, reminiscent to that of peptide. But, remarkably longer passage through the gastrointestinal (GI) tract without rapid digestion was observed for peptoids. These unique in vivo properties of peptoids were rationalized by efficient cellular membrane permeability and protease resistance of peptoids. The results observed in the biodistribution studies could be confirmed by the PET imaging, which provides a reliable way to evaluate in vivo pharmacokinetic properties of peptoids noninvasively and in real time. The pharmacokinetic data presented here can provide an insight for further development of the antimicrobial peptoids

  18. Improved dead-time correction for PET scanners: application to small-animal PET

    NASA Astrophysics Data System (ADS)

    Vicente, E.; Herraiz, J. L.; España, S.; Herranz, E.; Desco, M.; Vaquero, J. J.; Udías, J. M.

    2013-04-01

    Pile-up and dead-time are two main causes of nonlinearity in the response of a PET scanner as a function of activity in the field of view (FOV). For a given scanner and acquisition system, pile-up effects depend on the material and size of the object being imaged and on the distribution of activity inside and outside the FOV, because these factors change the singles-to-coincidences ratio (SCR). Thus, it is difficult to devise an accurate correction that would be valid for any acquisition. In this work, we demonstrate a linear relationship between SCR and effective dead-time, which measures the effects of both dead-time (losses) and pile-up (gains and losses). This relationship allows us to propose a simple method to accurately estimate dead-time and pile-up corrections using only two calibration acquisitions with, respectively, a high and low SCR. The method has been tested with simulations and experimental data for two different scanner geometries: a scanner with large area detectors and no pile-up rejection, and a scanner composed of two full rings of smaller detectors. Our results show that the SCR correction method is accurate within 7%, even for high activities in the FOV, and avoids the bias of the standard single-parameter method.

  19. Design of a Second Generation Firewire Based Data Acquisition System for Small Animal PET Scanners

    PubMed Central

    Lewellen, T.K.; Miyaoka, R.S.; MacDonald, L.R.; Haselman, M.; DeWitt, D.; Hunter, William; Hauck, S.

    2009-01-01

    The University of Washington developed a Firewire based data acquisition system for the MiCES small animal PET scanner. Development work has continued on new imaging scanners that require more data channels and need to be able to operate within a MRI imaging system. To support these scanners, we have designed a new version of our data acquisition system that leverages the capabilities of modern field programmable gate arrays (FPGA). The new design preserves the basic approach of the original system, but puts almost all functions into the FPGA, including the Firewire elements, the embedded processor, and pulse timing and pulse integration. The design has been extended to support implementation of the position estimation and DOl algorithms developed for the cMiCE detector module. The design is centered around an acquisition node board (ANB) that includes 65 ADC channels, Firewire 1394b support, the FPGA, a serial command bus and signal lines to support a rough coincidence window implementation to reject singles events from being sent on the Firewire bus. Adapter boards convert detector signals into differential paired signals to connect to the ANB. PMID:20228958

  20. A LSO β microprobe for measuring input functions for quantitative small animal PET

    NASA Astrophysics Data System (ADS)

    Maramraju, S.; Stoll, S.; Woody, C.; Schlyer, D.; Schiffer, W.; Lee, D.; Dewey, S.; Vaska, P.

    2007-02-01

    A miniature scintillation microprobe has been developed to measure the input function in live rodents for use in longitudinal, quantitative PET studies. The probe consists of a small lutetium oxyorthosilicate (LSO) crystal measuring typically 0.3-0.5 mm diameter ×0.5-2 mm in length that is used to directly detect positrons in the blood or tissue. The probe has a sensitivity of 10-30 Hz/μCi/cm 3 and is primarily sensitive to short-range positrons emitted by labeled radiotracers in the blood. The sensitivity to γ-ray background can be minimized using a variable threshold in the readout to discriminate between positrons and γ's. The probe was implanted in one of the tail veins of a Sprague-Dawley rat and the input function was measured for the injection of 0.8 mCi of FDG in the other tail vein. The probe exhibits a fast time response that is able to quickly and accurately measure the concentration of 18F circulating in the bloodstream. Additional tests were also carried out to study the probe's sensitivity to γ-ray background.

  1. FDG-PET/CT in lymphoma

    PubMed Central

    D'souza, Maria M; Jaimini, Abhinav; Bansal, Abhishek; Tripathi, Madhavi; Sharma, Rajnish; Mondal, Anupam; Tripathi, Rajendra Prashad

    2013-01-01

    Lymphomas are a heterogeneous group of diseases that arise from the constituent cells of the immune system or from their precursors. 18F-fludeoxyglucose positron emission tomography/computed tomography (18F-FDG PET/CT) is now the cornerstone of staging procedures in the state-of-the-art management of Hodgkin's disease and aggressive non-Hodgkin's lymphoma. It plays an important role in staging, restaging, prognostication, planning appropriate treatment strategies, monitoring therapy, and detecting recurrence. However, its role in indolent lymphomas is still unclear and calls for further investigational trials. The protean PET/CT manifestations of lymphoma necessitate a familiarity with the spectrum of imaging findings to enable accurate diagnosis. A meticulous evaluation of PET/CT findings, an understanding of its role in the management of lymphomas, and knowledge of its limitations are mandatory for the optimal utilization of this technique. PMID:24604942

  2. FDG-PET hyperactivity pattern in anti-NMDAr encephalitis.

    PubMed

    Novy, Jan; Allenbach, Gilles; Bien, Christian G; Guedj, Eric; Prior, John O; Rossetti, Andrea O

    2016-08-15

    FDG-PET can show anteroposterior glucose metabolism gradient in anti-NMDAr encephalitis, but there are also suggestions that basal ganglia are involved. We examined FDG-PET scans in 5 consecutive episodes of serologically proven anti-NMDAr encephalitis, compared with healthy controls. We confirmed the anteroposterior metabolic gradient and found a significant FDG uptake increase in the caudate nuclei in episodes of varying intensity and delay from the onset of the symptoms. FDG-PET can be useful in the work-up of suspected anti-NMDAr encephalitis disclosing a characteristic cortical and sub-cortical metabolism pattern. PMID:27397089

  3. Small-Animal PET Imaging of Tau Pathology with 18F-THK5117 in 2 Transgenic Mouse Models.

    PubMed

    Brendel, Matthias; Jaworska, Anna; Probst, Federico; Overhoff, Felix; Korzhova, Viktoria; Lindner, Simon; Carlsen, Janette; Bartenstein, Peter; Harada, Ryuichi; Kudo, Yukitsuka; Haass, Christian; Van Leuven, Fred; Okamura, Nobuyuki; Herms, Jochen; Rominger, Axel

    2016-05-01

    Abnormal accumulation of tau aggregates in the brain is one of the hallmarks of Alzheimer disease neuropathology. We visualized tau deposition in vivo with the previously developed 2-arylquinoline derivative (18)F-THK5117 using small-animal PET in conjunction with autoradiography and immunohistochemistry gold standard assessment in 2 transgenic mouse models expressing hyperphosphorylated tau. Small-animal PET recordings were obtained in groups of P301S (n = 11) and biGT mice (n = 16) of different ages, with age-matched wild-type (WT) serving as controls. After intravenous administration of 16 ± 2 MBq of (18)F-THK5117, a dynamic 90-min emission recording was initiated for P301S mice and during 20-50 min after injection for biGT mice, followed by a 15-min transmission scan. After coregistration to the MRI atlas and scaling to the cerebellum, we performed volume-of-interest-based analysis (SUV ratio [SUVR]) and statistical parametric mapping. Small-animal PET results were compared with autoradiography ex vivo and in vitro and further validated with AT8 staining for neurofibrillary tangles. SUVRs calculated from static recordings during the interval of 20-50 min after tracer injection correlated highly with estimates of binding potential based on the entire dynamic emission recordings (R = 0.85). SUVR increases were detected in the brain stem of aged P301S mice (+11%; P < 0.001) and in entorhinal/amygdaloidal areas (+15%; P < 0.001) of biGT mice when compared with WT, whereas aged WT mice did not show increased tracer uptake. Immunohistochemical tau loads correlated with small-animal PET SUVR for both P301S (R = 0.8; P < 0.001) and biGT (R = 0.7; P < 0.001) mice, and distribution patterns of AT8-positive neurons matched voxelwise statistical parametric mapping analysis. Saturable binding of the tracer was verified by autoradiographic blocking studies. In the first dedicated small-animal PET study in 2 different transgenic tauopathy mouse models using the tau tracer

  4. Small animal simultaneous PET/MRI: initial experiences in a 9.4 T microMRI.

    PubMed

    Maramraju, Sri Harsha; Smith, S David; Junnarkar, Sachin S; Schulz, Daniela; Stoll, Sean; Ravindranath, Bosky; Purschke, Martin L; Rescia, Sergio; Southekal, Sudeepti; Pratte, Jean-François; Vaska, Paul; Woody, Craig L; Schlyer, David J

    2011-04-21

    We developed a non-magnetic positron-emission tomography (PET) device based on the rat conscious animal PET that operates in a small-animal magnetic resonance imaging (MRI) scanner, thereby enabling us to carry out simultaneous PET/MRI studies. The PET detector comprises 12 detector blocks, each being a 4 × 8 array of lutetium oxyorthosilicate crystals (2.22 × 2.22 × 5 mm(3)) coupled to a matching non-magnetic avalanche photodiode array. The detector blocks, housed in a plastic case, form a 38 mm inner diameter ring with an 18 mm axial extent. Custom-built MRI coils fit inside the positron-emission tomography (PET) device, operating in transceiver mode. The PET insert is integrated with a Bruker 9.4 T 210 mm clear-bore diameter MRI scanner. We acquired simultaneous PET/MR images of phantoms, of in vivo rat brain, and of cardiac-gated mouse heart using [(11)C]raclopride and 2-deoxy-2-[(18)F]fluoro-D-glucose PET radiotracers. There was minor interference between the PET electronics and the MRI during simultaneous operation, and small effects on the signal-to-noise ratio in the MR images in the presence of the PET, but no noticeable visual artifacts. Gradient echo and high-duty-cycle spin echo radio frequency (RF) pulses resulted in a 7% and a 28% loss in PET counts, respectively, due to high PET counts during the RF pulses that had to be gated out. The calibration of the activity concentration of PET data during MR pulsing is reproducible within less than 6%. Our initial results demonstrate the feasibility of performing simultaneous PET and MRI studies in adult rats and mice using the same PET insert in a small-bore 9.4 T MRI. PMID:21441651

  5. Small animal simultaneous PET/MRI: initial experiences in a 9.4T microMRI

    SciTech Connect

    Maramraju, S.H.; Schlyer, D.; Maramraju, S.H.; Smith, S.D.; Junnarkar, S.S.; Schulz, D.; Stoll, S.; Ravindranath, B.; Purschke, M.L.; Rescia, S.; Southekal, S.; Pratte, J.-F.; Vaska, P.; Woody, C.L.; Schlyer, D.J.

    2011-03-25

    We developed a non-magnetic positron-emission tomography (PET) device based on the rat conscious animal PET that operates in a small-animal magnetic resonance imaging (MRI) scanner, thereby enabling us to carry out simultaneous PET/MRI studies. The PET detector comprises 12 detector blocks, each being a 4 x 8 array of lutetium oxyorthosilicate crystals (2.22 x 2.22 x 5 mm{sup 3}) coupled to a matching non-magnetic avalanche photodiode array. The detector blocks, housed in a plastic case, form a 38 mm inner diameter ring with an 18 mm axial extent. Custom-built MRI coils fit inside the positron-emission tomography (PET) device, operating in transceiver mode. The PET insert is integrated with a Bruker 9.4 T 210 mm clear-bore diameter MRI scanner. We acquired simultaneous PET/MR images of phantoms, of in vivo rat brain, and of cardiac-gated mouse heart using [{sup 11}C]raclopride and 2-deoxy-2-[{sup 18}F]fluoro-d-glucose PET radiotracers. There was minor interference between the PET electronics and the MRI during simultaneous operation, and small effects on the signal-to-noise ratio in the MR images in the presence of the PET, but no noticeable visual artifacts. Gradient echo and high-duty-cycle spin echo radio frequency (RF) pulses resulted in a 7% and a 28% loss in PET counts, respectively, due to high PET counts during the RF pulses that had to be gated out. The calibration of the activity concentration of PET data during MR pulsing is reproducible within less than 6%. Our initial results demonstrate the feasibility of performing simultaneous PET and MRI studies in adult rats and mice using the same PET insert in a small-bore 9.4 T MRI.

  6. Small animal simultaneous PET/MRI: initial experiences in a 9.4 T microMRI

    NASA Astrophysics Data System (ADS)

    Harsha Maramraju, Sri; Smith, S. David; Junnarkar, Sachin S.; Schulz, Daniela; Stoll, Sean; Ravindranath, Bosky; Purschke, Martin L.; Rescia, Sergio; Southekal, Sudeepti; Pratte, Jean-François; Vaska, Paul; Woody, Craig L.; Schlyer, David J.

    2011-04-01

    We developed a non-magnetic positron-emission tomography (PET) device based on the rat conscious animal PET that operates in a small-animal magnetic resonance imaging (MRI) scanner, thereby enabling us to carry out simultaneous PET/MRI studies. The PET detector comprises 12 detector blocks, each being a 4 × 8 array of lutetium oxyorthosilicate crystals (2.22 × 2.22 × 5 mm3) coupled to a matching non-magnetic avalanche photodiode array. The detector blocks, housed in a plastic case, form a 38 mm inner diameter ring with an 18 mm axial extent. Custom-built MRI coils fit inside the positron-emission tomography (PET) device, operating in transceiver mode. The PET insert is integrated with a Bruker 9.4 T 210 mm clear-bore diameter MRI scanner. We acquired simultaneous PET/MR images of phantoms, of in vivo rat brain, and of cardiac-gated mouse heart using [11C]raclopride and 2-deoxy-2-[18F]fluoro-d-glucose PET radiotracers. There was minor interference between the PET electronics and the MRI during simultaneous operation, and small effects on the signal-to-noise ratio in the MR images in the presence of the PET, but no noticeable visual artifacts. Gradient echo and high-duty-cycle spin echo radio frequency (RF) pulses resulted in a 7% and a 28% loss in PET counts, respectively, due to high PET counts during the RF pulses that had to be gated out. The calibration of the activity concentration of PET data during MR pulsing is reproducible within less than 6%. Our initial results demonstrate the feasibility of performing simultaneous PET and MRI studies in adult rats and mice using the same PET insert in a small-bore 9.4 T MRI.

  7. Quantitative accuracy of MAP reconstruction for dynamic PET imaging in small animals

    PubMed Central

    Cheng, Ju-Chieh (Kevin); Shoghi, Kooresh; Laforest, Richard

    2012-01-01

    Purpose: Iterative reconstruction algorithms are becoming more commonly employed in positron emission tomography (PET) imaging; however, the quantitative accuracy of the reconstructed images still requires validation for various levels of contrast and counting statistics. Methods: The authors present an evaluation of the quantitative accuracy of the 3D maximum a posteriori (3D-MAP) image reconstruction algorithm for dynamic PET imaging with comparisons to two of the most widely used reconstruction algorithms: the 2D filtered-backprojection (2D-FBP) and 2D-ordered subsets expectation maximization (2D-OSEM) on the Siemens microPET scanners. The study was performed for various levels of count density encountered in typical dynamic scanning as well as the imaging of cardiac activity concentration in small animal studies on the Focus 120. Specially designed phantoms were used for evaluation of the spatial resolution, image quality, and quantitative accuracy. A normal mouse was employed to evaluate the accuracy of the blood time activity concentration extracted from left ventricle regions of interest (ROIs) within the images as compared to the actual blood activity concentration measured from arterial blood sampling. Results: For MAP reconstructions, the spatial resolution and contrast have been found to reach a stable value after 20 iterations independent of the β values (i.e., hyper parameter which controls the weight of the penalty term) and count density within the frame. The spatial resolution obtained with 3D-MAP reaches values of ∼1.0 mm with a β of 0.01 while the 2D-FBP has value of 1.8 mm and 2D-OSEM has a value of 1.6 mm. It has been observed that the lower the hyper parameter β used in MAP, more iterations are needed to reach the stable noise level (i.e., image roughness). The spatial resolution is improved by using a lower β value at the expense of higher image noise. However, with similar noise level the spatial resolution achieved by 3D-MAP was

  8. IV Leiomyomatosis on FDG PET/CT.

    PubMed

    Jin, Xiaona; Li, Fang; Lu, Zhaohui; Cheng, Wuying

    2016-07-01

    A 48-year-old woman presented with a 2-month history of right lower extremity edema. Clinical examination only showed right lower limb swelling. Routine laboratory examination revealed no abnormal results. Abdominal ultrasonography identified uterine leiomyoma and soft tissue masses. An abdominal CT demonstrated a continuous mass extending from the right internal and external iliac vein into the common iliac vein and inferior vena cava. To distinguish the mass from malignancy, the patient underwent PET/CT scan which showed increased FDG activity in the mass. However, histopathological examination proved the mass to be IV leiomyomatosis. PMID:26914578

  9. Performance evaluation of a compact PET/SPECT/CT tri-modality system for small animal imaging applications

    NASA Astrophysics Data System (ADS)

    Wei, Qingyang; Wang, Shi; Ma, Tianyu; Wu, Jing; Liu, Hui; Xu, Tianpeng; Xia, Yan; Fan, Peng; Lyu, Zhenlei; Liu, Yaqiang

    2015-06-01

    PET, SPECT and CT imaging techniques are widely used in preclinical small animal imaging applications. In this paper, we present a compact small animal PET/SPECT/CT tri-modality system. A dual-functional, shared detector design is implemented which enables PET and SPECT imaging with a same LYSO ring detector. A multi-pinhole collimator is mounted on the system and inserted into the detector ring in SPECT imaging mode. A cone-beam CT consisting of a micro focus X-ray tube and a CMOS detector is implemented. The detailed design and the performance evaluations are reported in this paper. In PET imaging mode, the measured NEMA based spatial resolution is 2.12 mm (FWHM), and the sensitivity at the central field of view (CFOV) is 3.2%. The FOV size is 50 mm (∅)×100 mm (L). The SPECT has a spatial resolution of 1.32 mm (FWHM) and an average sensitivity of 0.031% at the center axial, and a 30 mm (∅)×90 mm (L) FOV. The CT spatial resolution is 8.32 lp/mm @10%MTF, and the contrast discrimination function value is 2.06% with 1.5 mm size cubic box object. In conclusion, a compact, tri-modality PET/SPECT/CT system was successfully built with low cost and high performance.

  10. Synthesis and quality control of fluorodeoxyglucose and performance assessment of Siemens MicroFocus 220 small animal PET scanner

    NASA Astrophysics Data System (ADS)

    Phaterpekar, Siddhesh Nitin

    The scope of this article is to cover the synthesis and quality control procedures involved in production of Fludeoxyglucose (18F--FDG). The article also describes the cyclotron production of 18F radioisotope and gives a brief overview on operations and working of a fixed energy medical cyclotron. The quality control procedures for FDG involve radiochemical and radionuclidic purity tests, pH tests, chemical purity tests, sterility tests, endotoxin tests. Each of these procedures were carried out for multiple batches of FDG with a passing rate of 95% among 20 batches. The article also covers the quality assurance steps for the Siemens MicroPET Focus 220 Scanner using a Jaszczak phantom. We have carried out spatial resolution tests on the scanner, with an average transaxial resolution of 1.775mm with 2-3mm offset. Tests involved detector efficiency, blank scan sinograms and transmission sinograms. A series of radioactivity distribution tests are also carried out on a uniform phantom, denoting the variations in radioactivity and uniformity by using cylindrical ROIs in the transverse region of the final image. The purpose of these quality control tests is to make sure the manufactured FDG is biocompatible with the human body. Quality assurance tests are carried on PET scanners for efficient performance, and to make sure the quality of images acquired is according to the radioactivity distribution in the subject of interest.

  11. Detector development for microPET II: a 1 microl resolution PET scanner for small animal imaging.

    PubMed

    Chatziioannou, A; Tai, Y C; Doshi, N; Cherry, S R

    2001-11-01

    We are currently developing a small animal positron emission tomography (PET) scanner with a design goal of 1 microlitre (1 mm3) image resolution. The detectors consist of a 12 x 12 array of 1 x 1 x 10 mm lutetium oxyorthosilicate (LSO) scintillator crystals coupled to a 64-channel photomultiplier tube (PMT) via 5 cm long optical fibre bundles. The optical fibre connection allows a high detector packing fraction despite the dead space surrounding the active region of the PMT. Optical fibre bundles made from different types of glass were tested for light transmission, and also their effects on crystal identification and energy resolution, and compared to direct coupling of the LSO arrays to the PMTs. We also investigated the effects of extramural absorber (EMA) in the fibre bundles. Based on these results, fibre bundles manufactured from F2 glass were selected. We built three pairs of prototype detectors (directly coupled LSO array, fibre bundle without EMA and fibre bundle with EMA) and measured flood histograms, energy resolution, intrinsic spatial resolution and timing resolution. The results demonstrated an intrinsic spatial resolution (FWHM) of 1.12 mm (directly coupled), 1.23 mm (fibre bundle without EMA coupling) and 1.27 mm (fibre bundle with EMA coupling) using an approximately 500 microm diameter Na-22 point source. Using a 330 microm outer diameter steel needle line source filled with F-18, spatial resolution for the detector with the EMA optical fibre bundle improved to 1.05 mm. The respective timing and energy FWHM values were 1.96 ns, 21% (directly coupled), 2.20 ns, 23% (fibre bundle without EMA) and 2.99 ns, 30% (fibre bundle with EMA). The peak-to-valley ratio in the flood histograms was better with EMA (5:1) compared to the optical fibre bundle without EMA (2.5:1), due to the decreased optical cross-talk. In comparison to the detectors used in our current generation microPET scanner, these detectors substantially improve on the spatial resolution

  12. Allergic Reaction to Ginkgo Nut on FDG PET/CT.

    PubMed

    Han, Eun Ji; Park, Hye Lim; Kim, Sung Hoon

    2016-09-01

    We report the case of a 36-year-old woman who previously underwent total thyroidectomy for papillary thyroid carcinoma. F FDG PET/CT images demonstrated multiple lymph nodes with increased FDG uptake in the neck, chest, and abdomen and diffusely increased FDG uptake in the spleen, which were highly suspicious findings for malignant lymphoma. However, subsequent biopsy of axillary lymph node presented reactive hyperplasia. Detailed history revealed that the patient had a history of generalized edema and severe arthralgia after contact with ginkgo nut one week ago. This case highlights allergic reaction mimicking lymphoma on FDG PET/CT. PMID:27276210

  13. Predictive and prognostic value of FDG-PET

    PubMed Central

    Oyen, Wim J.G.

    2008-01-01

    Abstract The predictive and prognostic value of fluorodeoxyglucose (FDG)-positron emission tomography (PET) in non-small-cell lung carcinoma, colorectal carcinoma and lymphoma is discussed. The degree of FDG uptake is of prognostic value at initial presentation, after induction treatment prior to resection and in the case of relapse of non-small cell lung cancer (NSCLC). In locally advanced and advanced stages of NSCLC, FDG-PET has been shown to be predictive for clinical outcome at an early stage of treatment. In colorectal carcinoma, limited studies are available on the prognostic value of FDG-PET, however, the technique appears to have great potential in monitoring the success of local ablative therapies soon after intervention and in the prediction and evaluation of response to radiotherapy, systemic therapy, and combinations thereof. The prognostic value of end-of treatment FDG-PET for FDG-avid lymphomas has been established, and the next step is to define how to use this information to optimize patient outcome. In Hodgkin's lymphoma, FDG-PET has a high negative predictive value, however, histological confirmation of positive findings should be sought where possible. For non-Hodgkin's lymphoma, the opposite applies. The newly published standardized guidelines for interpretation formulates specific criteria for visual interpretation and for defining PET positivity in the liver, spleen, lung, bone marrow and small residual lesions. The introduction of these guidelines should reduce variability among studies. Interim PET offers a reliable method for early prediction of long-term remission, however it should only be performed in prospective randomized controlled trials. Many of the diagnostic and management questions considered in this review are relevant to other tumour types. Further research in this field is of great importance, since it may lead to a change in the therapeutic concept of cancer. The preliminary findings call for systematic inclusion of FDG-PET

  14. Preliminary assessment of the imaging capability of the YAP (S)PET small animal scanner in neuroscience

    NASA Astrophysics Data System (ADS)

    Bartoli, Antonietta; Belcari, Nicola; Stark, Daniela; Höhnemann, Sabine; Piel, Markus; Jennewein, Marc; Schmitt, Ulrich; Tillmanns, Julia; Thews, Oliver; Hiemke, Christoph; Roesch, Frank; Del Guerra, Alberto

    2006-12-01

    The new and fully engineered version of the YAP-(S)PET small animal scanner has been tested at the University of Mainz for preliminary assessment of its imaging capability for studies related to neuropharmacology and psychiatry. The main feature of the scanner is the capability to combine PET and SPECT techniques. It allows the development of new and interesting protocols for the investigation of many biological phenomena, more effectively than with PET or SPECT modalities alone. The scanner is made up of four detector heads, each one composed of a 4×4 cm 2 of YAlO 3:Ce (or YAP:Ce) matrix, and has a field of view (FOV) of 4 cm axially×4 cm ∅ transaxially. In PET mode, the volume resolution is less than 8 mm 3 and is nearly constant over the whole FOV, while the sensitivity is about 2%. The SPECT performance is not so good, due to the presence of the multi-hole lead collimator in front of each head. Nevertheless, the YAP-PET scanner offers excellent resolution and sensitivity for performing on the availability of D2-like dopamine receptors on mice and rats in both PET and SPECT modalities.

  15. FDG PET-CT of gynecologic cancers: pearls and pitfalls.

    PubMed

    Prabhakar, Hima B; Kraeft, Jessica J; Schorge, John O; Scott, James A; Lee, Susanna I

    2015-10-01

    FDG PET-CT plays an important role in treatment planning and in prognosis assessment of gynecologic cancer patients. Detection of hypermetabolic tissue with FDG PET, when combined with the high spatial resolution of CT, results in improved cancer detection and localization not afforded by either modality independently. This article is a primer for a radiologist performing PET-CT on gynecologic cancer patients and includes the imaging protocol, normal pattern of FDG distribution in the female pelvis and the lymph node drainage pathways from the gynecologic organs. Clinically relevant imaging findings that should be included in the report are discussed. Case examples illustrate how potential errors in exam interpretation can be avoided by concurrently performing a high-quality diagnostic CT with the FDG PET scan and by analyzing both the stand-alone and the fusion images. PMID:25680500

  16. Preparedness of small animal veterinary practices to communicate with Spanish-speaking pet owners with limited proficiency in English.

    PubMed

    Landau, Ruth E; Beck, Alan; Glickman, Larry T; Litster, Annette; Widmar, Nicole J Olynk; Moore, George E

    2016-03-15

    OBJECTIVE To investigate the preparedness of small animal veterinary personnel to communicate with Spanish-speaking pet owners with limited English-language proficiency (LEP). DESIGN Cross-sectional telephone survey. SAMPLE Data from 383 small animal veterinary practices. PROCEDURES Telephone surveys were conducted with veterinarians and office or practice managers from a random sample of US small animal veterinary practices in 10 states to estimate the number of Spanish-speaking pet owners with LEP visiting these practices, proportion of practices that used services to facilitate communication with Spanish-speaking clients with LEP, and degree of veterinarian satisfaction with their communication with those clients. RESULTS Responses were obtained from 383 of 1,245 (31%) eligible practices, of which 340 (89%) had Spanish-speaking clients with LEP and 200 (52%) had such clients on a weekly basis. Eight percent of practices had veterinary personnel who were conversant or fluent in spoken Spanish. Veterinarians who depended on clients' friends or family to translate were significantly less satisfied with client communication than were those who could converse in Spanish with clients directly. Availability of Spanish-speaking staff and offering of Spanish-language resources were associated with an increase in the number of Spanish-speaking clients with LEP seen on a weekly basis. Industry- and practice-generated Spanish-language materials were offered at 32% (124/383) and 21% (81/383) of practices, respectively; 329 (86%) practices had no Spanish-language marketing. CONCLUSIONS AND CLINICAL RELEVANCE Opportunities were identified for improving communication with pet owners with LEP in the veterinary clinical setting, which could ultimately positively impact patient well-being and client compliance. PMID:26953924

  17. Small Animal Care.

    ERIC Educational Resources Information Center

    Livesey, Dennis W.; Fong, Stephen

    This small animal care course guide is designed for students who will be seeking employment in veterinary hospitals, kennels, grooming shops, pet shops, and small-animal laboratories. The guide begins with an introductory section that gives the educational philosophy of the course, job categories and opportunities, units of instruction required…

  18. A computational pipeline for quantification of pulmonary infections in small animal models using serial PET-CT imaging

    PubMed Central

    2013-01-01

    Background Infectious diseases are the second leading cause of death worldwide. In order to better understand and treat them, an accurate evaluation using multi-modal imaging techniques for anatomical and functional characterizations is needed. For non-invasive imaging techniques such as computed tomography (CT), magnetic resonance imaging (MRI), and positron emission tomography (PET), there have been many engineering improvements that have significantly enhanced the resolution and contrast of the images, but there are still insufficient computational algorithms available for researchers to use when accurately quantifying imaging data from anatomical structures and functional biological processes. Since the development of such tools may potentially translate basic research into the clinic, this study focuses on the development of a quantitative and qualitative image analysis platform that provides a computational radiology perspective for pulmonary infections in small animal models. Specifically, we designed (a) a fast and robust automated and semi-automated image analysis platform and a quantification tool that can facilitate accurate diagnostic measurements of pulmonary lesions as well as volumetric measurements of anatomical structures, and incorporated (b) an image registration pipeline to our proposed framework for volumetric comparison of serial scans. This is an important investigational tool for small animal infectious disease models that can help advance researchers’ understanding of infectious diseases. Methods We tested the utility of our proposed methodology by using sequentially acquired CT and PET images of rabbit, ferret, and mouse models with respiratory infections of Mycobacterium tuberculosis (TB), H1N1 flu virus, and an aerosolized respiratory pathogen (necrotic TB) for a total of 92, 44, and 24 scans for the respective studies with half of the scans from CT and the other half from PET. Institutional Administrative Panel on Laboratory Animal

  19. Monte Carlo modelling of singles-mode transmission data for small animal PET scanners

    NASA Astrophysics Data System (ADS)

    Vandervoort, Eric; Camborde, Marie-Laure; Jan, Sébastien; Sossi, Vesna

    2007-06-01

    The attenuation corrections factors (ACFs), which are necessary for quantitatively accurate PET imaging, can be obtained using singles-mode transmission scanning. However, contamination from scatter is a largely unresolved problem for these data. We present an extension of the Monte Carlo simulation tool, GATE, for singles-mode transmission data and its validation using experimental data from the microPET R4 and Focus 120 scanners. We first validated our simulated PET scanner for coincidence-mode data where we found that experimental resolution and scatter fractions (SFs) agreed well for simulations that included positron interactions and scatter in the source material. After modifying GATE to model singles-mode data, we compared simulated and experimental ACFs and SFs for three different sized water cylinders using 57Co (122 keV photon emitter) and 68Ge (positron emitter) transmission sources. We also propose a simple correction for a large background contamination we identified in the 68Ge singles-mode data due to intrinsic 176Lu radioactivity present in the detector crystals. For simulation data, the SFs agreed to within 1.5% and 2.5% of experimental values for background-corrected 68Ge and 57Co transmission data, respectively. This new simulation tool accurately models the photon interactions and data acquisition for singles-mode transmission scans.

  20. Design considerations for a C-shaped PET system, dedicated to small animal brain imaging, using GATE Monte Carlo simulations

    NASA Astrophysics Data System (ADS)

    Efthimiou, N.; Papadimitroulas, P.; Kostou, T.; Loudos, G.

    2015-09-01

    Commercial clinical and preclinical PET scanners rely on the full cylindrical geometry for whole body scans as well as for dedicated organs. In this study we propose the construction of a low cost dual-head C-shaped PET system dedicated for small animal brain imaging. Monte Carlo simulation studies were performed using GATE toolkit to evaluate the optimum design in terms of sensitivity, distortions in the FOV and spatial resolution. The PET model is based on SiPMs and BGO pixelated arrays. Four different configurations with C- angle 0°, 15°, 30° and 45° within the modules, were considered. Geometrical phantoms were used for the evaluation process. STIR software, extended by an efficient multi-threaded ray tracing technique, was used for the image reconstruction. The algorithm automatically adjusts the size of the FOV according to the shape of the detector's geometry. The results showed improvement in sensitivity of ∼15% in case of 45° C-angle compared to the 0° case. The spatial resolution was found 2 mm for 45° C-angle.

  1. FDG-PET Contributions to the Pathophysiology of Memory Impairment.

    PubMed

    Segobin, Shailendra; La Joie, Renaud; Ritz, Ludivine; Beaunieux, Hélène; Desgranges, Béatrice; Chételat, Gaël; Pitel, Anne Lise; Eustache, Francis

    2015-09-01

    Measurement of synaptic activity by Positron Emission Tomography (PET) and its relation to cognitive functions such as episodic memory, working memory and executive functions in healthy humans and patients with neurocognitive disorders have been well documented. In this review, we introduce the concept of PET imaging that allows the observation of a particular biological process in vivo through the use of radio-labelled compounds, its general use to the medical world and its contributions to the understanding of memory systems. We then focus on [(18)F]-2-fluoro-2-deoxy-D-glucose (FDG-PET), the radiotracer that is used to measure local cerebral metabolic rate of glucose that is indicative of synaptic activity in the brain. FDG-PET at rest has been at the forefront of functional neuroimaging over the past 3 decades, contributing to the understanding of cognitive functions in healthy humans and how these functional patterns change with cognitive alterations. We discuss methodological considerations that are important for optimizing FDG-PET imaging data prior to analysis. We then highlight the contribution of FDG-PET to the understanding of the patterns of functional differences in non-degenerative pathologies, normal ageing, and age-related neurodegenerative disorders. Through reasonable temporal and spatial resolution, its ability to measure synaptic activity in the whole brain, independently of any specific network and disease, makes it ideal to observe regional functional changes associated with memory impairment. PMID:26319237

  2. Time-Course of Alterations in Myocardial Glucose Utilization in the Zucker Diabetic Fatty (ZDF) Rat with Correlation to Gene Expression of Glucose Transporters: A Small Animal PET Investigation

    PubMed Central

    Shoghi, Kooresh I.; Gropler, Robert J.; Sharp, Terry; Herrero, Pilar; Fettig, Nicole; Su, Yi; Mitra, Mayurranjan S.; Kovacs, Attila; Finck, Brian N.; Welch, Michael J.

    2010-01-01

    Objective Diabetic cardiomyopathy is associated with abnormalities in glucose metabolism. We evaluated myocardial glucose metabolism in a rodent model of Type 2 Diabetes (T2D), namely the Zucker Diabetic Rat (ZDF), and validated PET measures of glucose uptake against gene and protein expression of glucose transporters. Methods Six lean and ZDF rat underwent small animal PET imaging at the age of 14 weeks and at the age of 19 weeks. The imaging protocol consisted of a 60-minute dynamic acquisition with 18FDG (0.5–0.8mCi). Dynamic images were reconstructed using filtered back projection (FBP) with a 2.5 zoom on the heart and 40 frames per imaging session. PET measures of myocardial glucose uptake rate (MGUp) and utilization were determined with an input function derived by the Hybrid Image- Blood Sampling (HIBS) algorithm on recovery-corrected anterolateral myocardial regions of interest. Following the PET imaging session at week 19, hearts were extracted for gene and protein expression analysis of GLUT1 and GLUT4. The dependence of MGUp on gene expression of GLUT1 and GLUT4 was characterized by multiple-regression analysis. Results Compared to lean littermate control rats, MGUp was significantly depressed in ZDF rats at both week 14 and week 19 (P<0.006). Moreover, lean rats at week 19 displayed significantly higher MGUp than week 14 (P=0.007). Consistent with diminished MGUp, gene expression of GLUT4 was significantly (P=0.004) lower in ZDF rats. Finally, MGUp significantly (P=0.0003) correlated with gene expression of GLUT4. Conclusions Using small animal PET, we confirmed alterations in myocardial glucose utilization and validated PET measure of MGUp against gene and protein expression of glucose transporters in the diabetic heart of an animal model of T2D. PMID:18632819

  3. Guidance for reading FDG PET scans in dementia patients.

    PubMed

    Herholz, K

    2014-12-01

    18F-2-fluoro-2-deoxy-D-glucose (FDG) positron emission tomography (PET) is a powerful method for detection of disease-related impairment of cerebral glucose metabolism in neurodegenerative diseases. It is of particular interest for early and differential diagnosis of dementia. Reading FDG PET scans requires training to recognise deviations from normal functional brain anatomy and its variations. This paper provides guidance for displaying FDG PET brain scans in a reproducible manner that allows reliable recognition of characteristic disease-related metabolic changes. It also describes typical findings in Alzheimer's disease, Frontotemporal Dementia and Dementia with Lewy Bodies and possible confounding factors, such as vascular changes and brain atrophy. It provides a brief overview on findings in other neurodegenerative diseases and addresses the potential and limitations of software packages for comparison of individual scans with reference data. PMID:25391316

  4. ¹⁸F-FDG-PET/CT in malignant mesothelioma.

    PubMed

    Fuccio, Chiara; Spinapolice, Elena Giulia; Ferretti, Alice; Castellucci, Paolo; Marzola, Maria Cristina; Trifirò, Giuseppe; Rubello, Domenico

    2013-07-01

    It is well known the useful role of ¹⁸F-FDG-PET/CT for differential diagnosis between benign and malignant disease, for staging, for monitoring response and for prognosis regarding mesothelioma. Recently, literature was enriched with new interesting studies regarding the potential applications of ¹⁸F-FDG-PET/CT in this field. The purpose of this review is to evaluate articles published on line (PubMed) from January 2011 until October 2012 in order to obtain an overview of recent progress of molecular imaging in malignant mesothelioma. The main topics concern the use of ¹⁸F-FDG-PET/CT in radiation therapy planning, monitoring of treatment (surgery/chemotherapy) response and prognosis assessment. PMID:23583476

  5. Use of [18F]FDG PET to Monitor The Development of Cardiac Allograft Rejection

    PubMed Central

    Daly, Kevin P.; Dearling, Jason L. J.; Seto, Tatsuichiro; Dunning, Patricia; Fahey, Frederic; Packard, Alan B.; Briscoe, David M.

    2014-01-01

    Background Positron Emission Tomography (PET) has the potential to be a specific, sensitive and quantitative diagnostic test for transplant rejection. To test this hypothesis, we evaluated 18F-labeled fluorodeoxyglucose ([18F]FDG) and 13N-labeled ammonia ([13N]NH3) small animal PET imaging in a well-established murine cardiac rejection model. Methods Heterotopic transplants were performed using minor MHC mismatched B6.C-H2bm12 donor hearts in C57BL/6(H-2b) recipients. C57BL/6 donor hearts into C57BL/6 recipients served as isograft controls. [18F]FDG PET imaging was performed weekly between post-transplant days 7 and 42 and the percent injected dose was computed for each graft. [13N]NH3 imaging was performed to evaluate myocardial perfusion. Results There was a significant increase in [18F]FDG uptake in allografts from day 14 to day 21 (1.6% to 5.2%; P<0.001) and uptake in allografts was significantly increased on post-transplant days 21 (5.2% vs. 0.9%; P=0.005) and 28 (4.8% vs. 0.9%; P=0.006) compared to isograft controls. Furthermore, [18F]FDG uptake correlated with an increase in rejection within allografts between days 14 and 28 post-transplant. Finally, the uptake of [13N]NH3 was significantly lower relative to the native heart in allografts with chronic vasculopathy compared to isograft controls on day 28 (P=0.01). Conclusions PET imaging with [18F]FDG can be used following transplantation to monitor the evolution of rejection. In addition, decreased uptake of [13N]NH3 in rejecting allografts may be reflective of decreased myocardial blood flow. These data suggest that combined [18F]FDG and [13N]NH3 PET imaging could be used as a non-invasive, quantitative technique for serial monitoring of allograft rejection and has potential application in human transplant recipients. PMID:25675207

  6. Conversion of arterial input functions for dual pharmacokinetic modeling using Gd-DTPA/MRI and 18F-FDG/PET.

    PubMed

    Poulin, Eric; Lebel, Réjean; Croteau, Etienne; Blanchette, Marie; Tremblay, Luc; Lecomte, Roger; Bentourkia, M'hamed; Lepage, Martin

    2013-03-01

    Reaching the full potential of magnetic resonance imaging (MRI)-positron emission tomography (PET) dual modality systems requires new methodologies in quantitative image analyses. In this study, methods are proposed to convert an arterial input function (AIF) derived from gadolinium-diethylenetriaminepentaacetic acid (Gd-DTPA) in MRI, into a (18)F-fluorodeoxyglucose ((18)F-FDG) AIF in PET, and vice versa. The AIFs from both modalities were obtained from manual blood sampling in a F98-Fisher glioblastoma rat model. They were well fitted by a convolution of a rectangular function with a biexponential clearance function. The parameters of the biexponential AIF model were found statistically different between MRI and PET. Pharmacokinetic MRI parameters such as the volume transfer constant (K(trans)), the extravascular-extracellular volume fraction (ν(e)), and the blood volume fraction (ν(p)) calculated with the Gd-DTPA AIF and the Gd-DTPA AIF converted from (18)F-FDG AIF normalized with or without blood sample were not statistically different. Similarly, the tumor metabolic rates of glucose (TMRGlc) calculated with (18) F-FDG AIF and with (18) F-FDG AIF obtained from Gd-DTPA AIF were also found not statistically different. In conclusion, only one accurate AIF would be needed for dual MRI-PET pharmacokinetic modeling in small animal models. PMID:22570280

  7. Performance evaluation of the small-animal PET scanner ClairvivoPET using NEMA NU 4-2008 Standards

    NASA Astrophysics Data System (ADS)

    Sato, K.; Shidahara, M.; Watabe, H.; Watanuki, S.; Ishikawa, Y.; Arakawa, Y.; Nai, YH; Furumoto, S.; Tashiro, M.; Shoji, T.; Yanai, K.; Gonda, K.

    2016-01-01

    The aim of this study was to evaluate the performance of ClairvivoPET using NEMA NU4 standards. The ClairvivoPET incorporates a LYSO dual depth-of-interaction detector system with 151 mm axial field of view (FOV). Spatial resolution, sensitivity, counting rate capabilities, and image quality were evaluated using NEMA NU4-2008 standards. Normal mouse imaging was also performed for 10min after intravenous injection of 18F(-)-NaF. Data were compared with 19 other preclinical PET scanners. Spatial resolution measured using full width at half maximum on FBP-ramp reconstructed images was 2.16 mm at radial offset 5 mm of the axial centre FOV. The maximum absolute sensitivity for a point source at the FOV centre was 8.72%. Peak noise equivalent counting rate (NECR) was 415kcps at 14.6MBq ml-1. The uniformity with the image-quality phantom was 4.62%. Spillover ratios in the images of air and water filled chambers were 0.19 and 0.06, respectively. Our results were comparable with the 19 other preclinical PET scanners based on NEMA NU4 standards, with excellent sensitivity because of the large FOV. The ClairvivoPET with iterative reconstruction algorithm also provided sufficient visualization of the mouse spine. The high sensitivity and resolution of the ClairvivoPET scanner provided high quality images for preclinical studies.

  8. Performance evaluation of the small-animal PET scanner ClairvivoPET using NEMA NU 4-2008 Standards.

    PubMed

    Sato, K; Shidahara, M; Watabe, H; Watanuki, S; Ishikawa, Y; Arakawa, Y; Nai, Y H; Furumoto, S; Tashiro, M; Shoji, T; Yanai, K; Gonda, K

    2016-01-21

    The aim of this study was to evaluate the performance of ClairvivoPET using NEMA NU4 standards. The ClairvivoPET incorporates a LYSO dual depth-of-interaction detector system with 151 mm axial field of view (FOV). Spatial resolution, sensitivity, counting rate capabilities, and image quality were evaluated using NEMA NU4-2008 standards. Normal mouse imaging was also performed for 10 min after intravenous injection of (18)F(-)-NaF. Data were compared with 19 other preclinical PET scanners. Spatial resolution measured using full width at half maximum on FBP-ramp reconstructed images was 2.16 mm at radial offset 5 mm of the axial centre FOV. The maximum absolute sensitivity for a point source at the FOV centre was 8.72%. Peak noise equivalent counting rate (NECR) was 415 kcps at 14.6 MBq ml(-1). The uniformity with the image-quality phantom was 4.62%. Spillover ratios in the images of air and water filled chambers were 0.19 and 0.06, respectively. Our results were comparable with the 19 other preclinical PET scanners based on NEMA NU4 standards, with excellent sensitivity because of the large FOV. The ClairvivoPET with iterative reconstruction algorithm also provided sufficient visualization of the mouse spine. The high sensitivity and resolution of the ClairvivoPET scanner provided high quality images for preclinical studies. PMID:26716872

  9. The Basic Principles of FDG-PET/CT Imaging.

    PubMed

    Basu, Sandip; Hess, Søren; Nielsen Braad, Poul-Erik; Olsen, Birgitte Brinkmann; Inglev, Signe; Høilund-Carlsen, Poul Flemming

    2014-10-01

    Positron emission tomography (PET) imaging with 2-[(18)F]fluoro-2-deoxy-D-glucose (FDG) forms the basis of molecular imaging. FDG-PET imaging is a multidisciplinary undertaking that requires close interdisciplinary collaboration in a broad team comprising physicians, technologists, secretaries, radio-chemists, hospital physicists, molecular biologists, engineers, and cyclotron technicians. The aim of this review is to provide a brief overview of important basic issues and considerations pivotal to successful patient examinations, including basic physics, instrumentation, radiochemistry, molecular and cell biology, patient preparation, normal distribution of tracer, and potential interpretive pitfalls. PMID:26050942

  10. FDG PET/CT Imaging of Prostate Carcinosarcoma.

    PubMed

    Oldan, Jorge Daniel; Chin, Bennett B

    2016-08-01

    We present a case of carcinosarcoma of the prostate. Workup of urinary retention after a previously treated squamous cell carcinoma of the prostate led to a transurethral prostate resection revealing carcinosarcoma of the prostate, which on F-FDG PET/CT demonstrated moderate to high avidity of this atypical prostate cancer, with partial obstruction of the urinary system and lung metastases. While FDG PET is not avid for typical prostatic adenocarcinomas, it should be considered for evaluation of atypical prostate cancers. PMID:27187727

  11. A feasibility study of PETiPIX: an ultra high resolution small animal PET scanner

    NASA Astrophysics Data System (ADS)

    Li, K.; Safavi-Naeini, M.; Franklin, D. R.; Petasecca, M.; Guatelli, S.; Rosenfeld, A. B.; Hutton, B. F.; Lerch, M. L. F.

    2013-12-01

    PETiPIX is an ultra high spatial resolution positron emission tomography (PET) scanner designed for imaging mice brains. Four Timepix pixellated silicon detector modules are placed in an edge-on configuration to form a scanner with a field of view (FoV) 15 mm in diameter. Each detector module consists of 256 × 256 pixels with dimensions of 55 × 55 × 300 μm3. Monte Carlo simulations using GEANT4 Application for Tomographic Emission (GATE) were performed to evaluate the feasibility of the PETiPIX design, including estimation of system sensitivity, angular dependence, spatial resolution (point source, hot and cold phantom studies) and evaluation of potential detector shield designs. Initial experimental work also established that scattered photons and recoil electrons could be detected using a single edge-on Timepix detector with a positron source. Simulation results estimate a spatial resolution of 0.26 mm full width at half maximum (FWHM) at the centre of FoV and 0.29 mm FWHM overall spatial resolution with sensitivity of 0.01%, and indicate that a 1.5 mm thick tungsten shield parallel to the detectors will absorb the majority of non-coplanar annihilation photons, significantly reducing the rates of randoms. Results from the simulated phantom studies demonstrate that PETiPIX is a promising design for studies demanding high resolution images of mice brains.

  12. Ga-68-DOTATOC: Feasibility of high throughput screening by small animal PET using a clinical high-resolution PET/CT scanner

    NASA Astrophysics Data System (ADS)

    Hofmann, Michael; Weitzel, Thilo; Krause, Thomas

    2006-12-01

    As radio peptide tracers have been developed in recent years for the high sensitive detection of neuroendocrine tumors, still the broad application of other peptides to breast and prostate cancer is missing. A rapid screening of new peptides can, in theory, be based on in vivo screening in animals by PET/CT. To test this hypothesis and to asses the minimum screening time needed per animal, we used the application of Ga-68-DOTATOC PET/CT in rats as test system. The Ga-68-DOTATOC yields in a hot spot imaging with minimal background. To delineate liver and spleen, we performed PET/CT of 10 animals on a SIEMENS Biograph 16 LSO HIGHREZ after intravenous injection of 1.5 MBq Ga-68-DOTATOC per animal. Animals were mounted in an '18 slot' holding device and scanned for a single-bed position. The emission times for the PET scan was varied from 1 to 20 min. The images were assessed first for "PET only" and afterwards in PET/CT fusion mode. The detection of the two organs was good at emission times down to 1 min in PET/CT fusion mode. In the "PET only" scans, the liver was clearly to be identified down to 1 min emission in all animals. But the spleen could only be delineated only by 1 min of emission in the PET/CT-fusion mode. In conclusion the screening of "hot spot" enriching peptides is feasible. "PET only" is in terms of delineation of small organs by far inferior to PET/CT fusion. If animal tumors are above a diameter of 10 mm small, animal PET/CT using clinical high resolution scanners will enable rapid screening. Even the determination of bio-distributions becomes feasible by using list mode tools. The time for the whole survey of 18 animals including anesthesia, preparation and mounting was approximately 20 min. By use of several holding devices mounted simultaneously, a survey time of less than 1 h for 180 animals can be expected.

  13. Experimental Approach to Evaluate the 11C Perfusion and Diffusion in Small Animal Tissues for HadronPET Applications

    PubMed Central

    Martínez-Rovira, Immaculada; Boisgard, Raphaël; Pottier, Géraldine; Kuhnast, Bertrand; Jan, Sébastien

    2016-01-01

    The development of a reliable dose monitoring system in hadron therapy is essential in order to control the treatment plan delivery. Positron Emission Tomography (PET) is the only method used in clinics nowadays for quality assurance. However, the accuracy of this method is limited by the loss of signal due to the biological washout processes. Up to the moment, very few studies measured the washout processes and there is no database of washout data as a function of the tissue and radioisotope. One of the main difficulties is related to the complexity of such measurements, along with the limited time slots available in hadron therapy facilities. Thus, in this work, we proposed an alternative in vivo methodology for the measurement and modeling of the biological washout parameters without any radiative devices. It consists in the implementation of a point-like radioisotope source by direct injection on the tissues of interest and its measurement by means of high-resolution preclinical PET systems. In particular, the washout of 11C carbonate radioisotopes was assessed, considering that 11C is is the most abundant β+ emitter produced by carbon beams. 11C washout measurements were performed in several tissues of interest (brain, muscle and 9L tumor xenograf) in rodents (Wistar rat). Results show that the methodology presented is sensitive to the washout variations depending on the selected tissue. Finally, a first qualitative correlation between 11C tumor washout properties and tumor metabolism (via 18F-FDG tracer uptake) was found. PMID:27015269

  14. Experimental Approach to Evaluate the 11C Perfusion and Diffusion in Small Animal Tissues for HadronPET Applications.

    PubMed

    Martínez-Rovira, Immaculada; Boisgard, Raphaël; Pottier, Géraldine; Kuhnast, Bertrand; Jan, Sébastien

    2016-01-01

    The development of a reliable dose monitoring system in hadron therapy is essential in order to control the treatment plan delivery. Positron Emission Tomography (PET) is the only method used in clinics nowadays for quality assurance. However, the accuracy of this method is limited by the loss of signal due to the biological washout processes. Up to the moment, very few studies measured the washout processes and there is no database of washout data as a function of the tissue and radioisotope. One of the main difficulties is related to the complexity of such measurements, along with the limited time slots available in hadron therapy facilities. Thus, in this work, we proposed an alternative in vivo methodology for the measurement and modeling of the biological washout parameters without any radiative devices. It consists in the implementation of a point-like radioisotope source by direct injection on the tissues of interest and its measurement by means of high-resolution preclinical PET systems. In particular, the washout of 11C carbonate radioisotopes was assessed, considering that 11C is is the most abundant β+ emitter produced by carbon beams. 11C washout measurements were performed in several tissues of interest (brain, muscle and 9L tumor xenograf) in rodents (Wistar rat). Results show that the methodology presented is sensitive to the washout variations depending on the selected tissue. Finally, a first qualitative correlation between 11C tumor washout properties and tumor metabolism (via 18F-FDG tracer uptake) was found. PMID:27015269

  15. SiliPET: Design of an ultra-high resolution small animal PET scanner based on stacks of semi-conductor detectors

    NASA Astrophysics Data System (ADS)

    Cesca, N.; Auricchio, N.; Di Domenico, G.; Zavattini, G.; Malaguti, R.; Andritschke, R.; Kanbach, G.; Schopper, F.

    2007-03-01

    We studied with Monte Carlo simulations, using the EGSnrc code, a new scanner for small animal positron emission tomography (PET), based on stacks of double-sided semiconductor detectors. Each stack is composed of planar detectors with dimension 70×60×1 mm 3 and orthogonal strips on both sides with 500 μm pitch to read the two interaction coordinates, the third being the detector number in the stack. Multiple interactions in a stack are discarded. In this way, we achieve a precise determination of the first interaction point of the two 511 keV photons. The reduced dimensions of the scanner also improve the solid angle coverage resulting in a high sensitivity. Preliminary results of scanners based on Si planar detectors are presented and the initial tomographic reconstructions demonstrate very good spatial resolution limited only by the positron range. This suggests that, this is a promising new approach for small animal PET imaging. We are testing some double-sided silicon detectors, equipped with 128 orthogonal p and n strips on opposite sides using VATAGP3 ASIC by IDEAS.

  16. FDG PET/CT in Hepatoid Adenocarcinoma of the Lung.

    PubMed

    Wang, Shouyang; Li, Mengxi; Chen, Huai; Li, Jianyu; Zeng, Qingsi

    2016-07-01

    A right upper lung mass was incidentally found on a chest radiograph in a routine health examination in a 56-year-old man. The mass showed mild heterogeneous enhancement on contrast chest CT images and intense FDG uptake on PET/CT images. Pathological examination demonstrated hepatoid adenocarcinoma in the lung. PMID:27124679

  17. FDG-PET/CT of Vulvar Adenocarcinoma With Diffuse Metastases.

    PubMed

    Patel, Darshan; Anderson, Thomas M; Lu, Yang

    2016-09-01

    A 52 year-old woman presented to her gynecologist with a 1-year history of a 1.5-cm left labial mass. Punch biopsy of the vulvar lesion revealed primary infiltrating adenocarcinoma. Staging FDG-PET/CT demonstrated multiorgan diffuse metastases. PMID:27187733

  18. [Interest of FDG-PET for lung cancer radiotherapy].

    PubMed

    Thureau, S; Mezzani-Saillard, S; Modzelewski, R; Edet-Sanson, A; Dubray, B; Vera, P

    2011-10-01

    The recent advances in medical imaging have profoundly altered the radiotherapy of non-small cell lung cancers (NSCLC). A meta-analysis has confirmed the superiority of FDG PET-CT over CT for initial staging. FDG PET-CT improves the reproducibility of target volume delineation, especially close to the mediastinum or in the presence of atelectasia. Although not formally validated by a randomized trial, the reduction of the mediastinal target volume, by restricting the irradiation to FDG-avid nodes, is widely accepted. The optimal method of delineation still remains to be defined. The role of FDG PET-CT in monitoring tumor response during radiotherapy is under investigation, potentially opening the way to adapting the treatment modalities to tumor radiation sensitivity. Other tracers, such as F-miso (hypoxia), are also under clinical investigation. To avoid excessive delays, the integration of PET-CT in routine practice requires quick access to the imaging equipment, technical support (fusion and image processing) and multidisciplinary delineation of target volumes. PMID:21880535

  19. FDG-anorectic parathyroid carcinoma with FDG-avid bone metastasis on PET/CT images.

    PubMed

    Li, Mei; Lu, Hankui; Gao, Yunchao

    2013-11-01

    A 53-year-old man complained of aggravated left hip pain of more than 2 months. Whole-body (18)F-FDG PET/CT revealed only 1 hypermetabolic lesion in the left ilium. Histopathologic examination of the lesion suggested metastatic disease. Blood tests documented mildly elevated blood calcium and parathyroid hormone. Subsequent neck ultrasonography, contrast-enhanced CT, and dual-phase scintigraphy with (99m)Tc-MIBI showed a right parathyroid tumor, which was confirmed to be a parathyroid carcinoma postoperatively. We report a case of parathyroid carcinoma rarely encountered with a FDG-negative primary but a FDG-positive metastasis on PET/CT images. PMID:24089062

  20. Characteristics of a multichannel low-noise front-end ASIC for CZT-based small animal PET imaging

    NASA Astrophysics Data System (ADS)

    Gao, W.; Liu, H.; Gan, B.; Hu, Y.

    2014-05-01

    In this paper, we present the design and characteristics of a novel low-noise front-end readout application-specific integrated circuit dedicated to CdZnTe (CZT) detectors for a small animal PET imaging system. A low-noise readout method based on the charge integration and the delayed peak detection is proposed. An eight-channel front-end readout prototype chip is designed and implemented in a 0.35 μm CMOS process. The die size is 2.3 mm ×2.3 mm. The prototype chip is tested in different methods including electronic test, energy spectrum test and irradiation test. The input range of the ASIC is from 2000e- to 180,000e-, reflecting the energy of the gamma ray from 11.2 keV to 1 MeV. The gain of the readout channel is 65 mV/fC at the shaping time of 1 μs. The best test result of the equivalent noise charge (ENC) is 58.9 e- at zero farad plus 5.4 e- per picofarad. The nonlinearity and the crosstalk are less than 3% and less than 2%, respectively, at the room temperature. The static power dissipation is about 3 mW/channel.

  1. CT with a CMOS flat panel detector integrated on the YAP-(S)PET scanner for in vivo small animal imaging

    NASA Astrophysics Data System (ADS)

    Di Domenico, Giovanni; Cesca, Nicola; Zavattini, Guido; Auricchio, Natalia; Gambaccini, Mauro

    2007-02-01

    Several research groups are pursuing multimodality simultaneous functional and morphological imaging. In this line of research the high resolution YAP-(S)PET small animal integrated PET-SPECT imaging system, constructed by our group of medical physics at the University of Ferrara, is being upgraded with a computed tomography (CT). In this way it will be possible to perform in vivo molecular and genomic imaging studies on small animals (such as mice and rats) and at the same time obtain morphological information necessary for both attenuation correction and accurate localization of the region under investigation. We have take simultaneous PET-CT and SPECT-CT images of phantoms obtained with a single scanner.

  2. Small-animal PET imaging of human epidermal growth factor receptor positive tumor with a 64Cu labeled affibody protein.

    PubMed

    Miao, Zheng; Ren, Gang; Liu, Hongguang; Jiang, Lei; Cheng, Zhen

    2010-05-19

    Epidermal growth factor receptor (EGFR) has become an attractive target for cancer molecular imaging and therapy. Affibody proteins against EGFR have been reported, and thus, we were interested in evaluating their potential for positron emission tomography (PET) imaging of EGFR positive cancer. An Affibody analogue (Ac-Cys-Z(EGFR:1907)) binding to EGFR was made through conventional solid phase peptide synthesis. The purified protein was site-specifically coupled with the 1,4,7,10-tetraazacyclododecane-1,4,7-tris-aceticacid-10-maleimidethylacetamide (maleimido-mono-amide-DOTA) to produce the bioconjugate, DOTA-Z(EGFR:1907). (64)Cu labeled probe (64)Cu-DOTA-Z(EGFR:1907) displayed a moderate specific activity (5-8 MBq/nmol, 22-35 microCi/microg). Cell uptake assays by pre-incubating without or with 300 times excess unlabeled Ac-Cys-Z(EGFR:1907) showed high EGFR-specific uptake (20% applied activity at 0.5 h) in A431 epidermoid carcinoma cancer cells. The affinity (K(D)) of (64)Cu-DOTA-Z(EGFR:1907) as tested by cell saturation analysis was 20 nM. The serum stability test showed excellent stability of the probe with >95% intact after 4 h of incubation in mouse serum. In vivo small-animal PET imaging showed fast tumor targeting, high tumor accumulation (approximately 10% ID/g at 1 h p.i.), and good tumor-to-normal tissue contrast of (64)Cu-DOTA-Z(EGFR:1907) spiked with a wide dose range of Ac-Cys-Z(EGFR:1907). Bio-distribution studies further demonstrated that the probe had high tumor, blood, liver, and kidney uptakes, while blood radioactivity concentration dropped dramatically at increased spiking doses. Co-injection of the probe with 500 microg of Ac-Cys-Z(EGFR:1907) for blocking significantly reduced the tumor uptake. Thus, (64)Cu-DOTA-Z(EGFR:1907) showed potential as a high tumor contrast EGFR PET imaging reagent. The probe spiked with 50 microg of Ac-Cys-Z(EGFR:1907) improved tumor imaging contrast which may have important clinical applications. PMID:20402512

  3. FDG-PET study of patients with Leigh syndrome.

    PubMed

    Haginoya, Kauzhiro; Kaneta, Tomohiro; Togashi, Noriko; Hino-Fukuyo, Naomi; Kobayashi, Tomoko; Uematsu, Mitsugu; Kitamura, Taro; Inui, Takehiko; Okubo, Yukimune; Takezawa, Yusuke; Anzai, Mai; Endo, Wakaba; Miyake, Noriko; Saitsu, Hirotomo; Matsumoto, Naomichi; Kure, Shigeo

    2016-03-15

    We conducted a [(18)F]fluorodeoxyglucose positron emission tomography (FDG-PET) study in five patients (median age 11 (range 4-13) years) with Leigh syndrome to evaluate its usefulness for understanding the functional brain dysfunction in this disease and in future drug trials. Four patients were found to have reported mitochondrial DNA gene mutations. The brain T2-weighted magnetic resonance imaging (MRI) showed high-intensity areas in the putamen bilaterally in five patients, caudate bilaterally in four, thalamus bilaterally in two, and brainstem in one. Cerebellar atrophy was observed in older two patients. For disease control, seven age-matched epilepsy patients who had normal MRI and FDG-PET studies were selected. For semiquantitative analysis of the lesions with decreased (18)F-FDG uptake, the mean standard uptake value (SUV) was calculated in regions of interest (ROIs) placed in each brain structure. We compared the SUV of nine segments (the frontal, temporal, parietal, and occipital lobes, thalami, basal ganglia, mid-brain, pons, and cerebellum) between patients with Leigh syndrome and controls. The glucose uptake was decreased significantly in the cerebellum and basal ganglia, which could explain the ataxia and dystonia in patients with Leigh syndrome. Although this study had some limitations, FDG-PET might be useful for evaluating the brain dysfunction and treatment efficacy of new drugs in patients with Leigh syndrome. Further study with more patients using advanced methods to quantify glucose uptake is needed before drawing a conclusion. PMID:26944169

  4. The utility of body FDG PET in staging primary central nervous system lymphoma

    PubMed Central

    Mohile, Nimish A.; DeAngelis, Lisa M.; Abrey, Lauren E.

    2008-01-01

    18F-Fluorodeoxyglucose (FDG) PET has become an important tool in the management of non-Hodgkin’s lymphoma (NHL), but its role in the evaluation of primary CNS lymphoma (PCNSL) has not been established. We investigated the ability of body FDG PET to detect systemic disease in the staging and restaging of PCNSL. The records of 166 PCNSL patients seen at Memorial Sloan-Kettering Cancer Center were examined. Forty-nine patients who underwent body FDG PET for staging of PCNSL were identified. Clinical data were reviewed to determine FDG PET results and their influence on therapy. Body FDG PET disclosed a systemic site of malignancy in 15% of patients. NHL was found in 11% of all patients, 7% of patients at diagnosis, and 27% of patients at CNS relapse. Four percent had a second systemic neoplasm. Workup with conventional staging did not reveal systemic disease, and in 8% of patients, body FDG PET was the only abnormal diagnostic exam suggestive of lymphoma. FDG PET findings altered patient treatment and resulted in additional chemotherapy, surgery, or radiotherapy. Our findings suggest that FDG PET may be more sensitive than conventional body staging and may disclose higher rates of concomitant systemic disease at PCNSL diagnosis. Body FDG PET may be an important noninvasive adjunct to conventional PCNSL staging, and its utility should be evaluated prospectively. PMID:18287338

  5. FDG PET/CT in Peritoneal Metastasis From Prostate Cancer.

    PubMed

    Gungor, Serkan; Asa, Sertac; Kupik, Osman

    2016-09-01

    Prostate cancer is one of the leading causes of cancer death in men. The prognosis in prostate cancer is greatly worsened by the presence of metastases, which are most commonly found in bone, lung, liver, and brain. The peritoneum is an extremely uncommon metastatic site for prostate cancer, even in autopsy series. We present a case of FDG PET/CT demonstration of peritoneal metastasis from prostate cancer. PMID:27187732

  6. Evaluation of Avulsion-Induced Neuropathology in Rat Spinal Cords with 18F-FDG Micro-PET/CT.

    PubMed

    Ling, Ze-Min; Tang, Ying; Li, Ying-Qin; Luo, Hao-Xuan; Liu, Lin-Lin; Tu, Qing-Qiang; Zhou, Li-Hua

    2015-01-01

    Brachial plexus root avulsion (BPRA) leads to dramatic motoneuron death and glial reactions in the corresponding spinal segments at the late stage of injury. To protect spinal motoneurons, assessment of the affected spinal segments should be done at an earlier stage of the injury. In this study, we employed 18F-FDG small-animal PET/CT to assess the severity of BPRA-induced cervical spinal cord injuries. Adult Sprague-Dawley rats were randomly treated and divided into three groups: Av+NS (brachial plexus root avulsion (Av) treated with normal saline), Av+GM1 (treated with monosialoganglioside), and control. At time points of 3 day (d), 1 week (w), 2 w, 4 w and 8 w post-injury, 18F-FDG micro-PET/CT scans and neuropathology assessments of the injured spinal roots, as well as the spinal cord, were performed. The outcomes of the different treatments were compared. The results showed that BPRA induced local bleeding and typical Wallerian degeneration of the avulsed roots accompanied by 18F-FDG accumulations at the ipsilateral cervical intervertebral foramen. BPRA-induced astrocyte reactions and overexpression of neuronal nitric oxide synthase in the motoneurons correlated with higher 18F-FDG uptake in the ipsilateral cervical spinal cord during the first 2 w post-injury. The GM1 treatment reduced BPRA-induced astrocyte reactions and inhibited the de novo nNOS expressions in spinal motoneurons. The GM1 treatment also protected spinal motoneurons from avulsion within the first 4 w post-injury. The data from this study suggest that 18F-FDG PET/CT could be used to assess the severity of BPRA-induced primary and secondary injuries in the spinal cord. Furthermore, GM1 is an effective drug for reducing primary and secondary spinal cord injuries following BPRA. PMID:26010770

  7. Evaluation of Avulsion-Induced Neuropathology in Rat Spinal Cords with 18F-FDG Micro-PET/CT

    PubMed Central

    Li, Ying-Qin; Luo, Hao-Xuan; Liu, Lin-Lin; Tu, Qing-Qiang; Zhou, Li-Hua

    2015-01-01

    Brachial plexus root avulsion (BPRA) leads to dramatic motoneuron death and glial reactions in the corresponding spinal segments at the late stage of injury. To protect spinal motoneurons, assessment of the affected spinal segments should be done at an earlier stage of the injury. In this study, we employed 18F-FDG small-animal PET/CT to assess the severity of BPRA-induced cervical spinal cord injuries. Adult Sprague-Dawley rats were randomly treated and divided into three groups: Av+NS (brachial plexus root avulsion (Av) treated with normal saline), Av+GM1 (treated with monosialoganglioside), and control. At time points of 3 day (d), 1 week (w), 2 w, 4 w and 8 w post-injury, 18F-FDG micro-PET/CT scans and neuropathology assessments of the injured spinal roots, as well as the spinal cord, were performed. The outcomes of the different treatments were compared. The results showed that BPRA induced local bleeding and typical Wallerian degeneration of the avulsed roots accompanied by 18F-FDG accumulations at the ipsilateral cervical intervertebral foramen. BPRA-induced astrocyte reactions and overexpression of neuronal nitric oxide synthase in the motoneurons correlated with higher 18F-FDG uptake in the ipsilateral cervical spinal cord during the first 2 w post-injury. The GM1 treatment reduced BPRA-induced astrocyte reactions and inhibited the de novo nNOS expressions in spinal motoneurons. The GM1 treatment also protected spinal motoneurons from avulsion within the first 4 w post-injury. The data from this study suggest that 18F-FDG PET/CT could be used to assess the severity of BPRA-induced primary and secondary injuries in the spinal cord. Furthermore, GM1 is an effective drug for reducing primary and secondary spinal cord injuries following BPRA. PMID:26010770

  8. Derivation of input function from FDG-PET studies in small hearts

    SciTech Connect

    Wu, Hsiao-Ming; Huang, Sung-Cheng; Allada, V.

    1996-10-01

    The extraction of pure arterial time-activity curves (TACs) from dynamic PET images of a small animal heart using factor analysis of dynamic structures (FADS) was found to be unsuccessful due to the small size of the cardiac chamber that causes extensive mixture of TACs of different structures. In this study, we used digital phantoms of the left ventricle (LV cavity size: 1-2 cm) and small monkey (LV cavity size: {approx} 2 cm) dynamic FDG PET studies to evaluate FADS for extracting the pure blood-pool TACs by adding a single blood sample (taken at a late scan time) constraint. In the digital phantom studies, spillover fractions in the extracted blood-pool TACs using FADS without a blood sample constraint (FADS(-)) and with a blood sample constraint (FADS(+)) were 3%-91% and < 3%, respectively. In the monkey studies (n = 4), FADS(+) extracted blood-pool TACs matched well with the arterialized well counter measurements (% differences of curve integration: FADS(-) < 82%; FADS(+) < 9%). The microparameters (K*{sub 1}, k*{sub 2}, k*{sub 3}, k*{sub 4}) and macroparameters (K{sub nlr}), obtained from the FADS(+) blood-pool TACs, were similar to those obtained from plasma samples in a three-compartment model fitting (% differences of K{sub nlr}: phantom studies < 5%; monkey studies < 9%). The FADS technique with a single-blood sample has the potential to extract the pure blood-pool TACs directly from dynamic PET images of a small animal without multiple blood sampling, region of interest definition or spillover correction. 14 refs., 5 figs., 3 tabs.

  9. FDG and (82)Rb PET/MRI features of brain metastasis of breast cancer.

    PubMed

    Lu, Yang

    2015-06-01

    A 64-year-old woman with stage IV breast cancer underwent an FDG and Rb PET brain studies. The PET brain images were fused with MRI brain T1 post-contrast images. The known enhancing left superoposterior frontal brain metastasis is positive on both FDG Rb PET/MRI images. The Rb PET/MRI showed better target-to-noise ratio, but showed nonspecific uptake in the superior sagittal sinus. PMID:25674864

  10. FDG-MicroPET and Diffusion-Weighted MR Image Evaluation of Early Changes After Radiofrequency Ablation in Implanted VX2 Tumors in Rabbits

    SciTech Connect

    Ohira, Tomohiro Okuma, Tomohisa; Matsuoka, Toshiyuki; Wada, Yasuhiro; Nakamura, Kenji; Watanabe, Yasuyoshi; Inoue, Yuichi

    2009-01-15

    The objective of this study was to evaluate the early changes after radiofrequency ablation (RFA) in VX2 rabbit tumors implanted into the back muscles by diffusion-weighted magnetic resonance (MR) imaging and {sup 18}F-2-fluoro-2-deoxy-D-glucose positron emission tomography ({sup 18}F-FDG PET). Percutaneous CT-guided RFA was conducted in seven rabbits with implanted VX2 tumors. VX2 tumors on the other side were untreated and served as the control. MR imaging was performed with a clinical 1.5-T instrument 2 days after RFA, and FDG-PET, using a high-resolution PET scanner for small animals, was obtained 3 days after the procedure. The mean apparent diffusion coefficient (ADC) values and radioactivity count of untreated and ablated tumors were calculated. Untreated VX2 tumors showed hyperintensity on T1-, T2-, and diffusion-weighted MR images, ring-enhanced on contrast-enhanced T1-weighted imaging, and ring-shaped FDG accumulation on FDG-PET. Ablated VX2 tumors showed slight hyperintensity on T1-, T2-, and diffusion-weighed images, slight enhancement on contrast-enhanced T1-weighted images, and low accumulation on FDG-PET. The ADC value of ablated VX2 tumors (1.52 {+-} 0.24 x 10{sup -3} mm{sup 2}/s) was significantly higher than that of untreated tumors (1.09 {+-} 0.12 x 10{sup -3}; p < 0.05). The tumor/muscle ratio of ablated tumors (0.5 {+-} 0.3) was significantly lower than that of untreated tumors (11.6 {+-} 3.2; p < 0.05). Histopathological examination confirmed the lack of viable tumor cells in the ablated lesions. The results indicate that both ADC value and FDG-PET are potentially useful markers for monitoring the early effects of RFA.

  11. Hepatosplenic Candidiasis Detected by 18F-FDG-PET/CT

    PubMed Central

    Albano, Domenico; Bosio, Giovanni; Bertoli, Mattia; Petrilli, Giulia; Bertagna, Francesco

    2016-01-01

    Hepatosplenic candidiasis is a fungal infection, which mostly affects patients with hematologic malignancies such as leukemia. The pathogenesis of this infection is not clear yet, and the liver is the most commonly affected organ. Diagnosis of hepatosplenic candidiasis can be only established via biopsy, since computed tomography (CT) scan, ultrasonography, and magnetic resonance imaging (MRI) yield non-specific results. The role of fluorine-18 fluorodeoxyglucose positron emission tomography /computed tomography (18F-FDG PET/CT) in diagnosis of hepatosplenic candidiasis remains undetermined, considering a few evidences in the literature. In this case report, we present the case of a 47-year-old patient, affected by acute myeloid leukemia, which was treated with three cycles of chemotherapy, resulting in the development of neutropenia and fever following the last cycle. The 18F-FDG PET/CT scan showed some foci of intense FDG uptake in the liver and spleen. The subsequent diagnostic investigations (i.e., abdominal CT scan and biopsy) were suggestive of hepatosplenic candidiasis. The patient was started on antifungal treatment with fluconazole. After one month, the clinical conditions were resolved, and the subsequent abdominal CT scan was negative.

  12. Hepatosplenic Candidiasis Detected by (18)F-FDG-PET/CT.

    PubMed

    Albano, Domenico; Bosio, Giovanni; Bertoli, Mattia; Petrilli, Giulia; Bertagna, Francesco

    2016-01-01

    Hepatosplenic candidiasis is a fungal infection, which mostly affects patients with hematologic malignancies such as leukemia. The pathogenesis of this infection is not clear yet, and the liver is the most commonly affected organ. Diagnosis of hepatosplenic candidiasis can be only established via biopsy, since computed tomography (CT) scan, ultrasonography, and magnetic resonance imaging (MRI) yield non-specific results. The role of fluorine-18 fluorodeoxyglucose positron emission tomography /computed tomography ((18)F-FDG PET/CT) in diagnosis of hepatosplenic candidiasis remains undetermined, considering a few evidences in the literature. In this case report, we present the case of a 47-year-old patient, affected by acute myeloid leukemia, which was treated with three cycles of chemotherapy, resulting in the development of neutropenia and fever following the last cycle. The (18)F-FDG PET/CT scan showed some foci of intense FDG uptake in the liver and spleen. The subsequent diagnostic investigations (i.e., abdominal CT scan and biopsy) were suggestive of hepatosplenic candidiasis. The patient was started on antifungal treatment with fluconazole. After one month, the clinical conditions were resolved, and the subsequent abdominal CT scan was negative. PMID:27408899

  13. FDG-Avid Portal Vein Tumor Thrombosis from Hepatocellular Carcinoma in Contrast-Enhanced FDG PET/CT

    PubMed Central

    Nguyen, Xuan Canh; Nguyen, Dinh Song Huy; Ngo, Van Tan; Maurea, Simone

    2015-01-01

    Objective(s): In this study, we aimed to describe the characteristics of portal vein tumor thrombosis (PVTT), complicating hepatocellular carcinoma (HCC) in contrast-enhanced FDG PET/CT scan. Methods: In this retrospective study, 9 HCC patients with FDG-avid PVTT were diagnosed by contrast-enhanced fluorodeoxyglucose positron emission tomography/computed tomography (FDG PET/CT), which is a combination of dynamic liver CT scan, multiphase imaging, and whole-body PET scan. PET and CT DICOM images of patients were imported into the PET/CT imaging system for the re-analysis of contrast enhancement and FDG uptake in thrombus, the diameter of the involved portal vein, and characteristics of liver tumors and metastasis. Results: Two patients with previously untreated HCC and 7 cases with previously treated HCC had FDG-avid PVTT in contrast-enhanced FDG PET/CT scan. During the arterial phase of CT scan, portal vein thrombus showed contrast enhancement in 8 out of 9 patients (88.9%). PET scan showed an increased linear FDG uptake along the thrombosed portal vein in all patients. The mean greatest diameter of thrombosed portal veins was 1.8 ± 0.2 cm, which was significantly greater than that observed in normal portal veins (P<0.001). FDG uptake level in portal vein thrombus was significantly higher than that of blood pool in the reference normal portal vein (P=0.001). PVTT was caused by the direct extension of liver tumors. All patients had visible FDG-avid liver tumors in contrast-enhanced images. Five out of 9 patients (55.6%) had no extrahepatic metastasis, 3 cases (33.3%) had metastasis of regional lymph nodes, and 1 case (11.1%) presented with distant metastasis. The median estimated survival time of patients was 5 months. Conclusion: The intraluminal filling defect consistent with thrombous within the portal vein, expansion of the involved portal vein, contrast enhancement, and linear increased FDG uptake of the thrombus extended from liver tumor are findings of FDG

  14. Incidental Detection of Femoral Pseudoaneurysm at 18F-FDG PET/CT.

    PubMed

    Nougaret, Stephanie; Ragucci, Monica; Bach, Ariadne M; Carollo, Gabriella; Mannelli, Lorenzo

    2016-01-01

    A 72-year-old man with history of lung cancer and melanoma was referred for routine follow-up with 18F-FDG PET/CT. CT images showed a new mass in the right groin associated with mild FDG activity on 18F-FDG PET images. Subsequent ultrasound obtained the same day demonstrated flow within the lesion to be a pseudoaneurysm of the right femoral artery. PMID:26462043

  15. Simultaneous scanning of two mice in a small-animal PET scanner: a simulation-based assessment of the signal degradation.

    PubMed

    Reilhac, Anthonin; Boisson, Frédéric; Wimberley, Catriona; Parmar, Arvind; Zahra, David; Hamze, Hasar; Davis, Emma; Arthur, Andrew; Bouillot, Caroline; Charil, Arnaud; Grégoire, Marie-Claude

    2016-02-01

    In PET imaging, research groups have recently proposed different experimental set ups allowing multiple animals to be simultaneously imaged in a scanner in order to reduce the costs and increase the throughput. In those studies, the technical feasibility was demonstrated and the signal degradation caused by additional mice in the FOV characterized, however, the impact of the signal degradation on the outcome of a PET study has not yet been studied. Here we thoroughly investigated, using Monte Carlo simulated [18F]FDG and [11C]Raclopride PET studies, different experimental designs for whole-body and brain acquisitions of two mice and assessed the actual impact on the detection of biological variations as compared to a single-mouse setting. First, we extended the validation of the PET-SORTEO Monte Carlo simulation platform for the simultaneous simulation of two animals. Then, we designed [18F]FDG and [11C]Raclopride input mouse models for the simulation of realistic whole-body and brain PET studies. Simulated studies allowed us to accurately estimate the differences in detection between single- and dual-mode acquisition settings that are purely the result of having two animals in the FOV. Validation results showed that PET-SORTEO accurately reproduced the spatial resolution and noise degradations that were observed with actual dual phantom experiments. The simulated [18F]FDG whole-body study showed that the resolution loss due to the off-center positioning of the mice was the biggest contributing factor in signal degradation at the pixel level and a minimal inter-animal distance as well as the use of reconstruction methods with resolution modeling should be preferred. Dual mode acquisition did not have a major impact on ROI-based analysis except in situations where uptake values in organs from the same subject were compared. The simulated [11C]Raclopride study however showed that dual-mice imaging strongly reduced the sensitivity to variations when mice were

  16. Simultaneous scanning of two mice in a small-animal PET scanner: a simulation-based assessment of the signal degradation

    NASA Astrophysics Data System (ADS)

    Reilhac, Anthonin; Boisson, Frédéric; Wimberley, Catriona; Parmar, Arvind; Zahra, David; Hamze, Hasar; Davis, Emma; Arthur, Andrew; Bouillot, Caroline; Charil, Arnaud; Grégoire, Marie-Claude

    2016-02-01

    In PET imaging, research groups have recently proposed different experimental set ups allowing multiple animals to be simultaneously imaged in a scanner in order to reduce the costs and increase the throughput. In those studies, the technical feasibility was demonstrated and the signal degradation caused by additional mice in the FOV characterized, however, the impact of the signal degradation on the outcome of a PET study has not yet been studied. Here we thoroughly investigated, using Monte Carlo simulated [18F]FDG and [11C]Raclopride PET studies, different experimental designs for whole-body and brain acquisitions of two mice and assessed the actual impact on the detection of biological variations as compared to a single-mouse setting. First, we extended the validation of the PET-SORTEO Monte Carlo simulation platform for the simultaneous simulation of two animals. Then, we designed [18F]FDG and [11C]Raclopride input mouse models for the simulation of realistic whole-body and brain PET studies. Simulated studies allowed us to accurately estimate the differences in detection between single- and dual-mode acquisition settings that are purely the result of having two animals in the FOV. Validation results showed that PET-SORTEO accurately reproduced the spatial resolution and noise degradations that were observed with actual dual phantom experiments. The simulated [18F]FDG whole-body study showed that the resolution loss due to the off-center positioning of the mice was the biggest contributing factor in signal degradation at the pixel level and a minimal inter-animal distance as well as the use of reconstruction methods with resolution modeling should be preferred. Dual mode acquisition did not have a major impact on ROI-based analysis except in situations where uptake values in organs from the same subject were compared. The simulated [11C]Raclopride study however showed that dual-mice imaging strongly reduced the sensitivity to variations when mice were

  17. Sub-millimetre DOI detector based on monolithic LYSO and digital SiPM for a dedicated small-animal PET system.

    PubMed

    Marcinkowski, Radosław; Mollet, Pieter; Van Holen, Roel; Vandenberghe, Stefaan

    2016-03-01

    The mouse model is widely used in a vast range of biomedical and preclinical studies. Thanks to the ability to detect and quantify biological processes at the molecular level in vivo, PET has become a well-established tool in these investigations. However, the need to visualize and quantify radiopharmaceuticals in anatomic structures of millimetre or less requires good spatial resolution and sensitivity from small-animal PET imaging systems.In previous work we have presented a proof-of-concept of a dedicated high-resolution small-animal PET scanner based on thin monolithic scintillator crystals and Digital Photon Counter photosensor. The combination of thin monolithic crystals and MLE positioning algorithm resulted in an excellent spatial resolution of 0.7 mm uniform in the entire field of view (FOV). However, the limitation of the scanner was its low sensitivity due to small thickness of the lutetium-yttrium oxyorthosilicate (LYSO) crystals (2 mm).Here we present an improved detector design for a small-animal PET system that simultaneously achieves higher sensitivity and sustains a sub-millimetre spatial resolution. The proposed detector consists of a 5 mm thick monolithic LYSO crystal optically coupled to a Digital Photon Counter. Mean nearest neighbour (MNN) positioning combined with depth of interaction (DOI) decoding was employed to achieve sub-millimetre spatial resolution. To evaluate detector performance the intrinsic spatial resolution, energy resolution and coincidence resolving time (CRT) were measured. The average intrinsic spatial resolution of the detector was 0.60 mm full-width-at-half-maximum (FWHM). A DOI resolution of 1.66 mm was achieved. The energy resolution was 23% FWHM at 511 keV and CRT of 529 ps were measured. The improved detector design overcomes the sensitivity limitation of the previous design by increasing the nominal sensitivity of the detector block and retains an excellent intrinsic spatial resolution. PMID:26907952

  18. 18F-FDG PET in the Diagnosis and Treatment of Primary Central Nervous System Lymphoma

    PubMed Central

    Yamamoto, Yuka; Nishiyama, Yoshihiro; Tamiya, Takashi

    2013-01-01

    This paper summarizes the usefulness and limitation of positron emission tomography (PET) with 18F-fluorodeoxyglucose (18F-FDG) in the diagnosis and treatment of primary central nervous system lymphoma (PCNSL). The 18F-FDG uptake in typical PCNSL is about 2.5 times higher than that in the normal gray matter, and the tumor can usually be identified visually. The 18F-FDG uptake pattern and value provide useful information for differentiating PCNSL from other enhancing malignant brain tumors especially glioblastoma (GB). The 18F-FDG uptake in typical PCNSL is usually homogenous, and the uptake value is significantly higher than that in GB. However, 18F-FDG PET often fails to show the presence of tumor in the brain as 18F-FDG uptake is faint in atypical PCNSL such as disseminated or nonenhancing lesions. 18F-FDG PET is also useful for evaluating the treatment response at a very early stage after the initial treatment. Pretreatment and posttreatment 18F-FDG uptake values may have a prognostic value in patients with PCNSL. In conclusion, 18F-FDG PET is very useful in the diagnosis of typical PCNSL and can differentiate PCNSL from other malignant brain tumors. However, the usefulness of 18F-FDG PET is limited in the diagnosis of atypical PCNSL. PMID:23844359

  19. Monitoring Vasculitis with 18F-FDG PET.

    PubMed

    Bucerius, Jan

    2016-09-01

    Whereas in the past the term "vasculitis" was most frequently used in context with systemic vasculitides, such as the large vessel vasculitides (LVV) Takayasa arteritis and giant cell arteritis, characterized by inflammation of blood vessel walls, it nowadays comprises also inflammatory changes of the vessel wall as a substantial part of the atherosclerotic disease process. Implementing non-invasive imaging techniques, such as computed tomography angiography (CTA), magnetic resonance angiography (MRA) as well as positron emission tomography (PET) in the diagnostic algorithm of atherosclerosis and LVV, depicts a promising step towards an earlier detection with a, consecutively, improved therapeutic approach and potentially prognostic benefit in patients suffering from vasculitis. Mainly molecular imaging with 18F-fluorodeoxyglucose (FDG) PET seems to be promising in offering an early and sensitive identification of inflammatory changes in both, atherosclerosis and LVV. This review will therefore provide an overview on the diagnostic performance and clinical relevance of FDG-PET in monitoring vasculitis in atherosclerosis and LVV, with a focus on LVV. PMID:27280732

  20. Parametric dynamic F-18-FDG PET/CT breast imaging

    NASA Astrophysics Data System (ADS)

    Magri, Alphonso; Feiglin, David; Lipson, Edward; Mandel, James; McGraw, Wendy; Lee, Wei; Krol, Andrzej

    2008-03-01

    This study was undertaken to estimate metabolic tissue properties from dynamic breast F-18-FDG PET/CT image series and to display them as 3D parametric images. Each temporal PET series was obtained immediately after injection of 10 mCi of F-18-FDG and consisted of fifty 1- minute frames. Each consecutive frame was nonrigidly registered to the first frame using a finite element method (FEM) based model and fiducial skin markers. Nonlinear curve fitting of activity vs. time based on a realistic two-compartment model was performed for each voxel of the volume. Curve fitting was accomplished by application of the Levenburg-Marquardt algorithm (LMA) that minimized X2. We evaluated which parameters are most suitable to determine the spatial extent and malignancy in suspicious lesions. In addition, Patlak modeling was applied to the data. A mixture model was constructed and provided a classification system for the breast tissue. It produced unbiased estimation of the spatial extent of the lesions. We conclude that nonrigid registration followed by voxel-by-voxel based nonlinear fitting to a realistic two-compartment model yields better quality parametric images, as compared to unprocessed dynamic breast PET time series. By comparison with the mixture model, we established that the total cumulated activity and maximum activity parametric images provide the best delineation of suspicious breast tissue lesions and hyperactive subregions within the lesion that cannot be discerned in unprocessed images.

  1. Role of FDG PET/CT in Baastrup's disease.

    PubMed

    Subramanyam, Padma; Palaniswamy, Shanmuga Sundaram

    2016-01-01

    Baastrup's disease is a benign condition, which presents as chronic low back pain. It is also known as "kissing spine syndrome" and refers to close approximation of adjacent spinous processes producing inflammation and back pain. This condition is often misdiagnosed, resulting in incorrect treatment and persistence of symptoms. Diagnosis of Baastrup's disease is verified with clinical examination and imaging studies. Conventionally, clinicians resort to magnetic resonance imaging (MRI) of spine rather than X-ray or computed tomography (CT) in the evaluation of back pain. MRI can additionally identify flattening, sclerosis, enlargement, cystic lesions, and bone edema at the articulating surfaces of the two affected spinous processes. Studies have reported that (18)Fluorine fluorodeoxyglucose-positron emission tomography/CT (FDG-PET/CT) can detect a bursitis or an inflammation as a form of stress reaction despite a negative MRI and (99m)Tc Methylene diphosphonate (MDP) bone scan. PET/CT is usually not a recommended investigation for this condition. However, this case report highlights the benefit of FDG-PET/CT in identifying the site of inflammatory pathology. It is also known to identify the exact site of inflammation where steroid or local anesthetic injection can be administered to alleviate pain, especially in patients with multilevel vertebral involvement. PMID:27385901

  2. Role of FDG PET/CT in Baastrup's disease

    PubMed Central

    Subramanyam, Padma; Palaniswamy, Shanmuga Sundaram

    2016-01-01

    Baastrup's disease is a benign condition, which presents as chronic low back pain. It is also known as “kissing spine syndrome” and refers to close approximation of adjacent spinous processes producing inflammation and back pain. This condition is often misdiagnosed, resulting in incorrect treatment and persistence of symptoms. Diagnosis of Baastrup's disease is verified with clinical examination and imaging studies. Conventionally, clinicians resort to magnetic resonance imaging (MRI) of spine rather than X-ray or computed tomography (CT) in the evaluation of back pain. MRI can additionally identify flattening, sclerosis, enlargement, cystic lesions, and bone edema at the articulating surfaces of the two affected spinous processes. Studies have reported that 18Fluorine fluorodeoxyglucose-positron emission tomography/CT (FDG-PET/CT) can detect a bursitis or an inflammation as a form of stress reaction despite a negative MRI and 99mTc Methylene diphosphonate (MDP) bone scan. PET/CT is usually not a recommended investigation for this condition. However, this case report highlights the benefit of FDG-PET/CT in identifying the site of inflammatory pathology. It is also known to identify the exact site of inflammation where steroid or local anesthetic injection can be administered to alleviate pain, especially in patients with multilevel vertebral involvement. PMID:27385901

  3. Comparison of 18F-FDG PET/CT and PET/MRI in patients with multiple myeloma

    PubMed Central

    Sachpekidis, Christos; Hillengass, Jens; Goldschmidt, Hartmut; Mosebach, Jennifer; Pan, Leyun; Schlemmer, Heinz-Peter; Haberkorn, Uwe; Dimitrakopoulou-Strauss, Antonia

    2015-01-01

    PET/MRI represents a promising hybrid imaging modality with several potential clinical applications. Although PET/MRI seems highly attractive in the diagnostic approach of multiple myeloma (MM), its role has not yet been evaluated. The aims of this prospective study are to evaluate the feasibility of 18F-FDG PET/MRI in detection of MM lesions, and to investigate the reproducibility of bone marrow lesions detection and quantitative data of 18F-FDG uptake between the functional (PET) component of PET/CT and PET/MRI in MM patients. The study includes 30 MM patients. All patients initially underwent 18F-FDG PET/CT (60 min p.i.), followed by PET/MRI (120 min p.i.). PET/CT and PET/MRI data were assessed and compared based on qualitative (lesion detection) and quantitative (SUV) evaluation. The hybrid PET/MRI system provided good image quality in all cases without artefacts. PET/MRI identified 65 of the 69 lesions, which were detectable with PET/CT (94.2%). Quantitative PET evaluations showed the following mean values in MM lesions: SUVaverage=5.5 and SUVmax=7.9 for PET/CT; SUVaverage=3.9 and SUVmax=5.8 for PET/MRI. Both SUVaverage and SUVmax were significantly higher on PET/CT than on PET/MRI. Spearman correlation analysis demonstrated a strong correlation between both lesional SUVaverage (r=0.744) and lesional SUVmax (r=0.855) values derived from PET/CT and PET/MRI. Regarding detection of myeloma skeletal lesions, PET/MRI exhibited equivalent performance to PET/CT. In terms of tracer uptake quantitation, a significant correlation between the two techniques was demonstrated, despite the statistically significant differences in lesional SUVs between PET/CT and PET/MRI. PMID:26550538

  4. MRI, enhanced CT, and FDG PET/CT in primary retroperitoneal mucinous cystadenocarcinoma.

    PubMed

    Dong, Aisheng; Zhai, Zhijun; Wang, Yang; Zuo, Changjing

    2015-01-01

    Primary retroperitoneal mucinous cystadenocarcinoma (PRMC) is an extremely rare neoplasm. We present a case of PRMC with MRI, enhanced CT, and FDG PET/CT findings. Abdominal MRI showed a cystic lesion in the retroperitoneum with a mural nodule. The mural nodule showed progressive enhancement on enhanced CT and intense FDG uptake on early PET/CT with increased SUVmax on delayed PET/CT. Laparoscopy was performed. Retroperitoneal mucinous cystadenocarcinoma was confirmed histopathologically. Metastasis from gastrointestinal tract or ovary was excluded. This case indicates, although rare, PRMC should be considered when a hypermetabolic retroperitoneal cystic lesion with bilateral normal ovaries is found on FDG PET/CT. PMID:24445275

  5. Assessment of MR-compatibility of SiPM PET insert using short optical fiber bundles for small animal research

    NASA Astrophysics Data System (ADS)

    Kang, H. G.; Hong, S. J.; Ko, G. B.; Yoon, H. S.; Song, I. C.; Rhee, J. T.; Lee, J. S.

    2015-12-01

    Simultaneous positron emission tomography (PET) and magnetic resonance imaging (MRI) can provide new perspectives in human disease research because of their complementary in-vivo imaging techniques. Previously, we have developed an MR-compatible PET insert based on optical fibers using silicon photomultipliers (SiPM). However when echo planar imaging (EPI) sequence was performed, signal intensity was slowly decreased by -0.9% over the 5.5 minutes and significant geometrical distortion was observed as the PET insert was installed inside an MRI bore, indicating that the PET electronics and its shielding boxes might have been too close to an MR imaging object. In this paper, optical fiber bundles with a length of 54 mm instead of 31 mm were employed to minimize PET interference on MR images. Furthermore, the LYSO crystals with a size of 1.5 × 1.5 × 7.0 mm3 were used instead of 2.47 × 2.74 × 20.0 mm3 for preclinical PET/MR applications. To improve the MR image quality, two receive-only loop coils were used. The effects of the PET insert on the SNR of the MR image either for morphological or advanced MR pulse sequences such as diffusion weighted imaging (DWI), functional MRI (fMRI), and magnetic resonance spectroscopy (MRS) were investigated. The quantitative MR compatibility such as B0 and B1 field homogeneity without PET, with `PET OFF', and with `PET ON' was also evaluated. In conclusion, B0 maps were not affected by the proposed PET insert whereas B1 maps were significantly affected by the PET insert. The advanced MRI sequences such as DWI, EPI, and MRS can be performed without a significant MR image quality degradation.

  6. FDG-PET/CT based response-adapted treatment

    PubMed Central

    Vriens, Dennis; Arens, Anne I.J.; Hutchings, Martin; Oyen, Wim J.G.

    2012-01-01

    Abstract It has been shown that [18F]fluorodeoxyglucose (FDG)-positron emission tomography (PET) provides robust and reproducible data for early metabolic response assessment in various malignancies. This led to the initiation of several prospective multicenter trials in malignant lymphoma and adenocarcinoma of the esophagogastric junction, in order to investigate whether the use of PET-guided treatment individualization results in a survival benefit. In Hodgkin lymphoma and aggressive non-Hodgkin lymphoma, several trials are ongoing. Some studies aim to investigate the use of PET in early identification of metabolic non-responders in order to intensify treatment to improve survival. Other studies aim at reducing toxicity without adversely affecting cure rates by safely de-escalating therapy in metabolic responders. In solid tumors the first PET response-adjusted treatment trials have been realized in adenocarcinoma of the esophagogastric junction. These trials showed that patients with an early metabolic response to neoadjuvant chemotherapy benefit from this treatment, whereas metabolic non-responders should switch early to surgery, thus reducing the risk of tumor progression during chemotherapy and the risk of toxic death. The trials provide a model for designing response-guided treatment algorithms in other malignancies. PET-guided treatment algorithms are the promise of the near future; the choice of therapy, its intensity, and its duration will become better adjusted to the biology of the individual patient. Today’s major challenge is to investigate the impact on patient outcome of personalized response-adapted treatment concepts. PMID:23023063

  7. Spectrum of the Breast Lesions With Increased 18F-FDG Uptake on PET/CT

    PubMed Central

    Dong, Aisheng; Wang, Yang; Lu, Jianping; Zuo, Changjing

    2016-01-01

    Abstract Interpretation of 18F-FDG PET/CT studies in breast is challenging owing to nonspecific FDG uptake in various benign and malignant conditions. Benign conditions include breast changes in pregnancy and lactation, gynecomastia, mastitis, fat necrosis, fibroadenoma, intraductal papilloma, and atypical ductal hyperplasia. Among malignancies, invasive ductal carcinoma and invasive lobular carcinoma are common histological types of breast carcinoma. Rarely, other unusual histological types of breast carcinomas (eg, intraductal papillary carcinoma, invasive micropapillary carcinoma, medullary carcinoma, mucinous carcinoma, and metaplastic carcinoma), lymphoma, and metastasis can be the causes. Knowledge of a wide spectrum of hypermetabolic breast lesions on FDG PET/CT is essential in accurate reading of FDG PET/CT. The purpose of this atlas article is to demonstrate features of various breast lesions encountered at our institution, both benign and malignant, which can result in hypermetabolism on FDG PET/CT imaging. PMID:26975010

  8. Spectrum of the Breast Lesions With Increased 18F-FDG Uptake on PET/CT.

    PubMed

    Dong, Aisheng; Wang, Yang; Lu, Jianping; Zuo, Changjing

    2016-07-01

    Interpretation of F-FDG PET/CT studies in breast is challenging owing to nonspecific FDG uptake in various benign and malignant conditions. Benign conditions include breast changes in pregnancy and lactation, gynecomastia, mastitis, fat necrosis, fibroadenoma, intraductal papilloma, and atypical ductal hyperplasia. Among malignancies, invasive ductal carcinoma and invasive lobular carcinoma are common histological types of breast carcinoma. Rarely, other unusual histological types of breast carcinomas (eg, intraductal papillary carcinoma, invasive micropapillary carcinoma, medullary carcinoma, mucinous carcinoma, and metaplastic carcinoma), lymphoma, and metastasis can be the causes. Knowledge of a wide spectrum of hypermetabolic breast lesions on FDG PET/CT is essential in accurate reading of FDG PET/CT. The purpose of this atlas article is to demonstrate features of various breast lesions encountered at our institution, both benign and malignant, which can result in hypermetabolism on FDG PET/CT imaging. PMID:26975010

  9. Monte Carlo simulations versus experimental measurements in a small animal PET system. A comparison in the NEMA NU 4-2008 framework

    NASA Astrophysics Data System (ADS)

    Popota, F. D.; Aguiar, P.; España, S.; Lois, C.; Udias, J. M.; Ros, D.; Pavia, J.; Gispert, J. D.

    2015-01-01

    In this work a comparison between experimental and simulated data using GATE and PeneloPET Monte Carlo simulation packages is presented. All simulated setups, as well as the experimental measurements, followed exactly the guidelines of the NEMA NU 4-2008 standards using the microPET R4 scanner. The comparison was focused on spatial resolution, sensitivity, scatter fraction and counting rates performance. Both GATE and PeneloPET showed reasonable agreement for the spatial resolution when compared to experimental measurements, although they lead to slight underestimations for the points close to the edge. High accuracy was obtained between experiments and simulations of the system’s sensitivity and scatter fraction for an energy window of 350-650 keV, as well as for the counting rate simulations. The latter was the most complicated test to perform since each code demands different specifications for the characterization of the system’s dead time. Although simulated and experimental results were in excellent agreement for both simulation codes, PeneloPET demanded more information about the behavior of the real data acquisition system. To our knowledge, this constitutes the first validation of these Monte Carlo codes for the full NEMA NU 4-2008 standards for small animal PET imaging systems.

  10. FDG cardiac SPECT versus PET: Relation to SPECT radionuclide angiography and thallium scintigraphy

    SciTech Connect

    Srinivasan, G.; Kitsiou, A.N.; Bacharach, S.L.

    1996-05-01

    To determine whether fluorodeoxyglucose (FDG) imaging with SPECT, using high-energy collimation, provides comparable viability information to FDG-PET, 16 pts with chronic CAD undergoing FDG-PET studies were reimaged with SPECT immediately after the PET acquisition was completed. All pts had stress (S)-redistribution (RD)-reinjection (RI) thallium (TL) studies and a subset of 12 pts had SPECT radionuclide angiography (RNA). The LV was divided into 4 long-axis tomograms encompassing the entire LV and the myocardial activity of 11 sectors per tomogram was assessed quantitatively. The mean counts per pixel of corresponding FDG-SPECT, FDG-PET, RD and RI-TL images were normalized to that sector having peak activity on TL-S and compared on the basis of severity of reduction in FDG and TL activity as follows: normal (NI = >85% of peak), mild-moderate (50-86%) and severe (<50%). FDG-SPECT provided concordant viability information with FDG-PET (NI/mild-mod vs severe) in 581 of 615 (94%) sectors and with TL S-RD-RI(NI/reversible/mild-mod vs severe irreversible) in 555 or 615 (90%) sectors. To facilitate comparison of FDG and TK uptake with regional contraction, these sectors were grouped into 5 regions (anterior, septal, apex, inferior and lateral). These data suggest that most normal/HK regions are viable both by FDG and TL. Among a total of 33 sHK and AK/DK regions, in which viability is a clinical concern, 17 (52%) were viable by TL, 22 (67%) by FDG-SPECT and 24 (73%) by FDG-PET (p=NS). These data suggest that most normal/HK regions are viable both by FDG and TL. Among a total of 33 sHK and AK/DK regions, in which viability is a clinical concern, 17 (52%) were viable by TL, 22 (67%) by FDG-SPECT and 24 (73%) by FDG-PET (p=NS). These data affirm the good overall correlation between FDG uptake and TL for differentiating viable from nonviable myocardium in asynergic regions regardless of the technology applied, PET or SPECT.

  11. MRI and FDG PET/CT imaging manifestations of cardiac sarcoidosis.

    PubMed

    Lu, Yang; Sweiss, Nadera J

    2015-12-01

    A 52-year-old man had biopsy-proven sarcoidosis of mediastinal lymph nodes. Cardiac sarcoidosis was confirmed on cardiac MRI with typical imaging features as delayed gadolinium enhancement. Follow-up FDG PET/CT with a 3-day pretest diet modification showed suppression of overall myocardial uptake of FDG but with multifocal abnormal FDG uptake in the myocardium regions corresponding to the previous MRI findings. Additional noncardiac active sarcoidosis involving multiple organ and lymph nodes were also visualized on FDG PET/CT. PMID:26544904

  12. FDG-PET improves accuracy in distinguishing frontotemporal dementia and Alzheimer's disease.

    PubMed

    Foster, Norman L; Heidebrink, Judith L; Clark, Christopher M; Jagust, William J; Arnold, Steven E; Barbas, Nancy R; DeCarli, Charles S; Turner, R Scott; Koeppe, Robert A; Higdon, Roger; Minoshima, Satoshi

    2007-10-01

    Distinguishing Alzheimer's disease (AD) and frontotemporal dementia (FTD) currently relies on a clinical history and examination, but positron emission tomography with [(18)F] fluorodeoxyglucose (FDG-PET) shows different patterns of hypometabolism in these disorders that might aid differential diagnosis. Six dementia experts with variable FDG-PET experience made independent, forced choice, diagnostic decisions in 45 patients with pathologically confirmed AD (n = 31) or FTD (n = 14) using five separate methods: (1) review of clinical summaries, (2) a diagnostic checklist alone, (3) summary and checklist, (4) transaxial FDG-PET scans and (5) FDG-PET stereotactic surface projection (SSP) metabolic and statistical maps. In addition, we evaluated the effect of the sequential review of a clinical summary followed by SSP. Visual interpretation of SSP images was superior to clinical assessment and had the best inter-rater reliability (mean kappa = 0.78) and diagnostic accuracy (89.6%). It also had the highest specificity (97.6%) and sensitivity (86%), and positive likelihood ratio for FTD (36.5). The addition of FDG-PET to clinical summaries increased diagnostic accuracy and confidence for both AD and FTD. It was particularly helpful when raters were uncertain in their clinical diagnosis. Visual interpretation of FDG-PET after brief training is more reliable and accurate in distinguishing FTD from AD than clinical methods alone. FDG-PET adds important information that appropriately increases diagnostic confidence, even among experienced dementia specialists. PMID:17704526

  13. FDG PET/CT Findings in Abdominal Fat Necrosis After Treatment for Lymphoma.

    PubMed

    Dubreuil, Julien; Moreau, Aurélie; Sarkozy, Clémentine; Traverse-Glehen, Alexandra; Skanjeti, Andrea; Salles, Gilles; Giammarile, Francesco

    2016-05-01

    FDG PET/CT is now validated in non-Hodgkin lymphoma for response assessment in interim and posttreatment lymphoma. We report the case of a 62-year-old man followed by FDG PET/CT for a diffuse large B-cell lymphoma, with initial stage III. The interim FDG PET/CT examination concluded in complete metabolic and morphological response of subdiaphragmatic lymphadenopathy but a persistent abnormal subdiaphragmatic uptake (SUVmax at 9 and Deauville 5-point scale at 5). Therefore, an abdominal biopsy of the corresponding nodules was conducted with a final diagnosis of diffuse fat necrosis. PMID:26825213

  14. Dynamic functional imaging of brain glucose utilization using fPET-FDG

    SciTech Connect

    Villien, Marjorie; Wey, Hsiao-Ying; Mandeville, Joseph B.; Catana, Ciprian; Polimeni, Jonathan R.; Sander, Christin Y.; Zürcher, Nicole R.; Chonde, Daniel B.; Fowler, Joanna S.; Rosen, Bruce R.; Hooker, Jacob M.

    2014-06-14

    We report that glucose is the principal source of energy for the brain and yet the dynamic response of glucose utilization to changes in brain activity is still not fully understood. Positron emission tomography (PET) allows quantitative measurement of glucose metabolism using 2-[18F]-fluorodeoxyglucose (FDG). However, FDG PET in its current form provides an integral (or average) of glucose consumption over tens of minutes and lacks the temporal information to capture physiological alterations associated with changes in brain activity induced by tasks or drug challenges. Traditionally, changes in glucose utilization are inferred by comparing two separate scans, which significantly limits the utility of the method. We report a novel method to track changes in FDG metabolism dynamically, with higher temporal resolution than exists to date and within a single session. Using a constant infusion of FDG, we demonstrate that our technique (termed fPET-FDG) can be used in an analysis pipeline similar to fMRI to define within-session differential metabolic responses. We use visual stimulation to demonstrate the feasibility of this method. Ultimately, this new method has a great potential to be used in research protocols and clinical settings since fPET-FDG imaging can be performed with most PET scanners and data acquisition and analysis are straightforward. fPET-FDG is a highly complementary technique to MRI and provides a rich new way to observe functional changes in brain metabolism.

  15. Dynamic functional imaging of brain glucose utilization using fPET-FDG

    DOE PAGESBeta

    Villien, Marjorie; Wey, Hsiao-Ying; Mandeville, Joseph B.; Catana, Ciprian; Polimeni, Jonathan R.; Sander, Christin Y.; Zürcher, Nicole R.; Chonde, Daniel B.; Fowler, Joanna S.; Rosen, Bruce R.; et al

    2014-06-14

    We report that glucose is the principal source of energy for the brain and yet the dynamic response of glucose utilization to changes in brain activity is still not fully understood. Positron emission tomography (PET) allows quantitative measurement of glucose metabolism using 2-[18F]-fluorodeoxyglucose (FDG). However, FDG PET in its current form provides an integral (or average) of glucose consumption over tens of minutes and lacks the temporal information to capture physiological alterations associated with changes in brain activity induced by tasks or drug challenges. Traditionally, changes in glucose utilization are inferred by comparing two separate scans, which significantly limits themore » utility of the method. We report a novel method to track changes in FDG metabolism dynamically, with higher temporal resolution than exists to date and within a single session. Using a constant infusion of FDG, we demonstrate that our technique (termed fPET-FDG) can be used in an analysis pipeline similar to fMRI to define within-session differential metabolic responses. We use visual stimulation to demonstrate the feasibility of this method. Ultimately, this new method has a great potential to be used in research protocols and clinical settings since fPET-FDG imaging can be performed with most PET scanners and data acquisition and analysis are straightforward. fPET-FDG is a highly complementary technique to MRI and provides a rich new way to observe functional changes in brain metabolism.« less

  16. Measurement of radioactivity concentration in blood by using newly developed ToT LuAG-APD based small animal PET tomograph.

    PubMed

    Malik, Azhar H; Shimazoe, Kenji; Takahashi, Hiroyuki

    2013-01-01

    In order to obtain plasma time activity curve (PTAC), input function for almost all quantitative PET studies, patient blood is sampled manually from the artery or vein which has various drawbacks. Recently a novel compact Time over Threshold (ToT) based Pr:LuAG-APD animal PET tomograph is developed in our laboratory which has 10% energy resolution, 4.2 ns time resolution and 1.76 mm spatial resolution. The measured value of spatial resolution shows much promise for imaging the blood vascular, i.e; artery of diameter 2.3-2.4mm, and hence, to measure PTAC for quantitative PET studies. To find the measurement time required to obtain reasonable counts for image reconstruction, the most important parameter is the sensitivity of the system. Usually small animal PET systems are characterized by using a point source in air. We used Electron Gamma Shower 5 (EGS5) code to simulate a point source at different positions inside the sensitive volume of tomograph and the axial and radial variations in the sensitivity are studied in air and phantom equivalent water cylinder. An average sensitivity difference of 34% in axial direction and 24.6% in radial direction is observed when point source is displaced inside water cylinder instead of air. PMID:24110223

  17. Choline molecular imaging with small-animal PET for monitoring tumor cellular response to photodynamic therapy of cancer

    NASA Astrophysics Data System (ADS)

    Fei, Baowei; Wang, Hesheng; Wu, Chunying; Meyers, Joseph; Xue, Liang-Yan; MacLennan, Gregory; Schluchter, Mark

    2009-02-01

    We are developing and evaluating choline molecular imaging with positron emission tomography (PET) for monitoring tumor response to photodynamic therapy (PDT) in animal models. Human prostate cancer (PC-3) was studied in athymic nude mice. A second-generation photosensitizer Pc 4 was used for PDT in tumor-bearing mice. MicroPET images with 11C-choline were acquired before PDT and 48 h after PDT. Time-activity curves of 11C-choline uptake were analyzed before and after PDT. For treated tumors, normalized choline uptake decreased significantly 48 h after PDT, compared to the same tumors pre-PDT (p <~ 0.001). However, for the control tumors, normalized choline uptake increased significantly (p <~ 0.001). PET imaging with 11C-choline is sensitive to detect early tumor response to PDT in the animal model of human prostate cancer.

  18. Cold wall effect eliminating method to determine the contrast recovery coefficient for small animal PET scanners using the NEMA NU-4 image quality phantom

    NASA Astrophysics Data System (ADS)

    Lajtos, Imre; Czernin, Johannes; Dahlbom, Magnus; Daver, Freddie; Emri, Miklos; Farshchi-Heydari, Salman; Forgacs, Attila; Hoh, Carl K.; Joszai, Istvan; Krizsan, Aron K.; Lantos, Judit; Major, Peter; Molnar, Jozsef; Opposits, Gabor; Tron, Lajos; Vera, David R.; Balkay, Laszlo

    2014-06-01

    The contrast recovery coefficients (CRC) were evaluated for five different small animal PET scanners: GE Explore Vista, Genisys4, MiniPET-2, nanoScan PC and Siemens Inveon. The NEMA NU-4 2008 performance test with the suggested image quality phantom (NU4IQ) does not allow the determination of the CRC values for the hot regions in the phantom. This drawback of NU4IQ phantom motivated us to develop a new method for this purpose. The method includes special acquisition and reconstruction protocols using the original phantom, and results in an artificially merged image enabling the evaluation of CRC values. An advantageous feature of this method is that it stops the cold wall effect from distorting the CRC calculation. Our suggested protocol results in a set of CRC values contributing to the characterization of small animal PET scanners. GATE simulations were also performed to validate the new method and verify the evaluated CRC values. We also demonstrated that the numerical values of this parameter depend on the actual object contrast of the hot region(s) and this mainly comes from the spillover effect. This effect was also studied while analysing the background activity level around the hot rods. We revealed that the calculated background mean values depended on the target contrast in a scanner specific manner. Performing the artificially merged imaging procedure and additional simulations using the micro hollow sphere (MHS) phantom geometry, we also proved that the inactive wall around the hot spheres can have a remarkable impact on the calculated CRC. In conclusion, we have shown that the proposed artificial merging procedure and the commonly used NU4IQ phantom prescribed by the NEMA NU-4 can easily deliver reliable CRC data otherwise unavailable for the NU4IQ phantom in the conventional protocol or the MHS phantom.

  19. (18)F-FDG PET/CT imaging in granulomatosis with polyangiitis.

    PubMed

    De Geeter, Frank; Gykiere, Pieterjan

    2016-01-01

    The paper gives an overview of the literature data on uptake of fluorine-18-fluorodeoxyglucose ((18)F-FDG) into the different tissue lesions which may occur in granulomatosis with polyangiitis (formerly called Wegener's syndrome). It discusses the cellular mechanisms of such (18)F-FDG uptake, which provide a basis for its interpretation in the context of (18)F-FDG positron emission tomography (PET) for inflammatory conditions. PMID:26929934

  20. The Evaluation of Cardiac Sarcoidosis with 18F-FDG PET.

    PubMed

    Al-Faham, Zaid; Jolepalem, Prashant; Oliver Wong, Ching Yee

    2016-06-01

    Cardiac involvement in sarcoidosis is associated with poor prognosis. (18)F-FDG PET can detect the presence of cardiac sarcoidosis, assess disease activity, and serve as a means to monitor treatment response in patients with cardiac sarcoidosis. PMID:26271805

  1. Reproducibility of 18F-FDG PET uptake measurements in head and neck squamous cell carcinoma on both PET/CT and PET/MR

    PubMed Central

    Fischer, B M; Aznar, M C; Hansen, A E; Vogelius, I R; Löfgren, J; Andersen, F L; Loft, A; Kjaer, A; Højgaard, L; Specht, L

    2015-01-01

    Objective: To investigate reproducibility of fluorine-18 fludeoxyglucose (18F-FDG) uptake on 18F-FDG positron emission tomography (PET)/CT and 18F-FDG PET/MR scans in patients with head and neck squamous cell carcinoma (HNSCC). Methods: 30 patients with HNSCC were included in this prospective study. The patients were scanned twice before radiotherapy treatment with both PET/CT and PET/MR. Patients were scanned on the same scanners, 3 days apart and according to the same protocol. Metabolic tumour activity was measured by the maximum and peak standardized uptake value (SUVmax and SUVpeak, respectively), and total lesion glycolysis from the metabolic tumour volume defined from ≥50% SUVmax. Bland–Altman analysis with limits of agreement, coefficient of variation (CV) from the two modalities were performed in order to test the reproducibility. Furthermore, CVs from SUVmax and SUVpeak were compared. The area under the curve from cumulative SUV–volume histograms were measured and tested for reproducibility of the distribution of 18F-FDG uptake. Results: 24 patients had two pre-treatment PET/CT scans and 21 patients had two pre-treatment PET/MR scans available for further analyses. Mean difference for SUVmax, peak and mean was approximately 4% for PET/CT and 3% for PET/MR, with 95% limits of agreement less than ±20%. CV was small (5–7%) for both modalities. There was no significant difference in CVs between PET/CT and PET/MR (p = 0.31). SUVmax was not more reproducible than SUVpeak (p = 0.09). Conclusion: 18F-FDG uptake in PET/CT and PET/MR is highly reproducible and we found no difference in reproducibility between PET/CT and PET/MR. Advances in knowledge: This is the first report to test reproducibility of PET/CT and PET/MR. PMID:25634069

  2. Breast Sparganosis Incidentally Detected by FDG PET/CT.

    PubMed

    Ha, Seunggyun; Oh, So Won; Kim, Yu Kyeong; Yi, Ann; Ahn, Young Joon

    2013-06-01

    Sparganosis is a rare, parasitic infection that is caused by the plercercoid tapeworm larvae of the genus Spirometra. Sparganosis is transmitted by ingestion of larvae-containing water or intermediate hosts, such as raw amphibians, and usually presented with a subcutaneous nodule in the abdominal wall, extremities, and genital organs. Among the various involved organs, the breast is a seldom encountered site for sparganosis. However, breast sparganosis has clinical importance, since it is generally presented with an indolent palpable mass that mimics malignancy, even without evidence of inflammation. Herein, we report a case of breast sparganosis that was detected incidentally by FDG PET/CT during staging work ups in a patient with gall bladder cancer. PMID:24900094

  3. A Case of Lung Squamous Cell Carcinoma With Duodenal Metastasis on FDG PET/CT.

    PubMed

    Cheng, Gang

    2016-08-01

    Non-small cell lung cancer (NSCLC) tends to have distant metastasis. However, metastasis from NSCLC to the small bowel is uncommon, and duodenal metastasis from NSCLC is extremely rare. FDG PET/CT findings of duodenal metastasis from NSCLC have not been reported in the literature. In this case, we report FDG PET/CT findings in a 61-year-old NSCLC patient with biopsy-proven metastasis in the transverse duodenum. PMID:27055139

  4. FDG PET/CT Evidence of Effective Treatment of Cardiac Sarcoidosis With Adalimumab.

    PubMed

    Miller, Christina T; Sweiss, Nadera J; Lu, Yang

    2016-05-01

    A 53-year-old man with mediastinal lymph node biopsy and cardiac MRI-proven cardiac sarcoidosis (CS) received treatment with pacemaker and steroids. FDG PET/CT showed active CS despite treatment with prednisone and methotrexate. Addition of weekly adalimumab (Humira) injections was introduced for 3 months. Follow-up FDG PET/CT showed complete resolution of CS as well as improvement of other sarcoid lesions in the thoracic lymph nodes. PMID:26828145

  5. MRI and FDG-PET/CT imaging in gynecological malignancies: the radiation oncology perspective.

    PubMed

    Fennell, Jamina; Scholber, Jutta; Grosu, Anca L; Volegova-Neher, Natalja; Henne, Karl; Langer, Mathias; Meyer, Philipp T; Gitsch, Gerald; Bartl, Nico

    2016-06-01

    MRI and FDG-PET imaging plays an important role in diagnosis, monitoring and follow-up of gynecological cancer. The goal of this paper was to summarize data of the literature about sensitivity and specificity of MRI and FDG-PET/CT for detection of primary tumor, lymph nodes invasion and metastases in cervix and endometrial cancer and to discuss their implication for radiation treatment planning and monitoring. PMID:26957003

  6. Wavelet denoising in voxel-based parametric estimation of small animal PET images: a systematic evaluation of spatial constraints and noise reduction algorithms

    NASA Astrophysics Data System (ADS)

    Su, Yi; Shoghi, Kooresh I.

    2008-11-01

    Voxel-based estimation of PET images, generally referred to as parametric imaging, can provide invaluable information about the heterogeneity of an imaging agent in a given tissue. Due to high level of noise in dynamic images, however, the estimated parametric image is often noisy and unreliable. Several approaches have been developed to address this challenge, including spatial noise reduction techniques, cluster analysis and spatial constrained weighted nonlinear least-square (SCWNLS) methods. In this study, we develop and test several noise reduction techniques combined with SCWNLS using simulated dynamic PET images. Both spatial smoothing filters and wavelet-based noise reduction techniques are investigated. In addition, 12 different parametric imaging methods are compared using simulated data. With the combination of noise reduction techniques and SCWNLS methods, more accurate parameter estimation can be achieved than with either of the two techniques alone. A less than 10% relative root-mean-square error is achieved with the combined approach in the simulation study. The wavelet denoising based approach is less sensitive to noise and provides more accurate parameter estimation at higher noise levels. Further evaluation of the proposed methods is performed using actual small animal PET datasets. We expect that the proposed method would be useful for cardiac, neurological and oncologic applications.

  7. Feasibility of FDG-PET/CT for the initial diagnosis of papillary thyroid cancer.

    PubMed

    Kim, Heejin; Na, Kyung Jin; Choi, Jae Hyuk; Ahn, Byeong-Cheol; Ahn, Dongbin; Sohn, Jin Ho

    2016-06-01

    To assess the role of [18F]-fluorodeoxyglucose (FDG) positron emission tomography-computed tomography (PET/CT) as a preoperative diagnostic tool in papillary thyroid carcinoma (PTC). From 2011 to 2014, 197 patients with PTC (246 tumor foci in all) underwent FDG-PET. Among these patients, 46 underwent neck dissection for lateral neck metastasis. According to the FDG avidity of the tumor foci or lateral neck metastasis, factors associated with the prognostic value were evaluated by univariate and multivariate logistic regression analyses. Among the 197 patients, 7 (3.6 %) were incidentally found to have non-thyroid origin malignancy. Additionally, 63.0 % (155/246) of PTC foci showed FDG uptake on PET/CT. Univariate analysis showed that the tumor size, the presence of extrathyroidal extension, BRAF mutation, and Hashimoto thyroiditis were associated with FDG avidity. However, except for pathological extrathyroidal extension, the other factors showed statistically significant correlations with FDG avidity (p < 0.001, p = 0.008, and p = 0.009, respectively). FDG uptake in lateral neck node metastasis showed high specificity and negative predictive value (NPV). In four cases of nonspecific findings on ultrasonography (USG)/CT, FDG avidity was helpful to diagnose the presence of lateral neck metastasis. The maximum standardized uptake value (SUVmax) of PET/CT was correlated with the maximum diameter of the involved lateral node. FDG avidity did not show any significance in the recurrence-free survival of both the thyroid tumor and lateral neck metastasis. The FDG avidity of PTC did not show prognostic predictive meaning. However, in the case of lateral neck metastasis, FDG avidity showed high sensitivity and NPV, and could provide better information in cases of nonspecific findings on USG and CT. PMID:25971994

  8. Characterization and optimization of image quality as a function of reconstruction algorithms and parameter settings in a Siemens Inveon small-animal PET scanner using the NEMA NU 4-2008 standards

    NASA Astrophysics Data System (ADS)

    Visser, Eric P.; Disselhorst, Jonathan A.; van Lier, Monique G. J. T. B.; Laverman, Peter; de Jong, Gabie M.; Oyen, Wim J. G.; Boerman, Otto C.

    2011-02-01

    The image reconstruction algorithms provided with the Siemens Inveon small-animal PET scanner are filtered backprojection (FBP), 3-dimensional reprojection (3DRP), ordered subset expectation maximization in 2 or 3 dimensions (OSEM2D/3D) and maximum a posteriori (MAP) reconstruction. This study aimed at optimizing the reconstruction parameter settings with regard to image quality (IQ) as defined by the NEMA NU 4-2008 standards. The NEMA NU 4-2008 image quality phantom was used to determine image noise, expressed as percentage standard deviation in the uniform phantom region (%STD unif), activity recovery coefficients for the FDG-filled rods (RC rod), and spill-over ratios for the non-radioactive water- and air-filled phantom compartments (SOR wat and SOR air). Although not required by NEMA NU 4, we also determined a contrast-to-noise ratio for each rod (CNR rod), expressing the trade-off between activity recovery and image noise. For FBP and 3DRP the cut-off frequency of the applied filters, and for OSEM2D and OSEM3D, the number of iterations was varied. For MAP, the "smoothing parameter" β and the type of uniformity constraint (variance or resolution) were varied. Results of these analyses were demonstrated in images of an FDG-injected rat showing tumours in the liver, and of a mouse injected with an 18F-labeled peptide, showing a small subcutaneous tumour and the cortex structure of the kidneys. Optimum IQ in terms of CNR rod for the small-diameter rods was obtained using MAP with uniform variance and β=0.4. This setting led to RC rod,1 mm=0.21, RC rod,2 mm=0.57, %STD unif=1.38, SOR wat=0.0011, and SOR air=0.00086. However, the highest activity recovery for the smallest rods with still very small %STD unif was obtained using β=0.075, for which these IQ parameters were 0.31, 0.74, 2.67, 0.0041, and 0.0030, respectively. The different settings of reconstruction parameters were clearly reflected in the rat and mouse images as the trade-off between the recovery of

  9. Wavelet-based regularization and edge preservation for submillimetre 3D list-mode reconstruction data from a high resolution small animal PET system

    NASA Astrophysics Data System (ADS)

    de Jesús Ochoa Domínguez, Humberto; Máynez, Leticia Ortega; Villegas, Osslan Osiris Vergara; Castillo, Nelly Gordillo; Sánchez, Vianey Guadalupe Cruz; Casas, Efrén David Gutiérrez

    2011-10-01

    The data obtained from a PET system tend to be noisy because of the limitations of the current instrumentation and the detector efficiency. This problem is particularly severe in images of small animals as the noise contaminates areas of interest within small organs. Therefore, denoising becomes a challenging task. In this paper, a novel wavelet-based regularization and edge preservation method is proposed to reduce such noise. To demonstrate this method, image reconstruction using a small mouse 18F NEMA phantom and a 18F mouse was performed. Investigation on the effects of the image quality was addressed for each reconstruction case. Results show that the proposed method drastically reduces the noise and preserves the image details.

  10. Prognostic value of interim and end-of-treatment FDG-PET in follicular lymphoma: a systematic review.

    PubMed

    Adams, Hugo J A; Nievelstein, Rutger A J; Kwee, Thomas C

    2016-01-01

    This study aimed to systematically review the prognostic value of interim and end-of-treatment (18)F-fluoro-2-deoxy-D-glucose positron emission tomography (FDG-PET) in follicular lymphoma during and after first-line therapy. The PubMed/MEDLINE database was searched for relevant original studies. Included studies were methodologically assessed, and their results were extracted and descriptively analyzed. Three studies on the prognostic value of interim FDG-PET and eight studies on the prognostic value of end-of-treatment FDG-PET were included. Overall, studies were of poor methodological quality. In addition, there was incomplete reporting of progression-free survival (PFS) and overall survival (OS) data by several studies, and none of the studies incorporated the Follicular Lymphoma International Prognostic Index (FLIPI) in the OS analyses. Two studies reported no significant difference in PFS between interim FDG-PET positive and negative patients, whereas one study reported a significant difference in PFS between the two groups. Two studies reported no significant difference in OS between interim FDG-PET positive and negative patients. Five studies reported end-of-treatment FDG-PET positive patients to have a significantly worse PFS than end-of-treatment FDG-PET negative patients, and one study reported a non-significant trend towards a worse PFS for end-of-treatment FDG-PET positive patients. Three studies reported end-of-treatment FDG-PET positive patients to have a significantly worse OS than end-of-treatment FDG-PET negative patients. In conclusion, the available evidence does not support the use of interim FDG-PET in follicular lymphoma. Although published studies suggest end-of-treatment FDG-PET to be predictive of PFS and OS, they suffer from numerous biases and failure to correct OS prediction for the FLIPI. PMID:26576560

  11. Pharmacological challenge and synaptic response - assessing dopaminergic function in the rat striatum with small animal single-photon emission computed tomography (SPECT) and positron emission tomography (PET).

    PubMed

    Nikolaus, Susanne; Larisch, Rolf; Vosberg, Henning; Beu, Markus; Wirrwar, Andreas; Antke, Christina; Kley, Konstantin; Silva, Maria Angelica De Souza; Huston, Joseph P; Müller, Hans-Wilhelm

    2011-01-01

    Disturbances of dopaminergic neurotransmission may be caused by changes in concentrations of synaptic dopamine (DA) and/or availabilities of pre- and post-synaptic transporter and receptor binding sites. We present a series of experiments which focus on the regulatory mechanisms of the dopamin(DA)ergic synapse in the rat striatum. In these studies, DA transporter (DAT) and/or D(2) receptor binding were assessed with either small animal single-photon emission computed tomography (SPECT) or positron emission tomography (PET) after pharmacological challenge with haloperidol, L-DOPA and methylphenidate, and after nigrostriatal 6-hydroxydopamine lesion. Investigations of DAT binding were performed with [(123)I]N-ω-fluoropropyl-2β-carbomethoxy-3β-(4-iodophenyl)nortropane ([(123)I]FP-CIT). D(2) receptor bindingd was assessed with either [(123)I](S)-2-hydroxy-3-iodo-6-methoxy-N-[(1-ethyl-2-pyrrolidinyl)methyl]benzamide ([(123)I]IBZM) or [(18)F]1[3-(4'fluorobenzoyl)propyl]-4-(2-keto-3-methyl-1-benzimidazolinyl)piperidine ([(18)F]FMB). Findings demonstrate that in vivo investigations of transporter and/or receptor binding are feasible with small animal SPECT and PET. Therefore, tracers that are radiolabeled with isotopes of comparatively long half-lives such as (123)I may be employed. Our approach to quantify DAT and/or D(2) receptor binding at baseline and after pharmacological interventions inducing DAT blockade, D(2) receptor blockade, and increases or decreases of endogenous DA concentrations holds promise for the in vivo assessment of synaptic function. This pertains to animal models of diseases associated with pre- or postsynaptic DAergic deficiencies such as Parkinson's disease, Huntington's disease, attention-deficit/hyperactivity disorder, schizophrenia or drug abuse. PMID:22103308

  12. Post-PET ultrasound improves specificity of 18F-FDG-PET for recurrent differentiated thyroid cancer while maintaining sensitivity

    PubMed Central

    Kråkenes, Jostein; Brauckhoff, Katrin; Haugland, Hans Kristian; Heinecke, Achim; Akslen, Lars A; Varhaug, Jan Erik; Brauckhoff, Michael

    2015-01-01

    Background Positron emission tomography (PET) using fluor-18-deoxyglucose (18F-FDG) with or without computed tomography (CT) is generally accepted as the most sensitive imaging modality for diagnosing recurrent differentiated thyroid cancer (DTC) in patients with negative whole body scintigraphy with iodine-131 (I-131). Purpose To assess the potential incremental value of ultrasound (US) over 18F-FDG-PET-CT. Material and Methods Fifty-one consecutive patients with suspected recurrent DTC were prospectively evaluated using the following multimodal imaging protocol: (i) US before PET (pre-US) with or without fine needle biopsy (FNB) of suspicious lesions; (ii) single photon emission computed tomography (≥3 GBq I-131) with co-registered CT (SPECT-CT); (iii) 18F-FDG-PET with co-registered contrast-enhanced CT of the neck; (iv) US in correlation with the other imaging modalities (post-US). Postoperative histology, FNB, and long-term follow-up (median, 2.8 years) were taken as composite gold standard. Results Fifty-eight malignant lesions were identified in 34 patients. Forty lesions were located in the neck or upper mediastinum. On receiver operating characteristics (ROC) analysis, 18F-FDG-PET had a limited lesion-based specificity of 59% at a set sensitivity of 90%. Pre-US had poor sensitivity and specificity of 52% and 53%, respectively, increasing to 85% and 94% on post-US, with knowledge of the PET/CT findings (P < 0.05 vs. PET and pre-US). Multimodal imaging changed therapy in 15 out of 51 patients (30%). Conclusion In patients with suspected recurrent DTC, supplemental targeted US in addition to 18F-FDG-PET-CT increases specificity while maintainin sensitivity, as non-malignant FDG uptake in cervical lesions can be confirmed. PMID:25770086

  13. The value of FDG-PET in the diagnosis of thromboangiitis obliterans--a case series.

    PubMed

    Hackl, Gerald; Milosavljevic, Robert; Belaj, Klara; Gary, Thomas; Rief, Peter; Hafner, Franz; Lipp, Rainer W; Brodmann, Marianne

    2015-04-01

    Thromboangiitis obliterans (TAO) is an inflammatory vascular disease affecting dominantly the vessels of the extremities and is etiologically strongly associated with tobacco consumption. Different imaging techniques are generally used to exclude potential differential diagnoses. We investigated the value of (18) F-flourodeoxyglucose positron emission tomography ([(18) F]FDG-PET) in the diagnosis of TAO. All consecutive patients with diagnosed TAO between Nov 2001 and Nov 2003 at our institution who underwent [(18) F]FDG-PET in the diagnostic workup were analyzed retrospectively. Whole-body scans were conducted after a fasting period of at least 6 h and blood glucose levels lower than 180 mg/dl. The primary endpoint was defined as significantly increased vascular FDG uptake. Tracer uptake was visually determined and, in accordance with strength, divided into grades 0 to 3. In total, ten patients were statistically evaluated. The median patient age at the date of the first [(18) F]FDG-PET was 41.5 years. Repetitive FDG-PET imaging was performed in seven out of ten patients (70 %). The endpoint was objectified in one of the initial examinations (10 %) and in another one out of seven follow-up scans (14.3 %). One positive [(18) F]FDG-PET was observed in the pelvic vessels and the other in the infrapopliteal arteries. Therefore, increased tracer uptake could be observed in two examinations on two different patients (both with grade 3 tracer uptake) out of 17 conducted [(18) F]FDG-PETs in total. The [(18) F]FDG-PET was not a suitable investigative procedure for the diagnosis of TAO in the present patient cohort. PMID:24794493

  14. Performance evaluation of principal component analysis in dynamic FDG-PET studies of recurrent colorectal cancer.

    PubMed

    Thireou, Trias; Strauss, Ludwig G; Dimitrakopoulou-Strauss, Antonia; Kontaxakis, George; Pavlopoulos, Sotiris; Santos, Andres

    2003-01-01

    Performance evaluation of principal component analysis (PCA) of dynamic F-18-FDG-PET studies of patients with recurrent colorectal cancer. Principal component images (PCI) of 17 iteratively reconstructed data sets were visually and quantitatively evaluated. The F-18-FDG compartment model parameters were estimated using polynomial regression. All structures were present in PCI1. PCI2 was correlated with the vascular component and PCI3 with the tumor. The vessel density in the tumor was estimated with a correlation coefficient equal to 0.834. PCA supports the visual interpretation of dynamic F-18-FDG-PET studies, facilitates the application of compartment modeling and is a promising quantification technique. PMID:12573889

  15. Primary Uterine Cervical Lymphoma Manifesting as Menolipsis Staged and Followed Up by FDG PET/CT.

    PubMed

    Zhou, Weiyan; Hua, Fengchun; Zuo, Chuantao; Guan, Yihui

    2016-07-01

    Primary uterine non-Hodgkin's lymphoma of the cervix is rare. We report a 31-year-old woman presented with menolipsis for 8 weeks. Transvaginal ultrasonography and pelvic MRI detected a solid cervical mass invading the adjacent vaginal wall. The lesion showed obvious FDG uptake on PET/CT scan, and malignancy was considered. It proved to be primary diffuse large B-cell lymphoma of the cervix by biopsy. After 6-cycle R-CHOP chemotherapy, no abnormal FDG uptake was found on another FDG PET/CT scan. PMID:27055133

  16. [A case of hepatocellular carcinoma with multiple lymph node metastases detected by FDG-PET].

    PubMed

    Ito, Tadao; Noguchi, Akinori; Shimizu, Takeshi; Tani, Naoki; Yamaguchi, Masahide; Okano, Shinji; Yamane, Tetsuro; Kawabata, Kenji

    2012-11-01

    We report a case of hepatocellular carcinoma (HCC) with multiple lymph node (LN) metastases. A 68-year-old man underwent hepatectomy at our hospital. Intrahepatic recurrence and swelling of multiple LNs were detected by enhanced CT 21 months later. FDG-PET was positive for multiple swollen LNs, but all were negative for the intrahepatic recurrences. Biopsy of para-aortic LNs was revealed LN metastases from HCC. Immunohistochemically, the LN metastases were composed of poorly differentiated HCC. The sensitivity of FDG-PET in patients with HCC varies in relation to degree of differentiation and decreased FDG uptake must be noted. PMID:23132040

  17. 18F-FDG PET/CT Demonstrating Malignant Degeneration of a Uterine Fibroid.

    PubMed

    Sharma, Punit

    2016-10-01

    Whereas benign leiomyoma of the uterus (fibroid) is very common, malignant degeneration of such fibroids to leiomyosarcoma is rare. Anatomical imaging with CT or MRI cannot differentiate between larger leiomyoma and leiomyosarcoma. Imaging with F-FDG PET/CT can be helpful in differentiating the two. High-grade F-FDG uptake in uterine fibroids is suspected and warrants surgical excision for further evaluation. We present such as case of a 42-year-old premenopausal woman where F-FDG PET/CT helped in making the diagnosis of malignant degeneration of uterine fibroid. PMID:27556790

  18. FDG-PET/CT in staging of clear cell odontogenic carcinoma.

    PubMed

    Krishnamoorthy, R; Ravi Kumar, A S; Batstone, M

    2014-11-01

    Clear cell odontogenic carcinoma (CCOC) is a rare neoplasm; only 75 cases have been reported in the English language literature. They have a tendency for recurrence and a capacity to metastasize. There is very little known regarding the metabolic features of this tumour or the utility of fluorodeoxyglucose positron emission tomography/computed tomography (FDG-PET/CT) scans in the staging and follow-up of these tumours. We present two cases of CCOC with their relevant FDG-PET/CT scan findings. The first patient had primary CCOC of the mandible that was FDG-avid, and the other had recurrence of CCOC of the anterior mandible and superomedial orbit that was not FDG-avid. FDG uptake in CCOC appears to be variable. Although FDG-PET/CT is useful in other head and neck cancers and has benefits compared to other imaging modalities, further studies are needed to investigate the sensitivity of FDG-PET/CT in CCOC. PMID:25015905

  19. FDG PET/CT Findings of Ménétrier Disease.

    PubMed

    Dong, Aisheng; Zhang, Ling; He, Tianlin; Zuo, Changjing

    2016-07-01

    Ménétrier disease is a very rare chronic gastric disorder characterized by gastric mucosal hypertrophy. We present a case of Ménétrier disease with CT, MRI, and FDG PET/CT findings. Enhanced CT and MRI showed diffuse thickened mucosa of the greater curvature and elongated mucosa of the antrum with remarkable enhancement. The early and delayed FDG PET/CT showed increased FDG uptake of these thickened mucosa. The increased FDG uptake may be due to the mucosal inflammation. This case indicates Ménétrier disease should be included in the differential diagnosis of abnormal gastric FDG accumulation along with tumor and nontumor processes. PMID:26825202

  20. Construction and tests of demonstrator modules for a 3-D axial PET system for brain or small animal imaging

    NASA Astrophysics Data System (ADS)

    Beltrame, P.; Bolle, E.; Braem, A.; Casella, C.; Chesi, E.; Clinthorne, N.; Cochran, E.; de Leo, R.; Dissertori, G.; Djambazov, G.; Fanti, V.; Honscheid, K.; Huh, S.; Johnson, I.; Joram, C.; Kagan, H.; Lustermann, W.; Meddi, F.; Nappi, E.; Nessi-Tedaldi, F.; Oliver, J. F.; Pauss, P.; Rafecas, M.; Renker, D.; Rudge, A.; Schinzel, D.; Schneider, T.; Seguinot, J.; Smith, S.; Solevi, P.; Stapnes, S.; Weilhammer, P.

    2011-04-01

    The design and construction of a PET camera module with high sensitivity, full 3-D spatial reconstruction and very good energy resolution is presented. The basic principle consists of an axial arrangement of long scintillation crystals around the Field Of View (FOV), providing a measurement of the transverse coordinates of the interacting 511 keV gamma ray. On top of each layer of crystals, an array of Wave-Length Shifter (WLS) strips, which collect the light leaving the crystals sideways, is positioned orthogonal to the crystal direction. The signals in the WLS strips allow a precise measurement of the z (axial) co-ordinate of the 511 keV γ-ray gamma impact. The construction of two modules used for demonstration of the concept is described. First preliminary results on spatial and energy resolution from one full module will be shown.

  1. Comparison of CE-FDG-PET/CT with CE-FDG-PET/MR in the evaluation of osseous metastases in breast cancer patients

    PubMed Central

    Catalano, O A; Nicolai, E; Rosen, B R; Luongo, A; Catalano, M; Iannace, C; Guimaraes, A; Vangel, M G; Mahmood, U; Soricelli, A; Salvatore, M

    2015-01-01

    Background: Despite improvements in treatments, metastatic breast cancer remains difficult to cure. Bones constitute the most common site of first-time recurrence, occurring in 40–75% of cases. Therefore, evaluation for possible osseous metastases is crucial. Technetium 99 (99Tc) bone scintigraphy and fluorodexossyglucose (FDG) positron emission tomography (PET)-computed tomography (PET-CT) are the most commonly used techniques to assess osseous metastasis. PET magnetic resonance (PET-MR) imaging is an innovative technique still under investigation. We compared the capability of PET-MR to that of same-day PET-CT to assess osseous metastases in patients with breast cancer. Methods: One hundred and nine patients with breast cancer, who underwent same-day contrast enhanced (CE)-PET-CT and CE-PET-MR, were evaluated. CE-PET-CT and CE-PET-MR studies were interpreted by consensus by a radiologist and a nuclear medicine physician. Correlations with prior imaging and follow-up studies were used as the reference standard. Binomial confidence intervals and a χ2 test were used for categorical data, and paired t-test was used for the SUVmax data; a non-informative prior Bayesian approach was used to estimate and compare the specificities. Results: Osseous metastases affected 25 out 109 patients. Metastases were demonstrated by CE-PET-CT in 22 out of 25 patients (88%±7%), and by CE-PET-MR in 25 out of 25 patients (100%). CE-PET-CT revealed 90 osseous metastases and CE-PET-MR revealed 141 osseous metastases (P<0.001). The estimated sensitivity of CE-PET-CT and CE-PET-MR were 0.8519 and 0.9630, respectively. The estimated specificity for CE-FDG-PET-MR was 0.9884. The specificity of CE-PET-CT cannot be determined from patient-level data, because CE-PET-CT yielded a false-positive lesion in a patient who also had other, true metastases. Conclusions: CE-PET-MR detected a higher number of osseous metastases than did same-day CE-PET-CT, and was positive for 12% of the patients

  2. FDG PET with contrast-enhanced CT: a critical imaging tool for laryngeal carcinoma.

    PubMed

    Chu, Mae Mae A Y; Kositwattanarerk, Arpakorn; Lee, David J; Makkar, Jasnit S; Genden, Eric M; Kao, Johnny; Packer, Stuart H; Som, Peter M; Kostakoglu, Lale

    2010-09-01

    Fluorine 18 fluorodeoxyglucose (FDG) positron emission tomography (PET) has evolved to be an essential imaging modality in the evaluation of laryngeal carcinoma. Although the modality has limited utility in assessing the extent of the primary tumor, FDG PET has proved to be superior to anatomic modalities in the detection of lymph node and distant metastases. The role of FDG PET in the evaluation of patients with laryngeal tumors that are clinically classified as N0 has not shown consistent usefulness because of the innate resolution limitations of the camera. In the posttherapy setting, however, FDG PET has consistently demonstrated a high negative predictive value in the identification of recurrent disease, both during the course of therapy and during long-term follow-up. In addition, contrast material-enhanced computed tomography (CT) in conjunction with FDG PET has demonstrated a complementary role by allowing for superior anatomic coregistration and therefore more definitive diagnosis. There is sufficient evidence that with further advances in PET technology, this modality will likely become more useful in the detection of small lesions and occult nodal disease, as well as in guiding the management of laryngeal carcinoma. PMID:20833855

  3. Nuclear Medicine Imaging of Infection in Cancer Patients (With Emphasis on FDG-PET)

    PubMed Central

    Vos, Fidel J.; van der Graaf, Winette T.A.; Oyen, Wim J.G.

    2011-01-01

    Infections are a common cause of death and an even more common cause of morbidity in cancer patients. Timely and adequate diagnosis of infection is very important. This article provides clinicians as well as nuclear medicine specialists with a concise summary of the most important and widely available nuclear medicine imaging techniques for infectious and inflammatory diseases in cancer patients with an emphasis on fluorodeoxyglucose positron emission tomography (FDG-PET). 67Ga-citrate has many unfavorable characteristics, and the development of newer radiopharmaceuticals has resulted in the replacement of 67Ga-citrate scintigraphy by scintigraphy with labeled leukocytes or FDG-PET for the majority of conditions. The sensitivity of labeled leukocyte scintigraphy in non-neutropenic cancer patients is comparable with that in patients without malignancy. The specificity, however, is lower because of the uptake of labeled leukocytes in many primary tumors and metastases, most probably as a result of their inflammatory component. In addition, labeled leukocyte scintigraphy cannot be used for febrile neutropenia because of the inability to harvest sufficient peripheral leukocytes for in vitro labeling. FDG-PET has several advantages over these conventional scintigraphic techniques. FDG-PET has shown its usefulness in diagnosing septic thrombophlebitis in cancer patients. It has also been shown that imaging of infectious processes using FDG-PET is possible in patients with severe neutropenia. Although larger prospective studies examining the value of FDG-PET in cancer patients suspected of infection, especially in those with febrile neutropenia, are needed, FDG-PET appears to be the most promising scintigraphic technique for the diagnosis of infection in this patient group. PMID:21680576

  4. Extramedullary Involvement of Mast Cell Leukemia Detected by 18F-FDG PET/CT.

    PubMed

    Fu, Zhanli; Zhang, Jin; Liu, Meng; Li, Ziao; Li, Qian

    2016-07-01

    Mast cell leukemia (MCL) is a very rare subtype of systemic mastocytosis, characterized by the leukemic expansion of immature mast cells. We present a case of MCL with extramedullary involvement of cervical lymph node and lung demonstrated by the initial F-FDG PET/CT scan. After a transient complete remission by induction chemotherapy and allogeneic hematopoietic stem cell transplantation, the follow-up PET/CT showed extensive extramedullary relapse involving multiple lymph nodes and small bowel. F-FDG PET/CT may be a useful tool to comprehensively stage and follow-up MCL. PMID:26975014

  5. Segmental "misty mesentery" on FDG PET/CT: an uncommon manifestation of mesenteric lymphoma.

    PubMed

    Puranik, Ameya D; Purandare, Nilendu C; Agrawal, Archi; Shah, Sneha; Rangarajan, Venkatesh

    2014-01-01

    Mesenteric lymphomas are commonly seen as bulky hypermetabolic nodal masses on F-FDG PET/CT. Very rarely, these are seen as mesenteric haziness due to localized hyperattenuation of fat, known as "misty mesentery", which morphological imaging-wise has other differentials as well. We report a unique imaging finding of segmental misty mesentery with hypermetabolic mesenteric nodes on FDG PET/CT in a patient who was kept on observation due to inconclusive biopsy, which on follow-up imaging progressed to extensive lymphomatous involvement. Thus, in retrospect, this imaging feature on baseline PET/CT was diagnostic for mesenteric lymphoma. PMID:23797224

  6. Primary Liver Carcinosarcoma and 18F-FDG PET/CT.

    PubMed

    Li, Beilei; Zhang, Yiqiu; Hou, Jun; Yu, Haojun; Shi, Hongcheng

    2016-08-01

    Primary liver carcinosarcoma is a very rare, malignant neoplasm that is concomitantly composed of a mixture of sarcomatous and carcinomatous elements. In the present study, an initial staging FDG PET/CT showed intense FDG uptake in a patient with liver carcinosarcoma composed of hepatocellular carcinoma and rhabdomyosarcoma. Two months after surgical resection, a restaging PET/CT showed rapid progression of the disease with abdominal and lung metastases, indicating aggressive feature of the disease. The case shows the importance to repeat a restaging PET/CT at early time after surgery for a patient with liver carcinosarcoma to monitor disease progression. PMID:27280902

  7. fdg-pet in two cases of neurofibromatosis type 1 and atypical malignancies

    PubMed Central

    de Blank, P.; Cole, K.; Kersun, L.; Green, A.; Wilkes, J.J.; Belasco, J.; Bagatell, R.; Bailey, L.C.; Fisher, M.J.

    2014-01-01

    Patients with neurofibromatosis type 1 (nf1) are at increased risk for both benign and malignant tumours, and distinguishing the malignant potential of an individual tumour is a common clinical problem in these patients. Here, we review two cases of uncommon malignancies (Hodgkin lymphoma and mediastinal germ-cell tumour) in patients with nf1. Although 18F-fluorodeoxyglucose positron-emission tomography (fdg-pet) has been used to differentiate benign neurofibromas from malignant peripheral nerve sheath tumours, fdg-pet characteristics for more rare tumours have been poorly described in children with nf1. Here, we report the role of pet imaging in clinical decision-making in each case. In nf1, fdg-pet might be useful in the clinical management of unusual tumour presentations and might help to provide information about the malignant potential of uncommon tumours. PMID:24764718

  8. Evaluation of brain SERT occupancy by resveratrol against MDMA-induced neurobiological and behavioral changes in rats: A 4-[¹⁸F]-ADAM/small-animal PET study.

    PubMed

    Shih, Jui-Hu; Ma, Kuo-Hsing; Chen, Chien-Fu F; Cheng, Cheng-Yi; Pao, Li-Heng; Weng, Shao-Ju; Huang, Yuahn-Sieh; Shiue, Chyng-Yann; Yeh, Ming-Kung; Li, I-Hsun

    2016-01-01

    The misuse of 3,4-methylenedioxymethamphetamine (MDMA) has drawn a growing concern worldwide for its psychophysiological impacts on humans. MDMA abusers are often accompanied by long-term serotonergic neurotoxicity, which is associated with reduced density of cerebral serotonin transporters (SERT) and depressive disorders. Resveratrol (RSV) is a natural polyphenolic phytoalexin that has been known for its antidepressant and neuroprotective effects. However, biological targets of RSV as well as its neuroprotective effects against MDMA remained largely unknown. In this study, we examined binding potency of RSV and MDMA to SERT using small-animal positron emission tomography (PET) with the SERT radioligand, N,N-dimethyl-2-(2-amino-4-[(18)F]fluorophenylthio)benzylamine (4-[(18)F]-ADAM) and investigated the protection of RSV against the acute and long-term adverse effects of MDMA. We found that RSV exhibit binding potentials to SERT in vivo in a dose-dependent manner with variation among brain regions. When the MDMA-treated rats (10mg/kg, s.c.) were co-injected with RSV (20mg/kg, i.p.) twice daily for 4 consecutive days, MDMA-induced acute elevation in plasma corticosterone was significantly reduced. Further, 4-[(18)F]-ADAM PET imaging revealed that RSV protected against the MDMA-induced decrease in SERT availability in the midbrain and the thalamus 2 weeks following the co-treatment. The PET data were comparable to the observation from the forced swim test that RSV sufficiently ameliorated the depressive-like behaviors of the MDMA-treated rats. Together, these findings suggest that RSV is a potential antidepressant and may confer protection against neurobiological and behavioral changes induced by MDMA. PMID:26612383

  9. The Potential Roles of 18F-FDG-PET in Management of Acute Stroke Patients

    PubMed Central

    Bunevicius, Adomas; Yuan, Hong

    2013-01-01

    Extensive efforts have recently been devoted to developing noninvasive imaging tools capable of delineating brain tissue viability (penumbra) during acute ischemic stroke. These efforts could have profound clinical implications for identifying patients who may benefit from tPA beyond the currently approved therapeutic time window and/or patients undergoing neuroendovascular treatments. To date, the DWI/PWI MRI and perfusion CT have received the most attention for identifying ischemic penumbra. However, their routine use in clinical settings remains limited. Preclinical and clinical PET studies with [18F]-fluoro-2-deoxy-D-glucose (18F-FDG) have consistently revealed a decreased 18F-FDG uptake in regions of presumed ischemic core. More importantly, an elevated 18F-FDG uptake in the peri-ischemic regions has been reported, potentially reflecting viable tissues. To this end, this paper provides a comprehensive review of the literature on the utilization of 14C-2-DG and 18F-FDG-PET in experimental as well as human stroke studies. Possible cellular mechanisms and physiological underpinnings attributed to the reported temporal and spatial uptake patterns of 18F-FDG are addressed. Given the wide availability of 18F-FDG in routine clinical settings, 18F-FDG PET may serve as an alternative, non-invasive tool to MRI and CT for the management of acute stroke patients. PMID:23762852

  10. The Effect of Endogenous Adenosine on Neuronal Activity in Rats: An FDG PET Study.

    PubMed

    Parkinson, Fiona E; Paul, Soumen; Zhang, Dali; Mzengeza, Shadreck; Ko, Ji Hyun

    2016-07-01

    2-(18) F-fluorodeoxy-D-glucose (FDG) is a glucose analog that is taken up by cells and phosphorylated. The amount of FDG accumulated by cells is a measure of the rate of glycolysis, which reflects cellular activity. As the levels and actions of the neuromodulator adenosine are dynamically regulated by neuronal activity, this study was designed to test whether endogenous adenosine affects tissue accumulation of FDG as assessed by positron emission tomography (PET) or by postmortem analysis of tissue radioactivity. Rats were given an intraperitoneal injection of the adenosine A1 receptor antagonist 8-cyclopentyl-1,3-dipropyl-xanthine (DPCPX, 3 mg/kg), the adenosine kinase inhibitor ABT-702 (3 mg/kg), or vehicle 10 minutes prior to an intravenous injection of FDG (15.4 ± 0.7 MBq per rat). Rats were then subjected to a 15 minute static PET scan. Reconstructed images were normalized to FDG PET template for rats and standard uptake values (SUVs) were calculated. To examine the regional effect of active treatment compared to vehicle, statistical parametric mapping analysis was performed. Whole-brain FDG uptake was not affected by drug treatment. Significant regional hypometabolism was detected, particularly in cerebellum, of DPCPX- and ABT-702 treated rats, relative to vehicle-treated rats. Thus, endogenous adenosine can affect FDG accumulation although this effect is modest in quiescent rats. PMID:27082948

  11. The Role of 18F-FDG PET/CT Integrated Imaging in Distinguishing Malignant from Benign Pleural Effusion

    PubMed Central

    Sun, Yajuan; Yu, Hongjuan; Ma, Jingquan

    2016-01-01

    Objective The aim of our study was to evaluate the role of 18F-FDG PET/CT integrated imaging in differentiating malignant from benign pleural effusion. Methods A total of 176 patients with pleural effusion who underwent 18F-FDG PET/CT examination to differentiate malignancy from benignancy were retrospectively researched. The images of CT imaging, 18F-FDG PET imaging and 18F-FDG PET/CT integrated imaging were visually analyzed. The suspected malignant effusion was characterized by the presence of nodular or irregular pleural thickening on CT imaging. Whereas on PET imaging, pleural 18F-FDG uptake higher than mediastinal activity was interpreted as malignant effusion. Images of 18F-FDG PET/CT integrated imaging were interpreted by combining the morphologic feature of pleura on CT imaging with the degree and form of pleural 18F-FDG uptake on PET imaging. Results One hundred and eight patients had malignant effusion, including 86 with pleural metastasis and 22 with pleural mesothelioma, whereas 68 patients had benign effusion. The sensitivities of CT imaging, 18F-FDG PET imaging and 18F-FDG PET/CT integrated imaging in detecting malignant effusion were 75.0%, 91.7% and 93.5%, respectively, which were 69.8%, 91.9% and 93.0% in distinguishing metastatic effusion. The sensitivity of 18F-FDG PET/CT integrated imaging in detecting malignant effusion was higher than that of CT imaging (p = 0.000). For metastatic effusion, 18F-FDG PET imaging had higher sensitivity (p = 0.000) and better diagnostic consistency with 18F-FDG PET/CT integrated imaging compared with CT imaging (Kappa = 0.917 and Kappa = 0.295, respectively). The specificities of CT imaging, 18F-FDG PET imaging and 18F-FDG PET/CT integrated imaging were 94.1%, 63.2% and 92.6% in detecting benign effusion. The specificities of CT imaging and 18F-FDG PET/CT integrated imaging were higher than that of 18F-FDG PET imaging (p = 0.000 and p = 0.000, respectively), and CT imaging had better diagnostic consistency with

  12. FDG PET in the evaluation of the aggressiveness of pulmonary adenocarcinoma: correlation with histopathological features.

    PubMed

    Higashi, K; Ueda, Y; Ayabe, K; Sakurai, A; Seki, H; Nambu, Y; Oguchi, M; Shikata, H; Taki, S; Tonami, H; Katsuda, S; Yamamoto, I

    2000-08-01

    2-[Fluorine-18]fluoro-2-deoxy-d-glucose (FDG) uptake within the primary lesion correlates with survival on positron emission tomography (PET) studies of patients with non-small cell lung cancer. The more metabolically active the tumour, the worse the outcome. The aim of this study was to determine whether a correlation exists between aggressiveness as determined by pathology and the findings of FDG PET in pulmonary adenocarcinoma. Thirty-five patients with 38 adenocarcinomas of the lung were studied. All patients underwent thoracotomy within 4 weeks of the FDG PET study. For semiquantitative analysis, standardized uptake values (SUVs) were calculated. Patients were classified into high SUV (> or = 4.0) and low SUV (<4.0) groups. The degree of FDG uptake (SUVs) in primary lung lesions was correlated with the histopathological features of aggressiveness (pleural involvement, vascular invasion or lymphatic permeation). The mean SUV of aggressive adenocarcinomas (4.36+/-1.94, n = 22) was higher than that of non-aggressive ones (1.53+/-0.88, n = 16) (P < 0.0001). Tumours with a high FDG uptake have a significantly higher likelihood of aggressiveness than those with a low FDG uptake (P = 0.0004). Analysis by the Kaplan-Meier methods revealed that the groups had different prognoses (log-rank test, P = 0.0099). The high SUV group had a significantly worse prognosis. In conclusion, a correlation was seen between aggressiveness as determined by pathology and glucose metabolism as measured by FDG PET in adenocarcinoma of the lung. FDG PET may be used as a non-invasive diagnostic technique in measuring aggressiveness and prognosis in patients with pulmonary adenocarcinoma. PMID:11039452

  13. Clinical significance of incidental FDG uptake in the prostate gland detected by PET/CT

    PubMed Central

    Sahin, Ertan; Elboga, Umut; Kalender, Ebuzer; Basıbuyuk, Mustafa; Demir, Hasan Deniz; Celen, Yusuf Zeki

    2015-01-01

    The value of FDG-positron emission tomography/computed tomography (PET/CT) for detecting prostate cancer is unknown. We aimed to investigate the clinical value of incidental prostate FDG uptake on PET/CT scans. We reviewed 6128 male patients who underwent FDG-PET/CT scans and selected cases that reported hypermetabolic lesion in the prostate. The patients who have prior history of prostate carcinoma or prostate surgery were excluded from the study. We have analyzed the correlation between PET/CT findings and serum prostate-specific antigen (PSA) levels, imaging (USG), urological examinations and biopsy. Incidental 18F-FDG uptake of the prostate gland was observed in 79 patients (1.3%). While sixteen of them were excluded due to inadequate clinical data, the remaining 63 patients were included for further analysis. The patients were divided into two groups; 8 patients (12.7%) in the malignant group and 55 patients (87.3%) in the benign group. The SUVmax values were not significantly different between the two groups. In 6 (75%) patients with prostate cancer, FDG uptake was observed focally in the peripheral zone of the prostate glands. There was no significant correlation between the SUVmax and the PSA levels. Incidental 18F-FDG uptake in the prostate gland is a rare condition, but a substantial portion of it is associated with the cancer. Benign and malignant lesions of the prostate gland in FDG-PET/CT imaging could not be reliably distinguished. The peripheral focally FDG uptake of prostate glands should be further examined with the clinical and labaratory evaluations. PMID:26379847

  14. [Technical Approaches for Quantitative Treatment Responses Using 18F-FDG PET].

    PubMed

    Miwa, Kenta; Miyaji, Noriaki; Umeda, Takuro; Murata, Taisuke; Wagatsuma, Kei; Sasaki, Masayuki

    2015-01-01

    Quantitative assessment of 18F-FDG PET can predict treatment responses or outcomes. Here, I briefly describe some world trends in standardizing PET images for image-based assessments of treatment responses, followed by present and future strategies for defining the optimal acquisition conditions for quantitative PET imaging. Finally, information is provided about new technical approaches to improving the quantitation of semi-quantitative indexes such as point spread function, time-of-flight and respiratory gating. PMID:26753394

  15. Hybrid 18F-FDG PET-MRI of the hand in rheumatoid arthritis: initial results.

    PubMed

    Miese, Falk; Scherer, Axel; Ostendorf, Benedikt; Heinzel, Alexander; Lanzman, Rotem S; Kröpil, Patric; Blondin, Dirk; Hautzel, Hubertus; Wittsack, Hans-Jörg; Schneider, Matthias; Antoch, Gerald; Herzog, Hans; Shah, N Jon

    2011-09-01

    18F-fluorodeoxyglucose PET (18F-FDG PET) is highly sensitive to inflammatory changes within the synovial tissue in rheumatoid arthritis (RA). However, the highest spatial resolution for soft tissue can be achieved with MRI. Here, we report on the first true hybrid PET-MRI examination of the hand in early RA exploiting the advantages of both modalities. PET-MRI was performed with a prototype of an APD-based magneto-insensitive BrainPET detector (Siemens Healthcare, Erlangen, Germany) operated within a standard 3T MR scanner (MAGNETOM Trio, Siemens). PET images were normalized, random, attenuation and scatter-corrected, iteratively reconstructed and calibrated to yield standardized uptake values (SUV) of 18F-FDG uptake. T1-weighted TSE in coronal as well as sagittal orientation prior to and following Gadolinium administration were acquired. Increased 18F-FDG uptake was present in synovitis and tenovaginitis as identified on contrast-enhanced MRI. The tracer distribution was surrounding the metacarpophalangeal joints II and III. Maximum SUV of 3.1 was noted. In RA, true hybrid 18F-FDG PET-MRI of the hand is technically feasible and bears the potential to directly visualize inflammation. PMID:21590292

  16. Does Delayed-Time-Point Imaging Improve 18F-FDG-PET in Patients With MALT Lymphoma?

    PubMed Central

    Mayerhoefer, Marius E.; Giraudo, Chiara; Senn, Daniela; Hartenbach, Markus; Weber, Michael; Rausch, Ivo; Kiesewetter, Barbara; Herold, Christian J.; Hacker, Marcus; Pones, Matthias; Simonitsch-Klupp, Ingrid; Müllauer, Leonhard; Dolak, Werner; Lukas, Julius; Raderer, Markus

    2016-01-01

    Purpose To determine whether in patients with extranodal marginal zone B-cell lymphoma of the mucosa-associated lymphoid tissue lymphoma (MALT), delayed–time-point 2-18F-fluoro-2-deoxy-d-glucose-positron emission tomography (18F-FDG-PET) performs better than standard–time-point 18F-FDG-PET. Materials and Methods Patients with untreated histologically verified MALT lymphoma, who were undergoing pretherapeutic 18F-FDG-PET/computed tomography (CT) and consecutive 18F-FDG-PET/magnetic resonance imaging (MRI), using a single 18F-FDG injection, in the course of a larger-scale prospective trial, were included. Region-based sensitivity and specificity, and patient-based sensitivity of the respective 18F-FDG-PET scans at time points 1 (45–60 minutes after tracer injection, TP1) and 2 (100–150 minutes after tracer injection, TP2), relative to the reference standard, were calculated. Lesion-to-liver and lesion-to-blood SUVmax (maximum standardized uptake values) ratios were also assessed. Results 18F-FDG-PET at TP1 was true positive in 15 o f 23 involved regions, and 18F-FDG-PET at TP2 was true-positive in 20 of 23 involved regions; no false-positive regions were noted. Accordingly, region-based sensitivities and specificities were 65.2% (confidence interval [CI], 45.73%–84.67%) and 100% (CI, 100%-100%) for 18F-FDG-PET at TP1; and 87.0% (CI, 73.26%–100%) and 100% (CI, 100%-100%) for 18F-FDG-PET at TP2, respectively. FDG-PET at TP1 detected lymphoma in at least one nodal or extranodal region in 7 of 13 patients, and 18F-FDG-PET at TP2 in 10 of 13 patients; accordingly, patient-based sensitivity was 53.8% (CI, 26.7%–80.9%) for 18F-FDG-PET at TP1, and 76.9% (CI, 54.0%–99.8%) for 18F-FDG-PET at TP2. Lesion-to-liver and lesion-to-blood maximum standardized uptake value ratios were significantly lower at TP1 (ratios, 1.05 ± 0.40 and 1.52 ± 0.62) than at TP2 (ratios, 1.67 ± 0.74 and 2.56 ± 1.10; P = 0.003 and P = 0.001). Conclusions Delayed–time-point imaging

  17. 11C-Choline and FDG PET/CT Imaging of Primary Cholangiocarcinoma: A Comparative Analysis

    PubMed Central

    Chotipanich, Chanisa; Promteangtrong, Chetsadaporn; Kunawudhi, Anchisa; Chanwat, Rawisak; Sricharunrat, Thaniya; Suratako, Savitree; Wongsa, Paramest

    2015-01-01

    Objective(s): This study aimed to compare the diagnostic values of 11C-choline and 18F-fluorodeoxyglucose (18F-FDG) positron emission tomography/computed tomography (PET/CT) in patients with cholangiocarcinoma (CCA). Methods: This prospective study was conducted on 10 patients (6 males and 4 females), aged 42-69 years, suspected of having CCA based on CT or magnetic resonance imaging (MRI) results. 11C-choline and 18F-FDG PET/CT studies were performed in all patients over 1 week. PET/CT results were visually analyzed by 2 independent nuclear medicine physicians and quantitatively by calculating the tumor-to-background ratio (T/B). Results: No 11C-choline PET/CT uptake was observed in primary extrahepatic or intrahepatic CCA cases. Intense 18F-FDG avidity was detected in the tumors of 8 patients (%80). Two patients, who were 18F-FDG negative, had primary extrahepatic CCA. Ki-67 measurements were positive in all patients (range; 14.2%-39.9%). The average T/B values of 11C-choline and 18F-FDG were 0.4±0.2 and 2.0±1.0 in all cases of primary CCA, respectively; these values were significantly lower for 11C-choline (P<0.005). Both FDG and 11C-choline PET/CT detected metastatic CCA foci in all 8 patients (two patients had no metastases). Conclusion: As the results suggested, primary CCA lesions showed a poor avidity for 11C-choline, whereas 18F-FDG PET/CT was of value for the detection of most primary CCA cases. In contrast to primary lesions, metastatic CCA lesions showed 11C-choline avidity.

  18. Correlation of PET and AMS analyses for early kinetics of 2-fluoro-2-deoxyglucose (FDG)

    NASA Astrophysics Data System (ADS)

    Minamimoto, Ryogo; Hamabe, Yoshimi; Miyaoka, Teiji; Theeraladanon, Chumpol; Oka, Takashi; Matsui, Takao; Inoue, Tomio

    2010-04-01

    The draft of the guidelines for microdosing in clinical trials was published in Japan in 2008 following the guidelines of the European Medicines Agency (EMEA) and the Food and Drug Administration (FDA). It recommends utilizing accelerator mass spectrometry (AMS), liquid chromatography/mass spectrometry (LC/MS/MS), and positron emission tomography (PET) for monitoring drug metabolites in preclinical studies. In this study, we clarified the correlation in measuring result between PET and AMS. The AMS measurement was undergone by using AMS system of Institute of Accelerator Analysis Ltd. (IAA, Kawasaki, Japan). First the back ground 14C level of blood in mice was measured by AMS. Second, we clarified the relationship between AMS and PET by using 2-fluoro-2-deoxyglucose (FDG). The correlation coefficient ( r) of the measurements using PET ( 18F-FDG) and AMS ( 14C-FDG) were quite high at 0.97 ( Y = 7.54 E - 05 X + 0.02, p < 0.001). The blood clearance profile of 18F-FDG was nearly identical with that of 14C-FDG. These results indicate that the AMS analysis has excellent correlation with the PET method.

  19. Optimal feature selection for automated classification of FDG-PET in patients with suspected dementia

    NASA Astrophysics Data System (ADS)

    Serag, Ahmed; Wenzel, Fabian; Thiele, Frank; Buchert, Ralph; Young, Stewart

    2009-02-01

    FDG-PET is increasingly used for the evaluation of dementia patients, as major neurodegenerative disorders, such as Alzheimer's disease (AD), Lewy body dementia (LBD), and Frontotemporal dementia (FTD), have been shown to induce specific patterns of regional hypo-metabolism. However, the interpretation of FDG-PET images of patients with suspected dementia is not straightforward, since patients are imaged at different stages of progression of neurodegenerative disease, and the indications of reduced metabolism due to neurodegenerative disease appear slowly over time. Furthermore, different diseases can cause rather similar patterns of hypo-metabolism. Therefore, classification of FDG-PET images of patients with suspected dementia may lead to misdiagnosis. This work aims to find an optimal subset of features for automated classification, in order to improve classification accuracy of FDG-PET images in patients with suspected dementia. A novel feature selection method is proposed, and performance is compared to existing methods. The proposed approach adopts a combination of balanced class distributions and feature selection methods. This is demonstrated to provide high classification accuracy for classification of FDG-PET brain images of normal controls and dementia patients, comparable with alternative approaches, and provides a compact set of features selected.

  20. [SPECT and FDG-PET in diagnostics of neurolues].

    PubMed

    Pichler, Robert; Doppler, Stefan; Szalay, Elisabeth; Hertl, Christine; Knell, Ulrich; Winkler, Johanna

    2008-01-01

    Syphilis is a recurrent treponematosis of acute and chronic evolution. In general it is either sexually or congenitally transmitted. Primary syphilis appears as a single and painless lesion. Secondary syphilis may manifest years later, the secondary bacteremic stage is accompanied by generalized mucocutaneous lesions. Tertiary disease can be disseminated to bones and virtually any organ, involving principally the ascending aorta and the central nervous system. Nuclear medicine provides diagnostic methods in case of skeletal manifestations by bone scan - identifying periostitis and osteomyelitis. Hepatic gummas can be imaged by 99m-Tc-colloid liver scintigraphy. In neurosyphilis brain perfusion SPECT enables imaging of cerebral involvement by small vessel endarteritis resulting from syphilitic vascular disease. 18-FDG PET is also useful to evaluate neurosyphilis, a reduction of brain glucose consumption is observed. The technique adequately enables imaging of therapeutic response and might be superior to morphologic imaging. We present our experiences with these nuclear medicine methods in patients with neurolues. The incidence of neurolues is estimated at 2 per 100.000 inhabitants worldwide, migration processes might bring a re-emergence of this disease to Austria and other developed countries of the EU. Scintigraphic methods should be kept in mind for diagnostic evaluation of neurosyphilis. PMID:19066767

  1. Exploring Small Animal Care. Teacher's Guide.

    ERIC Educational Resources Information Center

    Livesey, Dennis W.

    This course guide in small animal care is designed to give students seeking employment in veterinary hospitals, kennels, or pet shops an opportunity to (1) develop basic skills in small animal handling, sanitation of housing, and nutrition, (2) acquire skills in dog and cat grooming, including shop operation, (3) develop attitudes which contribute…

  2. High School Small Animal Laboratory--Business

    ERIC Educational Resources Information Center

    Penn, Alan

    1974-01-01

    An Ohio vocational school Small Animal Care program prepares students for entry level employment as veterinary assistants, pet shop salesmen, kennel workers, animal groomers, Humane Society workers, laboratory animal assistants, and riding stable assistants. (EA)

  3. 18F-FDG PET/CT Prediction of an Aggressive Clinical Course for Dermatofibrosarcoma Protuberans.

    PubMed

    Basu, Sandip; Goliwale, Fahim

    2016-06-01

    The ability to assess tumor biology is a benefit of molecular imaging with (18)F-FDG PET/CT, which performs better than anatomic imaging in evaluating malignancies. We present an unusual case of fatal dermatofibrosarcoma protuberans, a usually indolent entity for which high-grade (18)F-FDG uptake was predictive of an aggressive clinical course unabated by tyrosine kinase inhibitor imatinib mesylate, to which the patient showed a poor response. PMID:26338485

  4. Basic performance evaluation of a Si-PM array-based LGSO phoswich DOI block detector for a high-resolution small animal PET system.

    PubMed

    Yamamoto, Seiichi

    2013-07-01

    The silicon photomultiplier (Si-PM) is a promising photodetector for PET. However, it remains unclear whether Si-PM can be used for a depth-of-interaction (DOI) detector based on the decay time differences of the scintillator where pulse shape analysis is used. For clarification, we tested the Hamamatsu 4 × 4 Si-PM array (S11065-025P) combined with scintillators that used different decay times to develop DOI block detectors using the pulse shape analysis. First, Ce-doped Gd(2)SiO(5) (GSO) scintillators of 0.5 mol% Ce were arranged in a 4 × 4 matrix and were optically coupled to the center of each pixel of the Si-PM array for measurement of the energy resolution as well as its gain variations according to the temperature. Then two types of Ce-doped Lu(1.9)Gd(0.1)Si0(5) (LGSO) scintillators, 0.025 mol% Ce (decay time: ~31 ns) and 0.75 mol% Ce (decay time: ~46 ns), were optically coupled in the DOI direction, arranged in a 11 × 7 matrix, and optically coupled to a Si-PM array for testing of the possibility of a high-resolution DOI detector. The energy resolution of the Si-PM array-based GSO block detector was 18 ± 4.4 % FWHM for a Cs-137 gamma source (662 keV). Less than 1 mm crystals were clearly resolved in the position map of the LGSO DOI block detector. The peak-to-valley ratio (P/V) derived from the pulse shape spectra of the LGSO DOI block detector was 2.2. These results confirmed that Si-PM array-based DOI block detectors are promising for high-resolution small animal PET systems. PMID:23271446

  5. Detection of prostate cancer by an FDG-PET cancer screening program: results from a Japanese nationwide survey

    PubMed Central

    Minamimoto, Ryogo; Senda, Michio; Jinnouchi, Seishi; Terauchi, Takashi; Inoue, Tomio

    2014-01-01

    Objective(s): The aim of this study was to analyze detection rates and effectiveness of 18F-fluorodeoxyglucose positron emission tomography (FDG-PET) cancer screening program for prostate cancer in Japan, which is defined as a cancer-screening program for subjects without known cancer. It contains FDG-PET aimed at detection of cancer at an early stage with or without additional screening tests such as prostate-specific antigen (PSA) and magnetic resonance imaging (MRI). Methods: A total of 92,255 asymptomatic men underwent the FDG-PET cancer screening program. Of these, 504 cases with findings of possible prostate cancer in any screening method were analyzed. Results: Of the 504 cases, 165 were verified as having prostate cancer. Of these, only 61 cases were detected by FDG-PET, which result in 37.0% relative sensitivity and 32.8% positive predictive value (PPV). The sensitivity of PET/computed tomography (CT) scanner was higher than that of dedicated PET (44.0% vs. 20.4%). However, the sensitivity of FDG-PET was lower than that of PSA and pelvic MRI. FDG-PET did not contribute to improving the sensitivity and PPV when performed as combined screening. Conclusion: PSA should be included in FDG-PET cancer screening programs to screen for prostate cancer.

  6. Detection of Diffuse Infiltrative Primary Hepatic Lymphoma on FDG PET-CT: Hallmarks of Hepatic Superscan.

    PubMed

    Mahajan, Sonia; Kalra, Shefali; Chawla, Madhavi; Dougall, Pankaj

    2016-01-01

    Primary hepatic lymphoma (PHL) is an extremely rare entity with scarce information in evidence-based literature. Few case reports have described the role of 18F-fluorodeoxyglucose positron emission tomography-computed tomography (FDG PET-CT) in the diagnosing and staging of PHL. We report the case of a 78-year-old man with PHL who initially presented with weight loss and nonspecific fatigue. FDG PET-CT proved to be a beneficial tool in arriving at the diagnosis of this patient with nonspecific clinical presentation and also in the staging of PHL. Physiological uptake of FDG in the liver can be a potential cause of misinterpretation in such cases. Hence, knowing the imaging hallmarks can increase the accuracy in PET image interpretation. PMID:27134567

  7. Detection of Diffuse Infiltrative Primary Hepatic Lymphoma on FDG PET-CT: Hallmarks of Hepatic Superscan

    PubMed Central

    Mahajan, Sonia; Kalra, Shefali; Chawla, Madhavi; Dougall, Pankaj

    2016-01-01

    Primary hepatic lymphoma (PHL) is an extremely rare entity with scarce information in evidence-based literature. Few case reports have described the role of 18F-fluorodeoxyglucose positron emission tomography-computed tomography (FDG PET-CT) in the diagnosing and staging of PHL. We report the case of a 78-year-old man with PHL who initially presented with weight loss and nonspecific fatigue. FDG PET-CT proved to be a beneficial tool in arriving at the diagnosis of this patient with nonspecific clinical presentation and also in the staging of PHL. Physiological uptake of FDG in the liver can be a potential cause of misinterpretation in such cases. Hence, knowing the imaging hallmarks can increase the accuracy in PET image interpretation. PMID:27134567

  8. FDG-PET Quantification of Lung Inflammation with Image-Derived Blood Input Function in Mice

    PubMed Central

    Locke, Landon W.; Williams, Mark B.; Fairchild, Karen D.; Zhong, Min; Kundu, Bijoy K.; Berr, Stuart S.

    2011-01-01

    Dynamic FDG-PET imaging was used to study inflammation in lungs of mice following administration of a virulent strain of Klebsiella (K.) pneumoniae. Net whole-lung FDG influx constant (Ki) was determined in a compartment model using an image-derived blood input function. Methods. K. pneumoniae (~3 x 105 CFU) was intratracheally administered to six mice with 6 other mice serving as controls. Dynamic FDG-PET and X-Ray CT scans were acquired 24 hr after K. pneumoniae administration. The experimental lung time activity curves were fitted to a 3-compartment FDG model to obtain Ki. Following imaging, lungs were excised and immunohistochemistry analysis was done to assess the relative presence of neutrophils and macrophages. Results. Mean Ki for control and K. pneumoniae infected mice were (5.1 ± 1.2) ×10−3 versus (11.4 ± 2.0) ×10−3 min−1, respectively, revealing a 2.24 fold significant increase (P = 0.0003) in the rate of FDG uptake in the infected lung. Immunohistochemistry revealed that cellular lung infiltrate was almost exclusively neutrophils. Parametric Ki maps by Patlak analysis revealed heterogeneous inflammatory foci within infected lungs. Conclusion. The kinetics of FDG uptake in the lungs of mice can be noninvasively quantified by PET with a 3-compartment model approach based on an image-derived input function. PMID:22187641

  9. 18F-FDG PET/CT in multicentric Castleman disease: a case report

    PubMed Central

    Zhang, Jiexin; Yang, Lu

    2016-01-01

    Castleman disease (CD) is a chronic lymphoproliferative disorder characterized by unexplained enlarged lymph nodes. According to lymph nodes distribution it contains two types of single-centric and multicentric (more than one site) disease. Multicentric Castleman disease (MCD) is rare, and shows unspecific manifestation with high misdiagnosis rate. Here we reported a case of MCD in a 43-year-old male. 18F-FDG PET/CT imaging demonstrated higher FDG uptake in multiple lymph nodes and slightly FDG uptake in spleen and bone marrow. Right inguinal Lymph node biopsy was taken and the results confirmed CD. PMID:26904580

  10. Focal Inflammatory Myositis on 18F-FDG PET/CT.

    PubMed

    Bennett, Olivia; Ravi Kumar, Aravind S; Agnew, Julie

    2016-06-01

    Focal myositis is a rare benign inflammatory pseudotumor that can mimic malignancy, clinically and on imaging. A 34-year-old man presented with a 3-week history of sudden-onset, nontender, left upper neck mass that was nonresolving with antibiotics. Anatomical imaging was concerning for a sarcoma of the sternocleidomastoid muscle with possible regional nodal metastases and surrounding inflammatory change. F-FDG PET/CT showed marked FDG uptake extending around the anterior border of the sternocleidomastoid muscle with no FDG-avid local nodal disease. Core biopsy of the sternocleidomastoid muscle and adjacent node revealed inflammatory changes. A diagnosis of focal inflammatory myositis was made. PMID:27055132

  11. Accuracy of [18F]FDG PET/MRI for the Detection of Liver Metastases

    PubMed Central

    Beiderwellen, Karsten; Geraldo, Llanos; Ruhlmann, Verena; Heusch, Philipp; Gomez, Benedikt; Nensa, Felix; Umutlu, Lale; Lauenstein, Thomas C.

    2015-01-01

    Background The aim of this study was to compare the diagnostic accuracy of [18F]FDG-PET/MRI with PET/CT for the detection of liver metastases. Methods 32 patients with solid malignancies underwent [18F]FDG-PET/CT and subsequent PET/MRI of the liver. Two readers assessed both datasets regarding lesion characterization (benign, indeterminate, malignant), conspicuity and diagnostic confidence. An imaging follow-up (mean interval: 185±92 days) and/-or histopathological specimen served as standards of reference. Sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) were calculated for both modalities. Accuracy was determined by calculating the area under the receiver operating characteristic (ROC) curve. Values of conspicuity and diagnostic confidence were compared using Wilcoxon-signed-rank test. Results The standard of reference revealed 113 liver lesions in 26 patients (malignant: n = 45; benign: n = 68). For PET/MRI a higher accuracy (PET/CT: 82.4%; PET/MRI: 96.1%; p<0.001) as well as sensitivity (67.8% vs. 92.2%, p<0.01) and NPV (82.0% vs. 95.1%, p<0.05) were observed. PET/MRI offered higher lesion conspicuity (PET/CT: 2.0±1.1 [median: 2; range 0–3]; PET/MRI: 2.8±0.5 [median: 3; range 0–3]; p<0.001) and diagnostic confidence (PET/CT: 2.0±0.8 [median: 2; range: 1–3]; PET/MRI 2.6±0.6 [median: 3; range: 1–3]; p<0.001). Furthermore, PET/MRI enabled the detection of additional PET-negative metastases (reader 1: 10; reader 2: 12). Conclusions PET/MRI offers higher diagnostic accuracy compared to PET/CT for the detection of liver metastases. PMID:26335246

  12. Estimation of radiation dose to patients from 18FDG whole body PET/CT investigations using dynamic PET scan protocol

    PubMed Central

    Kaushik, Aruna; Jaimini, Abhinav; Tripathi, Madhavi; D’Souza, Maria; Sharma, Rajnish; Mondal, Anupam; Mishra, Anil K.; Dwarakanath, Bilikere S.

    2015-01-01

    Background & objectives: There is a growing concern over the radiation exposure of patients from undergoing 18FDG PET/CT (18F-fluorodeoxyglucose positron emission tomography/computed tomography) whole body investigations. The aim of the present study was to study the kinetics of 18FDG distributions and estimate the radiation dose received by patients undergoing 18FDG whole body PET/CT investigations. Methods: Dynamic PET scans in different regions of the body were performed in 49 patients so as to measure percentage uptake of 18FDG in brain, liver, spleen, adrenals, kidneys and stomach. The residence time in these organs was calculated and radiation dose was estimated using OLINDA software. The radiation dose from the CT component was computed using the software CT-Expo and measured using computed tomography dose index (CTDI) phantom and ionization chamber. As per the clinical protocol, the patients were refrained from eating and drinking for a minimum period of 4 h prior to the study. Results: The estimated residence time in males was 0.196 h (brain), 0.09 h (liver), 0.007 h (spleen), 0.0006 h (adrenals), 0.013 h (kidneys) and 0.005 h (stomach) whereas it was 0.189 h (brain), 0.11 h (liver), 0.01 h (spleen), 0.0007 h (adrenals), 0.02 h (kidneys) and 0.004 h (stomach) in females. The effective dose was found to be 0.020 mSv/MBq in males and 0.025 mSv/MBq in females from internally administered 18FDG and 6.8 mSv in males and 7.9 mSv in females from the CT component. For an administered activity of 370 MBq of 18FDG, the effective dose from PET/CT investigations was estimated to be 14.2 mSv in males and 17.2 mSv in females. Interpretation & conclusions: The present results did not demonstrate significant difference in the kinetics of 18FDG distribution in male and female patients. The estimated PET/CT doses were found to be higher than many other conventional diagnostic radiology examinations suggesting that all efforts should be made to clinically justify and

  13. Regional, kinetic [18F]FDG PET imaging of a unilateral Parkinsonian animal model

    PubMed Central

    Silva, Matthew D; Glaus, Charles; Hesterman, Jacob Y; Hoppin, Jack; Puppa, Geraldine Hill della; Kazules, Timothy; Orcutt, Kelly M; Germino, Mary; Immke, David; Miller, Silke

    2013-01-01

    Positron emission tomography (PET) imaging with the glucose analog 2-deoxy-2-[18F]fluoro-D-glucose ([18F] FDG) has demonstrated clinical utility for the monitoring of brain glucose metabolism alteration in progressive neurodegenerative diseases. We examined dynamic [18F]FDG PET imaging and kinetic modeling of atlas-based regions to evaluate regional changes in the cerebral metabolic rate of glucose in the widely-used 6-hydroxydopamine (6-OHDA) rat model of Parkinson’s disease. Following a bolus injection of 18.5 ± 1 MBq [18F]FDG and a 60-minute PET scan, image-derived input functions from the vena cava and left ventricle were used with three models, including Patlak graphical analysis, to estimate the influx constant and the metabolic rate in ten brain regions. We observed statistically significant changes in [18F]FDG uptake ipsilateral to the 6-OHDA injection in the basal ganglia, olfactory bulb, and amygdala regions; and these changes are of biological relevance to the disease. These experiments provide further validation for the use of [18F]FDG PET imaging in this model for drug discovery and development. PMID:23526185

  14. Repeatability of the Maximum Standard Uptake Value (SUVmax) in FDG PET

    PubMed Central

    Lindholm, Henry; Staaf, Johan; Jacobsson, Hans; Brolin, Fredrik; Hatherly, Robert; Sânchez-Crespo, Alejandro

    2014-01-01

    Objective: SUVmax is often calculated at FDG PET examinations in systematic studies as well as at clinical examinations. Since SUVmax represents a very small portion of a lesion it may be questioned how statistically reliable the figure is. This was studied by assessing the repeatability of SUVmax between two FDG acquisitions acquired immediately upon each other in patients with chest lesions. Methods: In 100 clinical patients with a known chest lesion, two identical 3 min PET registrations (PET1 and PET2, respectively) were initiated within 224±31 sec of each other. The difference in SUVmax between the lesion for the two PET scans (ΔSUVmax) was calculated and the uncertainty expressed as the coefficient of variation, CV (%). The correlation between ΔSUVmax and the lowest SUVmax from PET1 or PET2, the approximate metabolic lesion volume, the time from FDG injection to PET1 and the time between PET1 and PET2, respectively, was also assessed. Results: In 56 patients SUVmax increased at the second acquisition and in 44 patients it decreased. Mean of SUVmax was 7.8±6.1 and 7.8±6.2 for PET1 and PET2, respectively. The mean percentage difference was 0.9±7.8. The difference was not significant (p=0.20). CV gave an uncertainty of 4.3% between the two measurements which is a strong indicator of equivalence. There was no correlation between ΔSUVmax and any of the assessed four parameters. The difference between the acquisitions, 0.9%, was much lower compared to the 3 previous published similar, but more restricted studies where the difference was 2.5-8.2%. Conclusion: From camera and computational perspectives, SUVmax is a stable parameter Conflict of interest:None declared. PMID:24653930

  15. Present and future roles of FDG-PET/CT imaging in the management of lung cancer.

    PubMed

    Kitajima, Kazuhiro; Doi, Hiroshi; Kanda, Tomonori; Yamane, Tomohiko; Tsujikawa, Tetsuya; Kaida, Hayato; Tamaki, Yukihisa; Kuribayashi, Kozo

    2016-06-01

    Integrated positron emission tomography/computed tomography (PET/CT) using 2-[(18)F]fluoro-2-deoxy-D-glucose ((18)F-FDG) has emerged as a powerful tool for combined metabolic and anatomic evaluation in clinical oncologic imaging. This review discusses the utility of (18)F-FDG PET/CT as a tool for managing patients with lung cancer. We discuss different patient management stages, including diagnosis, initial staging, therapy planning, early treatment response assessment, re-staging, and prognosis. PMID:27121156

  16. Extraosseous Osteosarcoma of the Liver Demonstrated on 18F-FDG PET/CT Imaging.

    PubMed

    Jiang, Lei; Luan, Lijuan; Yun, Hong; Hou, Yingyong; Shi, Hongcheng

    2016-08-01

    A 66-year-old woman presented with abdominal pain for 1 month. Ultrasonography displayed multiple hepatic masses that were thought as metastases. FDG PET/CT was performed to assess the nature of these masses and to search primary malignancy. The images showed elevated FDG activity in the partially calcified hypodense lesions in the liver without abnormality elsewhere. The lesions were subsequently confirmed as primary extraosseous osteosarcoma in the liver. The patient received liver transplantation. Six months later, her CA-125 was significantly increased. The follow-up PET/CT scan demonstrated the widespread metastases. PMID:27055145

  17. 18F-FDG PET/CT Imaging of Burkitt Lymphoma Presenting With Unusual Muscle Involvement.

    PubMed

    Dirlik Serim, Burcu; Gurleyen Eren, Tuba; Oz Puyan, Fulya; Durmus Altun, Gülay

    2016-08-01

    Extranodal involvement is more common with Burkitt lymphoma (BL) than other subtypes of non-Hodgkin lymphoma in childhood. According to our knowledge, there are rare cases in the literature about muscle involvement of BL, and its F-FDG PET/CT findings were not well defined. We report a 6-year-old girl with a histopathologic diagnosis of BL and referred for staging with PET/CT. FDG-avid abdominal lymph nodes and diffuse involvements of right quadriceps muscle were demonstrated. PMID:27124681

  18. FDG PET/CT Findings of Recurrent Respiratory Papillomatosis With Malignant Degeneration in the Lung.

    PubMed

    Tatci, Ebru; Gokcek, Atila; Unsal, Ebru; Cimen, Filiz; Demirag, Funda; Yazici, Senem; Ozmen, Ozlem

    2015-10-01

    Recurrent respiratory papillomatosis is a rare benign disease caused by HPV-6 or HPV-11. The tumors may rarely undergo malignant degeneration. We performed FDG PET/CT in a patient experiencing recurrent respiratory papillomatosis who had pulmonary involvement. Although squamous cell carcinoma was detected in one of the pulmonary masses, squamous metaplasia with dysplasia were detected in the other one. Intensity modulated radiation therapy was performed to treat the malignancy. Second FDG PET/CT was performed 15 months after radiotherapy. PMID:26204210

  19. 18F-FDG PET/CT Findings in a Patient With a Proliferating Trichilemmal Cyst.

    PubMed

    Leyendecker, Pierre; de Cambourg, Ghislaine; Mahé, Antoine; Imperiale, Alessio; Blondet, Cyrille

    2015-07-01

    Proliferating trichilemmal cyst is considered as a rare tumor that originates in the outer root sheath of hair follicle. Metastatic potential has not been yet fully established. Moreover, histological analysis does not allow precise malignancy prediction. Proliferating trichilemmal cyst glucose metabolism behavior was never previously described. Herein, we report the case of a 62-year-old patient with a left shoulder proliferating trichilemmal cyst showing an intense uptake of ¹⁸F-FDG on PET/CT examination. ¹⁸F-FDG PET/CT could be proposed to optimize diagnostic strategy of patients with proliferating trichilemmal cysts. PMID:25706794

  20. Value of FDG PET/CT in staging of oral cancer: four simultaneous primary malignancies.

    PubMed

    Linz, Christian; Müller-Richter, Urs D A; Kircher, Stefan; Lapa, Constantin; Bluemel, Christina

    2015-05-01

    Patients with squamous cell cancer (SCC) of the head and neck are at increased risk for second primary malignancies (SPMs). We report on a 53-year-old patient with primary diagnosis of SCC in the anterior floor of the mouth. Panendoscopy suspected an SPM of the right vocal cord. FDG PET/CT, as a whole-body imaging method, confirmed this suspicion and raised concern for further SPM of both esophagus and colon. All malignancies were confirmed by biopsy. Subsequently, the patient underwent radiochemotherapy. In summary, FDG PET/CT revealed unexpected multiple SPMs, prevented unnecessary resection of the oral SCC, and enabled individualized therapeutic management. PMID:25742223

  1. Hypoxia is important in F-18 FDG accumulation in thecoma-fibroma tumors on F-18 FDG PET/CT scans

    PubMed Central

    SEINO, HIROKO; ONO, SHUICHI; MIURA, HIROYUKI; MOROHASHI, SATOKO; WU, YUNYAN; TSUSHIMA, FUMIYASU; TAKAI, YOSHIHIRO; KIJIMA, HIROSHI

    2016-01-01

    Several studies have noted benign thecoma-fibroma tumors with positive F-18 fluorodeoxyglucose (FDG) accumulation mimicking malignant ovarian tumors following F-18 FDG positron emission tomography (PET). The present study analyzed four cases with false-positive F-18 FDG PET/computed tomography (CT) diagnoses of thecoma-fibroma tumors as malignant tumors due to F-18 FDG accumulation, compared with eight cases of FDG-positive ovarian cancers and two cases of FDG-negative fibromas. Hypoxia inducible factor (HIF)-1α expression was examined in the six thecoma-fibroma tumors using reverse transcription-polymerase chain reaction (RT-PCR). The four F-18 FDG-positive cases exhibited higher cellularity, maximum standard uptake and signal intensity on T2-weighted imaging, and gadolinium (Gd) enhancement using magnetic resonance imaging than the two FDG-negative fibroma cases. In the F-18 FDG-positive thecoma-fibroma group, Ki-67 expression was low and LAT1 expression was not identified, ruling out the diagnosis and potential for malignancy. However, considerable glucose transporter 1, HIF-1α, and vascular endothelial growth factor expression was observed. HIF-1α expression was elevated in all four false-positive cases by RT-PCR. From these results, it was hypothesized that hypoxia due to elevated cellularity may stimulate HIF-1α expression and be associated with F-18 FDG accumulation in F-18-positive thecoma-fibroma tumors. PMID:27035330

  2. Tumor Response and Survival Predicted by Post-Therapy FDG-PET/CT in Anal Cancer

    SciTech Connect

    Schwarz, Julie K.; Siegel, Barry A.; Dehdashti, Farrokh; Myerson, Robert J.; Fleshman, James W.; Grigsby, Perry W.

    2008-05-01

    Purpose: To evaluate the response to therapy for anal carcinoma using post-therapy imaging with positron emission tomography (PET)/computed tomography and F-18 fluorodeoxyglucose (FDG) and to compare the metabolic response with patient outcome. Patients and Methods: This was a prospective cohort study of 53 consecutive patients with anal cancer. All patients underwent pre- and post-treatment whole-body FDG-PET/computed tomography. Patients had been treated with external beam radiotherapy and concurrent chemotherapy. Whole-body FDG-PET was performed 0.9-5.4 months (mean, 2.1) after therapy completion. Results: The post-therapy PET scan did not show any abnormal FDG uptake (complete metabolic response) in 44 patients. Persistent abnormal FDG uptake (partial metabolic response) was found in the anal tumor in 9 patients. The 2-year cause-specific survival rate was 94% for patients with a complete vs. 39% for patients with a partial metabolic response in the anal tumor (p = 0.0008). The 2-year progression-free survival rate was 95% for patients with a complete vs. 22% for patients with a partial metabolic response in the anal tumor (p < 0.0001). A Cox proportional hazards model of survival outcome indicated that a complete metabolic response was the most significant predictor of progression-free survival in our patient population (p = 0.0003). Conclusions: A partial metabolic response in the anal tumor as determined by post-therapy FDG-PET is predictive of significantly decreased progression-free and cause-specific survival after chemoradiotherapy for anal cancer.

  3. MicroPET II: design, development and initial performance of an improved microPET scanner for small-animal imaging

    NASA Astrophysics Data System (ADS)

    Tai, Yuan-Chuan; Chatziioannou, Arion F.; Yang, Yongfeng; Silverman, Robert W.; Meadors, Ken; Siegel, Stefan; Newport, Danny F.; Stickel, Jennifer R.; Cherry, Simon R.

    2003-06-01

    MicroPET II is a second-generation animal PET scanner designed for high-resolution imaging of small laboratory rodents. The system consists of 90 scintillation detector modules arranged in three contiguous axial rings with a ring diameter of 16.0 cm and an axial length of 4.9 cm. Each detector module consists of a 14 × 14 array of lutetium oxyorthosilicate (LSO) crystals coupled to a multi-channel photomultiplier tube (MC-PMT) through a coherent optical fibre bundle. Each LSO crystal element measures 0.975 mm × 0.975 mm in cross section by 12.5 mm in length. A barium sulphate reflector material was used between LSO elements leading to a detector pitch of 1.15 mm in both axial and transverse directions. Fused optical fibre bundles were made from 90 µm diameter glass fibres with a numerical aperture of 0.56. Interstitial extramural absorber was added between the fibres to reduce optical cross talk. A charge-division readout circuit was implemented on printed circuit boards to decode the 196 crystals in each array from the outputs of the 64 anode signals of the MC-PMT. Electronics from Concorde Microsystems Inc. (Knoxville, TN) were used for signal amplification, digitization, event qualification, coincidence processing and data capture. Coincidence data were passed to a host PC that recorded events in list mode. Following acquisition, data were sorted into sinograms and reconstructed using Fourier rebinning and filtered backprojection algorithms. Basic evaluation of the system has been completed. The absolute sensitivity of the microPET II scanner was 2.26% at the centre of the field of view (CFOV) for an energy window of 250-750 keV and a timing window of 10 ns. The intrinsic spatial resolution of the detectors in the system averaged 1.21 mm full width at half maximum (FWHM) when measured with a 22Na point source 0.5 mm in diameter. Reconstructed image resolution ranged from 0.83 mm FWHM at the CFOV to 1.47 mm FWHM in the radial direction, 1.17 mm FWHM in the

  4. MicroPET II: design, development and initial performance of an improved microPET scanner for small-animal imaging.

    PubMed

    Tai, Yuan-Chuan; Chatziioannou, Arion F; Yang, Yongfeng; Silverman, Robert W; Meadors, Ken; Siegel, Stefan; Newport, Danny F; Stickel, Jennifer R; Cherry, Simon R

    2003-06-01

    MicroPET II is a second-generation animal PET scanner designed for high-resolution imaging of small laboratory rodents. The system consists of 90 scintillation detector modules arranged in three contiguous axial rings with a ring diameter of 16.0 cm and an axial length of 4.9 cm. Each detector module consists of a 14 x 14 array of lutetium oxyorthosilicate (LSO) crystals coupled to a multi-channel photomultiplier tube (MC-PMT) through a coherent optical fibre bundle. Each LSO crystal element measures 0.975 mm x 0.975 mm in cross section by 12.5 mm in length. A barium sulphate reflector material was used between LSO elements leading to a detector pitch of 1.15 mm in both axial and transverse directions. Fused optical fibre bundles were made from 90 microm diameter glass fibres with a numerical aperture of 0.56. Interstitial extramural absorber was added between the fibres to reduce optical cross talk. A charge-division readout circuit was implemented on printed circuit boards to decode the 196 crystals in each array from the outputs of the 64 anode signals of the MC-PMT. Electronics from Concorde Microsystems Inc. (Knoxville, TN) were used for signal amplification, digitization, event qualification, coincidence processing and data capture. Coincidence data were passed to a host PC that recorded events in list mode. Following acquisition, data were sorted into sinograms and reconstructed using Fourier rebinning and filtered hackprojection algorithms. Basic evaluation of the system has been completed. The absolute sensitivity of the microPET II scanner was 2.26% at the centre of the field of view (CFOV) for an energy window of 250-750 keV and a timing window of 10 ns. The intrinsic spatial resolution of the detectors in the system averaged 1.21 mm full width at half maximum (FWHM) when measured with a 22Na point source 0.5 mm in diameter. Reconstructed image resolution ranged from 0.83 mm FWHM at the CFOV to 1.47 mm FWHM in the radial direction, 1.17 mm FWHM in the

  5. Metformin and cancer: Technical and clinical implications for FDG-PET imaging

    PubMed Central

    Capitanio, Selene; Marini, Cecilia; Sambuceti, Gianmario; Morbelli, Silvia

    2015-01-01

    Metformin is the most widely used hypoglycemic agent. Besides its conventional indications, increasing evidence demonstrate a potential efficacy of this biguanide as an anticancer drug. Possible mechanisms of actions seem to be independent from its hypoglycemic effect and seem to involve the interference with key pathways in cellular proliferation and glycolysis. To date, many clinical trials implying the use of metformin in cancer treatment are on-going. The increasing use of 18F-2-fluoro-2-deoxy-d-glucose positron emission tomography (FDG-PET) in cancer evaluation raises a number of questions about the possible interference of the biguanide on FDG distribution. In particular, the interferences exerted by metformin on AMP-activated protein kinase pathway (the cellular energy sensor), on insulin levels and on Hexokinase could potentially have repercussion on glucose handling and thus on FDG distribution. A better comprehension of the impact of metformin on FDG uptake is needed in order to optimize the use of PET in this setting. This evaluation would be useful to ameliorate scans interpretation in diabetic patients under chronic metformin treatment and to critically interpret images in the context of clinical trials. Furthermore, collecting prospective data in this setting would help to verify whether FDG-PET could be a valid tool to appreciate the anticancer effect of this new therapeutic approach. PMID:25825634

  6. Metformin and cancer: Technical and clinical implications for FDG-PET imaging.

    PubMed

    Capitanio, Selene; Marini, Cecilia; Sambuceti, Gianmario; Morbelli, Silvia

    2015-03-28

    Metformin is the most widely used hypoglycemic agent. Besides its conventional indications, increasing evidence demonstrate a potential efficacy of this biguanide as an anticancer drug. Possible mechanisms of actions seem to be independent from its hypoglycemic effect and seem to involve the interference with key pathways in cellular proliferation and glycolysis. To date, many clinical trials implying the use of metformin in cancer treatment are on-going. The increasing use of (18)F-2-fluoro-2-deoxy-d-glucose positron emission tomography (FDG-PET) in cancer evaluation raises a number of questions about the possible interference of the biguanide on FDG distribution. In particular, the interferences exerted by metformin on AMP-activated protein kinase pathway (the cellular energy sensor), on insulin levels and on Hexokinase could potentially have repercussion on glucose handling and thus on FDG distribution. A better comprehension of the impact of metformin on FDG uptake is needed in order to optimize the use of PET in this setting. This evaluation would be useful to ameliorate scans interpretation in diabetic patients under chronic metformin treatment and to critically interpret images in the context of clinical trials. Furthermore, collecting prospective data in this setting would help to verify whether FDG-PET could be a valid tool to appreciate the anticancer effect of this new therapeutic approach. PMID:25825634

  7. 18F-FDG PET/CT for the assessment of gastrointestinal GVHD: results of a pilot study.

    PubMed

    Bodet-Milin, C; Lacombe, M; Malard, F; Lestang, E; Cahu, X; Chevallier, P; Guillaume, T; Delaunay, J; Brissot, E; Moreau, P; Kraeber-Bodere, F; Mohty, M

    2014-01-01

    This prospective pilot study aimed to evaluate the predictive value of (18)F-FDG PET/CT for early diagnosis of acute gastrointestinal GVHD (GI-GVHD). In all, 42 consecutive patients who received allo-SCT were included. (18)F-FDG PET/CT was systematically performed at a median of 28 (range, 24-38) days after allo-SCT. (18)F-FDG PET/CT data review was positive in 15 cases (36%) (9 true positive (TP) cases and 6 false positive (FP) cases) and negative in 27 cases (64%; 26 true negative (TN) cases and 1 false negative (FN) case) at visual analysis. Sensitivity, specificity, positive predictive value, negative predictive value and accuracy of (18)F-FDG PET/CT for the diagnosis of acute GI-GVHD were, respectively, 81%, 90%, 60%, 96% and 83%. There were no significant differences of SUVmax values between grade 1-2 GI-GVHD and severe grade 3-4 GI-GVHD. Overall, these preliminary findings suggested that the inflammatory activity of the gastrointestinal tract associated with acute GI-GVHD could be assessed by (18)F-FDG PET/CT suggesting that noninvasive (18)F-FDG PET/CT could become a valuable examination to be performed shortly before endoscopy to map acute GI-GVHD lesions, guide the biopsy sites and choose the appropriate endoscopic procedure, especially in those asymptomatic patients with a positive (18)F-FDG PET/CT. PMID:24076550

  8. Interim FDG-PET Scan in Hodgkin's Lymphoma: Hopes and Caveats

    PubMed Central

    André, M.; Vander Borght, T.; Bosly, A.

    2011-01-01

    FDG-PET has recently emerged as an important tool for the management of Hodgkins lymphoma. Although its use for initial staging and response evaluation at the end of treatment is well established, the place of interim PET for response assessment and subsequent treatment tailoring is still quite controversial. The use of interim PET after a few cycles of chemotherapy may allow treatment reduction for good responders, leading to lesser treatment toxicities as well as early treatment adaptation for bad responders with a potential higher chance for cure. Interpretation of interim PET is a rapidly moving field. Actually, visual interpretation is preferred over quantitative interpretation in this situation. The notion of minimal residual uptake emerged for faint persisting FDG uptake, but has evolved during the recent years. Guidelines using mediastinum and liver as references have been proposed at the expert meeting in Deauville 2009. Actually, several trials are ongoing both for localised and advanced disease to evaluate the FDG-PET potential for early treatment monitoring and tailoring. Until the results of these prospective randomized trials become available, treatment changes according to the interim PET results should remain inappropriate and limited to well-conducted clinical trials. PMID:21234093

  9. F18-FDG-PET for recurrent differentiated thyroid cancer: a systematic meta-analysis

    PubMed Central

    Haslerud, Torjan; Brauckhoff, Katrin; Reisæter, Lars; Küfner Lein, Regina; Heinecke, Achim; Varhaug, Jan Erik

    2015-01-01

    Background Positron emission tomography (PET) with fluor-18-deoxy-glucose (FDG) is widely used for diagnosing recurrent or metastatic disease in patients with differentiated thyroid cancer (DTC). Purpose To assess the diagnostic accuracy of FDG-PET for DTC in patients after ablative therapy. Material and Methods A systematic search was conducted in Medline/PubMed, EMBASE, Cochrane Library, Web of Science, and Open Grey looking for all English-language original articles on the performance of FDG-PET in series of at least 20 patients with DTC having undergone ablative therapy including total thyroidectomy. Diagnostic performance measures were pooled using Reitsma’s bivariate model. Results Thirty-four publications between 1996 and 2014 met the inclusion criteria. Pooled sensitivity and specificity were 79.4% (95% confidence interval [CI], 73.9–84.1) and 79.4% (95% CI, 71.2–85.4), respectively, with an area under the curve of 0.858. Conclusion F18-FDG-PET is a useful method for detecting recurrent DTC in patients having undergone ablative therapy. PMID:26163534

  10. Primary Neuroendocrine Carcinoma of the Kidney on FDG PET/CT.

    PubMed

    Shi, Ximin; Li, Fang; Luo, Yaping; Huo, Li

    2016-09-01

    A 28-year-old woman presented gradually worsening intermittent right groin pain for 10 months. FDG PET/CT was performed to evaluate the suspected renal malignancy. The images demonstrated a large hypermetabolic tumor occupying the entire right kidney. Pathological examination demonstrated a primary neuroendocrine carcinoma of the kidney. PMID:27504808

  11. 18F-FDG PET/CT Findings in Acute Epstein-Barr Virus Infection Mimicking Malignant Lymphoma

    PubMed Central

    Ørbæk, Mathilde; Graff, Jesper; Markova, Elena; Kronborg, Gitte; Lebech, Anne-Mette

    2016-01-01

    We present a case demonstrating the diagnostic work-up and follow-up of a patient with acute Epstein-Barr virus (EBV) infection in which the clinical picture and imaging on 18F-FDG PET/CT mimicked malignant lymphoma. Follow-up 18F-FDG PET/CT scan in the patient performed 7 weeks after the abnormal scan revealed complete resolution of the metabolically active disease in the neck, axillas, lung hili, and spleen. This case highlights inflammation as one of the most well established false positives when interpreting 18F-FDG PET/CT scans. PMID:27187482

  12. (18)F-FDG PET/CT Findings in Acute Epstein-Barr Virus Infection Mimicking Malignant Lymphoma.

    PubMed

    Ørbæk, Mathilde; Graff, Jesper; Markova, Elena; Kronborg, Gitte; Lebech, Anne-Mette

    2016-01-01

    We present a case demonstrating the diagnostic work-up and follow-up of a patient with acute Epstein-Barr virus (EBV) infection in which the clinical picture and imaging on (18)F-FDG PET/CT mimicked malignant lymphoma. Follow-up (18)F-FDG PET/CT scan in the patient performed 7 weeks after the abnormal scan revealed complete resolution of the metabolically active disease in the neck, axillas, lung hili, and spleen. This case highlights inflammation as one of the most well established false positives when interpreting (18)F-FDG PET/CT scans. PMID:27187482

  13. Lymphadenopathy by Scrub Typhus Mimicking Metastasis on FDG PET/CT in a Patient with a History of Breast Cancer.

    PubMed

    Lee, Jeong Won; Lee, Sang Mi; Lee, Kyu Taek; Kim, Sung Young; Han, Sun Wook; Kim, Shin Young

    2015-06-01

    We report the case of a 60-year-old woman with left-sided breast cancer who showed lymphadenopathy mimicking metastatic lesions. She underwent surveillance (18)F-fluorodeoxyglucose (FDG) positron emission tomography/computed tomography (PET/CT) after treatment. PET/CT demonstrated multiple lymphadenopathies with increased FDG uptake, most notably in the right axilla. She had an eschar on the right axillary area, and her serologic test was positive for anti-Orientia tsutsugamushi IgM antibody. Ten months after the treatment, follow-up FDG PET/CT and ultrasonography showed improvement in generalized lymphadenopathy. PMID:26082810

  14. 18F-FDG PET of the hands with a dedicated high-resolution PEM system (arthro-PET): correlation with PET/CT, radiography and clinical parameters

    PubMed Central

    Mhlanga, Joyce C.; Carrino, John A.; Lodge, Martin; Wang, Hao

    2015-01-01

    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. PMID:25134669

  15. Natural history of atherosclerotic disease progression as assessed by (18)F-FDG PET/CT.

    PubMed

    Hetterich, Holger; Rominger, Axel; Walter, Lisa; Habs, Maximilian; Volpers, Sarah; Hacker, Marcus; Reiser, Maximilian F; Bartenstein, Peter; Saam, Tobias

    2016-01-01

    The aim of this study was to assess the impact of cardiovascular risk factors and plaque inflammation on the progression of atherosclerosis as assessed by positron emission tomography/computed tomography (PET/CT) imaging with (18)F-radiolabled fluorodeoxyglucose ((18)F-FDG). This study was designed as a retrospective cohort study. Patients who received a (18)F-FDG PET/CT scan and follow-up scan 9-24 months later without systemic inflammation or steroid medication were eligible for the study. (18)F-FDG PET/CT included a full diagnostic contrast enhanced CT scan. Cardiovascular risk factors and medication were documented. Calcified plaque volume, lumen area and (18)F-FDG uptake, quantified by the target-to-background ratio (TBR), were measured in the carotid arteries, aorta and iliac arteries. Influence of cardiovascular risk factors and vessel wall inflammation on atherosclerotic disease progression was analyzed. Ninety-four patients underwent baseline and follow-up whole body (18)F-FDG PET/CT (mean follow-up time 14.5 ± 3.5 months). Annualized calcified plaque volume increased by 15.4 % (p < 0.0001), carotid and aortic lumen area decreased by 10.5 % (p < 0.0001) and 1.7 % (p = 0.045). There was no significant difference in (18)F-FDG uptake at baseline and follow-up (mean TBR 1.44 ± 0.18 vs. 1.42 ± 0.19, p = 0.18). Multiple linear regression analysis identified hypertension as an independent predictor for total, aortic and iliac calcified plaque volume progression (all p < 0.04). Carotid lumen reduction was predicted by hypercholesterolemia (p = 0.008) while aortic lumen reduction was associated with BMI and mean (18)F-FDG uptake (p ≤ 0.005). Furthermore we observed a dose response relationship between the number of cardiovascular risk factors and calcified plaque volume progression in the aorta (p = 0.03). Findings from this study provide data on the natural history of atherosclerotic disease burden in multiple vascular beds and emphasize the value of

  16. Detection of bladder metabolic artifacts in (18)F-FDG PET imaging.

    PubMed

    Roman-Jimenez, Geoffrey; Crevoisier, Renaud De; Leseur, Julie; Devillers, Anne; Ospina, Juan David; Simon, Antoine; Terve, Pierre; Acosta, Oscar

    2016-04-01

    Positron emission tomography using (18)F-fluorodeoxyglucose ((18)F-FDG-PET) is a widely used imaging modality in oncology. It enables significant functional information to be included in analyses of anatomical data provided by other image modalities. Although PET offers high sensitivity in detecting suspected malignant metabolism, (18)F-FDG uptake is not tumor-specific and can also be fixed in surrounding healthy tissue, which may consequently be mistaken as cancerous. PET analyses may be particularly hampered in pelvic-located cancers by the bladder׳s physiological uptake potentially obliterating the tumor uptake. In this paper, we propose a novel method for detecting (18)F-FDG bladder artifacts based on a multi-feature double-step classification approach. Using two manually defined seeds (tumor and bladder), the method consists of a semi-automated double-step clustering strategy that simultaneously takes into consideration standard uptake values (SUV) on PET, Hounsfield values on computed tomography (CT), and the distance to the seeds. This method was performed on 52 PET/CT images from patients treated for locally advanced cervical cancer. Manual delineations of the bladder on CT images were used in order to evaluate bladder uptake detection capability. Tumor preservation was evaluated using a manual segmentation of the tumor, with a threshold of 42% of the maximal uptake within the tumor. Robustness was assessed by randomly selecting different initial seeds. The classification averages were 0.94±0.09 for sensitivity, 0.98±0.01 specificity, and 0.98±0.01 accuracy. These results suggest that this method is able to detect most (18)F-FDG bladder metabolism artifacts while preserving tumor uptake, and could thus be used as a pre-processing step for further non-parasitized PET analyses. PMID:26897070

  17. FDG-PET imaging in mild traumatic brain injury: a critical review

    PubMed Central

    Byrnes, Kimberly R.; Wilson, Colin M.; Brabazon, Fiona; von Leden, Ramona; Jurgens, Jennifer S.; Oakes, Terrence R.; Selwyn, Reed G.

    2013-01-01

    Traumatic brain injury (TBI) affects an estimated 1.7 million people in the United States and is a contributing factor to one third of all injury related deaths annually. According to the CDC, approximately 75% of all reported TBIs are concussions or considered mild in form, although the number of unreported mild TBIs (mTBI) and patients not seeking medical attention is unknown. Currently, classification of mTBI or concussion is a clinical assessment since diagnostic imaging is typically inconclusive due to subtle, obscure, or absent changes in anatomical or physiological parameters measured using standard magnetic resonance (MR) or computed tomography (CT) imaging protocols. Molecular imaging techniques that examine functional processes within the brain, such as measurement of glucose uptake and metabolism using [18F]fluorodeoxyglucose and positron emission tomography (FDG-PET), have the ability to detect changes after mTBI. Recent technological improvements in the resolution of PET systems, the integration of PET with magnetic resonance imaging (MRI), and the availability of normal healthy human databases and commercial image analysis software contribute to the growing use of molecular imaging in basic science research and advances in clinical imaging. This review will discuss the technological considerations and limitations of FDG-PET, including differentiation between glucose uptake and glucose metabolism and the significance of these measurements. In addition, the current state of FDG-PET imaging in assessing mTBI in clinical and preclinical research will be considered. Finally, this review will provide insight into potential critical data elements and recommended standardization to improve the application of FDG-PET to mTBI research and clinical practice. PMID:24409143

  18. FDG-PET imaging in mild traumatic brain injury: a critical review.

    PubMed

    Byrnes, Kimberly R; Wilson, Colin M; Brabazon, Fiona; von Leden, Ramona; Jurgens, Jennifer S; Oakes, Terrence R; Selwyn, Reed G

    2014-01-01

    Traumatic brain injury (TBI) affects an estimated 1.7 million people in the United States and is a contributing factor to one third of all injury related deaths annually. According to the CDC, approximately 75% of all reported TBIs are concussions or considered mild in form, although the number of unreported mild TBIs (mTBI) and patients not seeking medical attention is unknown. Currently, classification of mTBI or concussion is a clinical assessment since diagnostic imaging is typically inconclusive due to subtle, obscure, or absent changes in anatomical or physiological parameters measured using standard magnetic resonance (MR) or computed tomography (CT) imaging protocols. Molecular imaging techniques that examine functional processes within the brain, such as measurement of glucose uptake and metabolism using [(18)F]fluorodeoxyglucose and positron emission tomography (FDG-PET), have the ability to detect changes after mTBI. Recent technological improvements in the resolution of PET systems, the integration of PET with magnetic resonance imaging (MRI), and the availability of normal healthy human databases and commercial image analysis software contribute to the growing use of molecular imaging in basic science research and advances in clinical imaging. This review will discuss the technological considerations and limitations of FDG-PET, including differentiation between glucose uptake and glucose metabolism and the significance of these measurements. In addition, the current state of FDG-PET imaging in assessing mTBI in clinical and preclinical research will be considered. Finally, this review will provide insight into potential critical data elements and recommended standardization to improve the application of FDG-PET to mTBI research and clinical practice. PMID:24409143

  19. FDG-PET as a predictive biomarker for therapy with everolimus in metastatic renal cell cancer

    PubMed Central

    Chen, James L; Appelbaum, Daniel E; Kocherginsky, Masha; Cowey, Charles L; Kimryn Rathmell, Wendy; McDermott, David F; Stadler, Walter M

    2013-01-01

    Abstract The mTOR (mammalian target of rapamycin) inhibitor, everolimus, affects tumor growth by targeting cellular metabolic proliferation pathways and delays renal cell carcinoma (RCC) progression. Preclinical evidence suggests that baseline elevated tumor glucose metabolism as quantified by FDG-PET ([18F] fluorodeoxy-glucose positron emission tomography) may predict antitumor activity. Metastatic RCC (mRCC) patients refractory to vascular endothelial growth factor (VEGF) pathway inhibition were treated with standard dose everolimus. FDG-PET scans were obtained at baseline and 2 weeks; serial computed tomography (CT) scans were obtained at baseline and every 8 weeks. Maximum standardized uptake value (SUVmax) of the most FDG avid lesion, average SUVmax of all measured lesions and their corresponding 2-week relative changes were examined for association with 8-week change in tumor size. A total of 63 patients were enrolled; 50 were evaluable for the primary endpoint of which 48 had both PET scans. Patient characteristics included the following: 36 (72%) clear cell histology and median age 59 (range: 37–80). Median pre- and 2-week treatment average SUVmax were 6.6 (1–17.9) and 4.2 (1–13.9), respectively. Response evaluation criteria in solid tumors (RECIST)-based measurements demonstrated an average change in tumor burden of 0.2% (−32.7% to 35.9%) at 8 weeks. Relative change in average SUVmax was the best predictor of change in tumor burden (all evaluable P = 0.01; clear cell subtype P = 0.02), with modest correlation. Baseline average SUVmax was correlated with overall survival and progression-free survival (PFS) (P = 0.023; 0.020), but not with change in tumor burden. Everolimus therapy decreased SUVs on follow-up PET scans in mRCC patients, but changes were only modestly correlated with changes in tumor size. Thus, clinical use of FDG-PET-based biomarkers is challenged by high variability. In this phase II trial, FDG-PET was explored as a

  20. FDG-PET imaging for the assessment of physiologic volume response during radiotherapy in cervix cancer

    SciTech Connect

    Lin, Lilie L.; Yang Zhiyun; Mutic, Sasa; Miller, Tom R.; Grigsby, Perry W. . E-mail: pgrigsby@wustl.edu

    2006-05-01

    Purpose: To evaluate the physiologic tumor volume response during treatment in cervical cancer using 18F-fluorodeoxyglucose positron emission tomography (FDG-PET). Patients and Methods: This was a prospective study of 32 patients. Physiologic tumor volume in cubic centimeters was determined from the FDG-PET images using the 40% threshold method. Results: The mean pretreatment tumor volume was 102 cm{sup 3}. The mean volume by clinical Stages I, II, and III were 54, 79, and 176 cm{sup 3}, respectively. After 19.8 Gy external irradiation to the pelvis, the reduction in tumor volume was 29% (72 cm{sup 3}). An additional 13 Gy from high-dose-rate (HDR) brachytherapy reduced the mean volume to 15.4 cm{sup 3}, and this was subsequently reduced to 8.6 cm{sup 3} with 13 Gy additional HDR brachytherapy (26 Gy, HDR). Four patients had physiologic FDG uptake in the cervix at 3 months after the completion of therapy. The mean time to the 50% reduction in physiologic tumor volume was 19.9 days and after combined external irradiation and HDR to 24.9 Gy. Conclusion: These results indicate that physiologic tumor volume determination by FDG-PET is feasible and that a 50% physiologic tumor volume reduction occurs within 20 days of starting therapy.

  1. Diagnostic Ability of FDG-PET/CT in the Detection of Malignant Pleural Effusion

    PubMed Central

    Nakajima, Reiko; Abe, Koichiro; Sakai, Shuji

    2015-01-01

    Abstract We investigated the role of F-18 fluorodeoxyglucose (FDG)-positron emission tomography (PET)/computed tomography (CT) for the differential diagnosis of malignant and benign pleural effusion. We studied 36 consecutive patients with histologically proven cancer (excluding malignant mesothelioma) who underwent FDG-PET/CT for suspected malignant pleural effusion. Fourteen patients had cytologically proven malignant pleural effusion and the other 22 patients had either negative cytology or clinical follow-up, which confirmed the benign etiology. We examined the maximum standardized uptake values (SUVmax) of pleural effusion and the target-to-normal tissue ratio (TNR), calculated as the ratio of the pleural effusion SUVmax to the SUVmean of the normal tissues (liver, spleen, 12th thoracic vertebrae [Th12], thoracic aorta, and spinalis muscle). We also examined the size and density (in Hounsfield units) of the pleural effusion and pleural abnormalities on CT images. TNR (Th12) and increased pleural FDG uptake compared to background blood pool were significantly more frequent in cases with malignant pleural effusion (P < 0.05 for both). The cutoff TNR (Th12) value of >0.95 was the most accurate; the sensitivity, specificity, and accuracy for this value were 93%, 68%, and 75%, respectively. FDG-PET/CT can be a useful method for the differential diagnosis of malignant and benign pleural effusion. PMID:26200610

  2. Serial 18F-FDG PET/CT Findings in a Patient With IgLON5 Encephalopathy.

    PubMed

    Zhang, Wei; Niu, Na; Cui, Ruixue

    2016-10-01

    We presented the serial FDG PET/CT brain scans of a 64-year-old woman with IgLON5 encephalopathy, which is a novel syndrome in association with antibodies to a neuronal cell adhesion protein named IgLON5, and FDG PET findings have not been characterized previously. For our case, the relatively hypermetabolism in primary sensorimotor cortices, basal ganglia, and cerebrum comparing to other cortical regions on the pretreatment FDG PET/CT was partially recovered on the follow-up FDG PET/CT scan after immunotherapy, corresponding with the alleviation of clinical syndromes. The metabolic change pattern was not similar as other types of autoimmune encephalitis. PMID:27556794

  3. Circulating microparticles bearing Fibrin associated with whole-body 18FDG-PET: diagnostic tools to detect paraneoplastic polymyalgia rheumatica.

    PubMed

    Mege, Diane; Cammilleri, Serge; Mundler, Olivier; Dignat-George, Françoise; Dubois, Christophe; Panicot-Dubois, Laurence; Guis, Sandrine

    2016-08-01

    Polymyalgia rheumatica (PMR), a chronic inflammatory rheumatism, can be the expression of a paraneoplastic syndrome. The same clinical symptoms are frequently observed at the early stage of the benign and malignant forms. Here, our aim was to develop diagnostic tools to differentiate paraneoplastic PMR from essential PMR. We combined an 18FDG-PET and detection of circulating procoagulant microparticles (MPs), such as fibrin positive (FibMPs), by flow cytometry. Two patients with PMR and a similar profile were selected. In the two patients, the 18FDG-PET revealed a hypermetabolic focus. However, the concentrations of fibrin+/annexin+ microparticles detected were (10 times higher in one of the two patients, who was later found to have breast cancer. The association of 18FDG-PET and the detection of microparticle fibrin positives by flow cytometry allows separating essential PMR (hypermetabolism by 18FDG-PET, low FibMPs) from paraneoplastic PMR. PMID:27324631

  4. Comparative Analysis between [(18)F]Fludarabine-PET and [(18)F]FDG-PET in a Murine Model of Inflammation.

    PubMed

    Hovhannisyan, Narinée; Dhilly, Martine; Guillouet, Stéphane; Leporrier, Michel; Barré, Louisa

    2016-06-01

    Lymphoma research has advanced thanks to introduction of [(18)F]fludarabine, a positron-emitting tool. This novel radiotracer has been shown to display a great specificity for lymphoid tissues. However, in a benign process such as inflammation, the uptake of this tracer has not been questioned. Indeed, in inflammatory zones, elevated glucose metabolism rate may result in false-positives with [(18)F]FDG-PET Imaging. In the present investigation, it has been argued that cells, involved in inflammation, might be less avid of [(18)F]fludarabine. To generate inflammation, Swiss mice were intramuscularly injected with 0.1 mL of turpentine oil into the right front paw. Imaging sessions with (18)F-labeled tracers named above were conducted on days 5 and 25 after inoculation. For each animal, volumes of interest (VOI), delineating the muscle of the inflamed (IP) and normal paws (NP), were determined on PET scans. For characterization of inflammation, muscle samples from IP and NP were stained with hematoxylin and eosin (H&E). In early (day 5) inflammation, [(18)F]FDG accumulation was 4.00 ± 1.65 times greater in the IP than in the contralateral NP; for [(18)F]fludarabine, this IP/NP ratio was 1.31 ± 0.28, resulting in a significant difference between radiotracer groups (p < 0.01). In late (day 25) inflammation, the IP/NP ratios were 2.07 ± 0.49 and 1.03 ± 0.07, for [(18)F]FDG and [(18)F]fludarabine, respectively (p < 0.001). [(18)F]Fludarabine showed significantly weaker uptake in inflammation when compared with [(18)F]FDG. This encouraging finding suggests that [(18)F]fludarabine-PET might well be a robust approach for distinguishing tumor from inflammatory tissue, avoiding false-positive PET results and thus enabling an accurate imaging of lymphoma. PMID:27080099

  5. The value of 18F-FDG PET in pediatric patients with post-transplant lymphoproliferative disorder at initial diagnosis.

    PubMed

    Vali, R; Punnett, A; Bajno, L; Moineddin, R; Shammas, A

    2015-12-01

    PTLD is a serious complication of both solid organ and BMT. This study assessed whether (18) F-FDG PET, when added to CT scan, had additional value in the initial evaluation of PTLD in pediatric patients and whether PET/CT at baseline can reliably guide biopsy. This retrospective study evaluated 34 consecutive pediatric patients (14 female), aged 3.5-17.0 yr (mean age: 9.9 yr, s.d.: 4.9 yr), who had undergone (18) F-FDG PET/CT from May 2007 to December 2014 at initial diagnosis of PTLD following heart (n = 13), lung (n = 8), kidney (n = 4), liver (n = 3), liver and bowel (n = 3), and bone marrow (n = 3) transplantation. PTLD was diagnosed histopathologically in 33 patients and was based on clinical findings, elevated EBV, and imaging and follow-up results in one patient. On lesion-based analysis, (18) F-FDG PET showed more lesions than conventional CT scan (168 vs. 134), but CT revealed 22 lesions negative on PET. On per patient analysis, PET detected more lesions in 13 patients, CT identified more abnormalities in seven, and both showed the same number of lesions in 14. Adding (18) F-FDG PET to CT scans upstaged the disease in seven patients (20.5%). A combination of (18) F-FDG PET and CT was also useful in guiding biopsy, being positive in 36 of 39 samples (92.3%). These findings indicated that (18) F-FDG PET and CT are complementary at initial staging of pediatric PTLD and that (18) F-FDG PET/CT scanning can guide biopsies. PMID:26515450

  6. FDG PET/CT Findings in Multiple Splenic Amebomas (Amebic Granulomas).

    PubMed

    Dong, Aisheng; Wang, Yang; Zuo, Changjing; Zhu, Huaimin

    2016-05-01

    Splenic ameboma (amebic granuloma) is rare. A 38-year-old man with a severe pneumonia due to inhalation of swimming pool water 18 months ago complained of night sweat, tiredness, and anorexia for 1 month. Abdominal ultrasound showed multiple nodules in the spleen. These nodules showed slight enhancement on enhanced CT and intense FDG uptake on PET/CT. Splenectomy was performed. Multiple splenic amebomas were confirmed by pathology. Free-living amoebae were also detected in samples of pleural effusion and blood. Splenic ameboma, although rare, should be included in the differential diagnosis with isolated focally increased FDG activity in the spleen. PMID:26505858

  7. Chronic Esophageal Perforation With Periesophageal Abscess Mimicking Malignancy on FDG PET/CT.

    PubMed

    Dong, Aisheng; Zhang, Ling; Wang, Yang; Zuo, Changjing

    2016-06-01

    A 53-year-old man was admitted because of progressive dysphagia and retrosternal pain for 20 days. Esophagogastroduodenoscopy showed an irregular submucosal bulge on the distal esophageal wall. A barium swallow showed a triangular-shaped outpouching of contrast material with minimal contained extravasation into the periesophageal area. Enhanced CT showed thickening of the distal esophagus with an area containing air and septa. FDG PET/CT showed intense FDG uptake of the thickened esophageal wall mimicking malignancy. Endoscopic ultrasonography-guided biopsy of the submucosal mass revealed granulation tissue. The imaging and pathologic findings were consistent with chronic esophageal perforation with periesophageal abscess. PMID:26914572

  8. 18F-FDG PET/CT Osteometabolic Activity in Metastatic Parathyroid Carcinoma.

    PubMed

    do Vale, Rômulo Hermeto Bueno; Queiroz, Marcelo Araújo; Coutinho, Artur Martins Novaes; Buchpiguel, Carlos Alberto; de Menezes, Marcos Roberto

    2016-09-01

    Parathyroid cancer is an uncommon type of malignancy, which is frequently associated with poor prognosis. Clinical manifestations are caused by elevated serum calcium and parathyroid hormone (PTH). Diagnostic imaging studies as neck ultrasonography, technetium Tc Tc-sestamibi whole body scintigraphy, CT, and MR are already established tools for this malignancy. Nevertheless, the role of F-FDG PET/CT remains unknown in this scenario, with few published studies in literature. Hence, in this article, we aimed to report an illustrative case of increased skeletal FDG uptake associated with high calcium and PTH levels. PMID:27276208

  9. Increased 18F-FDG Uptake Associated With Gastric Banding Surgical Mesh on PET/CT.

    PubMed

    Chism, Charles B; Somcio, Ray; Chasen, Beth A; Ravizzini, Gregory C

    2016-05-01

    Surgical mesh was used in the 1980s and early 1990s for vertical banded gastroplasty as treatment for morbid obesity. This procedure was replaced by the more popular laparoscopic gastric banding in the mid-1990s. Surgical mesh, commonly used in hernioplasty, has been associated with increased F-FDG uptake related to an inflammatory foreign body reaction and is a known cause of false-positive PET scans. We present a case of increased F-FDG uptake related to surgical mesh in a patient who had undergone vertical banded gastroplasty. PMID:26825203

  10. Imaging of Hepatic Ectopic Pregnancy by 18F-FDG PET/CT.

    PubMed

    Hao, Jingwen; Cheng, Zhen; Hu, Na; Xiao, Lizhi; Wang, Yunhua

    2016-09-01

    Hepatic ectopic pregnancy is an uncommon form of extrauterine pregnancy. A 31-year-old woman had acute abdominal pain and distention. Laboratory examination showed significantly increased serum β-human chorionic gonadotropin level. Both ultrasound and MRI identified a lesion located at the right lobe of the liver. FDG PET/CT was performed to determine whether the other causes of elevated β-human chorionic gonadotropin level, which showed an oval mass with mid peripherally increased FDG activity. After surgery, pathological results confirmed a diagnosis of hepatic ectopic pregnancy. PMID:27454601

  11. Clinical significance of patterns of incidental thyroid uptake at (18)F-FDG PET/CT.

    PubMed

    Agrawal, K; Weaver, J; Ngu, R; Krishnamurthy Mohan, H

    2015-05-01

    Incidental uptake of 2-[(18)F]-fluoro-2-deoxy-d-glucose ((18)F-FDG) in the thyroid gland is not uncommonly encountered in day-to-day practice of oncological (18)F-FDG positron-emission tomography/computed tomography (PET/CT). These are often felt to be "nuisance lesions" by referring clinicians and radiologists alike. However, recognition of the importance of different patterns of FDG uptake in the thyroid gland and knowledge of the possible underlying aetiologies are crucial in ensuring that patients are managed appropriately in the clinical context of their primary diagnosis, as the underlying pathological condition may be clinically important in a significant minority of such cases. This review describes the various patterns of (18)F-FDG uptake within the thyroid and discusses the clinical significance and possible impact on patient management. Incidental low-grade homogeneous diffuse increased thyroid (18)F-FDG uptake is usually seen in the patients with chronic thyroiditis, Grave's disease, and hypothyroidism. Thyroid function tests and antibody profiling are advised in these patients. Incidental focal (18)F-FDG thyroid uptake should raise the possibility of underlying malignancy. Ultrasound with or without fine-needle aspiration cytology is usually recommended for the evaluation of these lesions. Heterogeneous uptake with prominent focal uptake in the thyroid should be further evaluated to exclude malignancy. PMID:25687827

  12. Adrenal tuberculosis masquerading as disseminated malignancy: A pitfall of (18)F-FDG PET/CT Imaging.

    PubMed

    Gorla, A K R; Gupta, K; Sood, A; Biswal, C K; Bhansali, A; Mittal, B R

    2016-01-01

    Non-invasive characterization of adrenal lesions is a commonly encountered diagnostic challenge. Characteristic clinical and correlative imaging findings may assist in only arriving at a probable diagnosis. Currently, (18)F-FDG PET/CT is considered to provide the most comprehensive imaging information. We here present a case of bilateral adrenal tuberculosis that highlights the need for caution during the interpretation of (18)F-FDG PET/CT and also the need to suggest histopathological correlation. PMID:26853485

  13. Occult Mediastinal Yolk Sac Tumor Producing α-Fetoprotein Detected by 18F-FDG PET/CT.

    PubMed

    Liu, Meng; Chen, Guoqian; Fu, Zhanli; Li, Ziao; Li, Qian

    2016-07-01

    Malignant mediastinal yolk sac tumor (YST), especially adult onset, is rare. Herein, we report a case of occult mediastinal YST with α-fetoprotein production revealed by F-FDG PET/CT in a young adult, in which the intense tracer uptake was demonstrated in the anterior mediastinum. This case indicates F-FDG PET/CT may be a useful tool for detecting the occult primaries of YST. PMID:27088388

  14. Histopathologic Validation of Lymph Node Staging With FDG-PET Scan in Cancer of the Esophagus and Gastroesophageal Junction

    PubMed Central

    Lerut, Toni; Flamen, Patrick; Ectors, Nadine; Van Cutsem, Erik; Peeters, Marc; Hiele, Martin; De Wever, Walter; Coosemans, Willy; Decker, Georges; De Leyn, Paul; Deneffe, Georges; Van Raemdonck, Dirk; Mortelmans, Luc

    2000-01-01

    Objective To assess the value of positron emission tomography with 18fluorodeoxyglucose (FDG-PET) for preoperative lymph node staging of patients with primary cancer of the esophagus and gastroesophageal junction. Summary Background Data FDG-PET appears to be a promising tool in the preoperative staging of cancer of the esophagus and gastroesophageal junction. Recent reports indicate a higher sensitivity and specificity for detection of stage IV disease and a higher specificity for diagnosis of lymph node involvement compared with the standard use of computed tomography and endoscopic ultrasound. Methods Forty-two patients entered the prospective study. All underwent attenuation-corrected FDG-PET imaging of the neck, thorax, and upper abdomen, a spiral computed tomography scan, and an endoscopic ultrasound. The gold standard consisted exclusively of the histology of sampled nodes obtained by extensive two-field or three-field lymphadenectomies (n = 39) or from guided biopsies of suspicious distant nodes indicated by imaging (n = 3). Results The FDG-PET scan had lower accuracy for the diagnosis of locoregional nodes (N1–2) than combined computed tomography and endoscopic ultrasound (48% vs. 69%) because of a significant lack of sensitivity (22% vs. 83%). The accuracy for distant nodal metastasis (M+Ly), however, was significantly higher for FDG-PET than the combined use of computed tomography and endoscopic ultrasound (86% vs. 62%). Sensitivity was not significantly different, but specificity was greater (90% vs. 69%). The FDG-PET scan correctly upstaged five patients (12%) from N1–2 stage to M+Ly stage. One patient was falsely downstaged by FDG-PET scanning. Conclusions FDG-PET scanning improves the clinical staging of lymph node involvement based on the increased detection of distant nodal metastases and on the superior specificity compared with conventional imaging modalities. PMID:11088069

  15. 18F-FDG PET/CT Imaging of Primary Hepatic Neuroendocrine Tumor

    PubMed Central

    Mitamura, Katsuya; Yamamoto, Yuka; Tanaka, Kenichi; Sanomura, Takayuki; Murota, Makiko; Nishiyama, Yoshihiro

    2015-01-01

    Primary hepatic neuroendocrine tumors (PHNETs) are extremely rare neoplasms. Herein, we report a case of a 70- year-old man with a hepatic mass. The non-contrast computed tomography (CT) image showed a low-density mass, and dynamic CT images indicated the enhancement of the mass in the arterial phase and early washout in the late phase. F-18 fluorodeoxyglucose (18F-FDG) positron emission tomography (PET) and fused PET/CT images showed increased uptake in the hepatic mass. Whole-body 18F-FDG PET images showed no abnormal activity except for the liver lesion. Presence of an extrahepatic tumor was also ruled out by performing upper gastrointestinal endoscopy, total colonoscopy, and chest and abdominal CT. A posterior segmentectomy was performed, and histologic examination confirmed a neuroendocrine tumor (grade 1). The patient was followed up for about 2 years after the resection, and no extrahepatic lesions were radiologically found. Therefore, the patient was diagnosed with PHNET. To the best of our knowledge, no previous case of PHNET have been detected by 18F-FDG PET imaging.

  16. Active herpes zoster infection with cutaneous manifestation and adenopathy on FDG PET/CT

    PubMed Central

    Wadih, Antoine; Rehm, Patrice K.; Deng, Chunli; Douvas, Michael

    2015-01-01

    We report a patient with history of Hodgkin lymphoma. Six months after treatment, 2-deoxy-2-[18F]fluoro-d-glucose positron emission tomography and/or computed tomography ([18F] FDG PET/CT) scan showed abnormal uptake in right axillary lymph nodes concerning for recurrence. In addition, PET/CT showed a new hypermetabolic skin lesion overlying the right scapula. Clinical evaluation was consistent with shingles, and the patient was treated with valacyclovir. Subsequent PET/CT scan was normal with no evidence of lymphoma. Although there have been reported cases of abnormal FDG in nodes or in skin due to herpes zoster, our case is unique in the literature in that the PET/CT demonstrates abnormalities involving both the skin and associated lymph nodes. The possibility of false positive uptake, not because of recurrent malignancy, must always be considered when abnormal FDG uptake is noted in the follow-up of oncology patients. Careful review of the scan and correlation with clinical findings can avoid false positive interpretation and facilitate patient management. PMID:26649113

  17. Active herpes zoster infection with cutaneous manifestation and adenopathy on FDG PET/CT.

    PubMed

    Wadih, Antoine; Rehm, Patrice K; Deng, Chunli; Douvas, Michael

    2015-10-01

    We report a patient with history of Hodgkin lymphoma. Six months after treatment, 2-deoxy-2-[18F]fluoro-d-glucose positron emission tomography and/or computed tomography ([18F] FDG PET/CT) scan showed abnormal uptake in right axillary lymph nodes concerning for recurrence. In addition, PET/CT showed a new hypermetabolic skin lesion overlying the right scapula. Clinical evaluation was consistent with shingles, and the patient was treated with valacyclovir. Subsequent PET/CT scan was normal with no evidence of lymphoma. Although there have been reported cases of abnormal FDG in nodes or in skin due to herpes zoster, our case is unique in the literature in that the PET/CT demonstrates abnormalities involving both the skin and associated lymph nodes. The possibility of false positive uptake, not because of recurrent malignancy, must always be considered when abnormal FDG uptake is noted in the follow-up of oncology patients. Careful review of the scan and correlation with clinical findings can avoid false positive interpretation and facilitate patient management. PMID:26649113

  18. Interobserver and Intraobserver Variability among Measurements of FDG PET/CT Parameters in Pulmonary Tumors

    PubMed Central

    Büyükdereli, Gülgün; Güler, Mehtap; şeydaoğlu, Gülşah

    2016-01-01

    Background: 18F-fluorodeoxyglucose (FDG) positron emission tomography computed tomography (PET/CT) provides information about metabolic and morphologic status of malignancies. Tumor size and standardized uptake value (SUV) measurements are crucial for cancer treatment monitoring. Aims: The purpose of our study was to assess the variability of these measurements performed by observers evaluating lung tumors. Study Design: Retrospective cross-sectional study. Methods: FDG PET/CT images of 97 patients with pulmonary tumors were independently evaluated by two experienced nuclear medicine physicians. Primary tumor size (UDCT), maximum SUV (SUVmax), mean SUV (SUVmean) and maximum SUV normalized to liver mean SUV (SUVnliv max) were measured by each observer at two different times with an interval of at least 2 weeks. Interobserver and intraobserver variabilities of measurements were evaluated through statistical methods. Results: Size of the lesions varied from 0.81 to 13.6 cm (mean 4.29±2.24 cm). Very good agreement was shown with correlation, Bland-Altman and regression analysis for all measured PET/CT parameters. In the interobserver and intraobserver variability analysis, the Pearson correlation coefficients were greater than 0.96 and 0.98, respectively. Conclusion: Semi-quantitative measurements of pulmonary tumors were highly reproducible when determined by experienced physicians with clinically available software for routine FDG PET/CT evaluation. Consistency may be improved if the same observer performs serial measurements for any one patient. PMID:27308075

  19. FDG PET and tumour markers in the diagnosis of recurrent and metastatic breast cancer.

    PubMed

    Siggelkow, Wulf; Rath, Werner; Buell, Udalrich; Zimny, Michael

    2004-06-01

    Breast cancer continues to be one of the most common cancers in North America and Western Europe. Positron emission tomography with 2-[fluorine-18]-fluoro-2-deoxy-D-glucose (FDG PET) represents a non-invasive functional imaging modality that is based on metabolic characteristics of malignant tumours. In breast cancer, FDG PET is more accurate than conventional methods for staging of distant metastases or local recurrences and enables early assessment of treatment response in patients undergoing primary chemotherapy. Recent data indicate a rationale for the use of FDG PET in cases of asymptomatically elevated tumour marker levels in the presence of uncertain results of conventional imaging. Despite the fact that PET cannot rule out microscopic disease, it does have particular value in providing, in a single examination, a reliable assessment of the true extent of the disease. This technique is complementary to morphological imaging for primary diagnosis, staging and re-staging. It may become the method of choice for the assessment of asymptomatic patients with elevated tumour marker levels. This method, however, cannot replace invasive procedures if microscopic disease is of clinical relevance. PMID:15146295

  20. FDG-PET in the selection of brain lesions for biopsy

    SciTech Connect

    Hanson, M.W.; Glantz, M.J.; Hoffman, J.M.; Friedman, A.H.; Burger, P.C.; Schold, S.C.; Coleman, R.E. )

    1991-09-01

    The CT-guided stereotaxic needle biopsy has become a widely used procedure in the diagnostic evaluation of intracranial lesions including tumors. Conventional CT or MR frequently defines the anatomic regions of abnormality, which may be multiple lesions or a single lesion that is heterogeneous in cellular composition owing to the topographic variation of cellular constituency or the combination of active disease, nonspecific inflammation, necrosis, and/or edema. In these cases, selection of the most appropriate site for a successful diagnostic needle biopsy can be difficult. In three patients, we have used (18F)fluorodeoxyglucose (FDG) positron emission tomography (PET) to determine the site most likely to provide a diagnostic biopsy result. In the first patient, who presented with confusion, multiple biopsies from the temporal lobe, based on MR abnormalities, revealed only reactive gliosis and edema. Repeat biopsy directed by PET revealed an anaplastic astrocytoma. In a second patient, PET allowed us to differentiate radiation effect from active metastatic breast cancer. In the third patient, who presented with a grand mal seizure, biopsy of a CT-defined hypodense region demonstrated lymphocytosis. Metabolism of FDG was normal or increased in areas of Aspergillus encephalitis at autopsy. These preliminary studies suggest a complementary role for FDG-PET and CT or MR in selected patients for defining the intracranial site most likely to yield a positive biopsy result.

  1. (18)F-FDG PET/CT Imaging of Primary Hepatic Neuroendocrine Tumor.

    PubMed

    Mitamura, Katsuya; Yamamoto, Yuka; Tanaka, Kenichi; Sanomura, Takayuki; Murota, Makiko; Nishiyama, Yoshihiro

    2015-01-01

    Primary hepatic neuroendocrine tumors (PHNETs) are extremely rare neoplasms. Herein, we report a case of a 70- year-old man with a hepatic mass. The non-contrast computed tomography (CT) image showed a low-density mass, and dynamic CT images indicated the enhancement of the mass in the arterial phase and early washout in the late phase. F-18 fluorodeoxyglucose ((18)F-FDG) positron emission tomography (PET) and fused PET/CT images showed increased uptake in the hepatic mass. Whole-body (18)F-FDG PET images showed no abnormal activity except for the liver lesion. Presence of an extrahepatic tumor was also ruled out by performing upper gastrointestinal endoscopy, total colonoscopy, and chest and abdominal CT. A posterior segmentectomy was performed, and histologic examination confirmed a neuroendocrine tumor (grade 1). The patient was followed up for about 2 years after the resection, and no extrahepatic lesions were radiologically found. Therefore, the patient was diagnosed with PHNET. To the best of our knowledge, no previous case of PHNET have been detected by (18)F-FDG PET imaging. PMID:27408882

  2. The role of FDG-PET/CT in the evaluation of residual disease in paediatric non-Hodgkin lymphoma.

    PubMed

    Bhojwani, Deepa; McCarville, Mary B; Choi, John K; Sawyer, Jennifer; Metzger, Monika L; Inaba, Hiroto; Davidoff, Andrew M; Gold, Robert; Shulkin, Barry L; Sandlund, John T

    2015-03-01

    (18) F-labelled-fluorodeoxyglucose positron emission tomography (FDG-PET) findings are challenging to interpret for residual disease versus complete response in paediatric patients with non-Hodgkin lymphoma (NHL). A biopsy is often warranted to confirm the presence or absence of viable tumour if there is clinical or radiographic evidence of residual disease. In this study, we compared conventional imaging and FDG-PET/computerized tomography (CT) findings with biopsy results in 18 children with NHL. Our goal was to provide additional data to establish more reliable criteria for response evaluation. Residual disease was suspected after conventional imaging alone in eight patients, after FDG-PET/CT alone in three and after both modalities in seven patients. Biopsy confirmed the presence of viable tumour in two patients. Two additional patients experienced progressive disease or relapse. The sensitivity and negative predictive value of FDG-PET/CT using the London criteria to indicate residual tumour detectable by biopsy were 100%, but specificity was low (60%), as was the positive predictive value (25%). Thus, in this study, a negative FDG-PET/CT finding was a good indicator of complete remission. However, because false-positive FDG-PET/CT findings are common, biopsy and close monitoring are required for accurate determination of residual disease in individual patients. PMID:25382494

  3. (18)F-FDG-PET/CT and (18)F-NaF-PET/CT in men with castrate-resistant prostate cancer.

    PubMed

    Zukotynski, Katherine A; Kim, Chun K; Gerbaudo, Victor H; Hainer, Jon; Taplin, Mary-Ellen; Kantoff, Philip; den Abbeele, Annick D Van; Seltzer, Steven; Sweeney, Christopher J

    2015-01-01

    To evaluate (18)F-labeled-fluorodeoxyglucose ((18)F-FDG-) and (18)F-labeled-sodium fluoride ((18)F-NaF-) positron emission tomography/computed tomography (PET/CT) as biomarkers in metastatic castrate-resistant prostate cancer (mCRPC). Nine men (53-75 years) in a phase 1 trial of abiraterone and cabozantinib had (18)F-FDG-PET/CT, (18)F-NaF-PET/CT and standard imaging ((99m)Tc-labeled-methylene-diphosphonate ((99m)Tc-MDP) bone scan and abdominal/pelvic CT) at baseline and after 8 weeks of therapy. Baseline disease was classified as widespread (18)F-FDG-avid, oligometastatic (18)F-FDG-avid (1 site), or non-(18)F-FDG-avid. Metabolic response was classified using European Organisation for Research and Treatment of Cancer (EORTC) criteria. Treatment response using Response Evaluation Criteria in Solid Tumors (RECIST) 1.1, Prostate Cancer Working Group 2 (PCWG2) guidelines and days on trial (DOT) were recorded. All men were followed for 1 year or until progression. Four men had (18)F-FDG-avid disease: two with widespread (DOT 53 and 76) and two with oligometastatic disease (DOT 231 and still on trial after 742+ days). Five men had non-(18)F-FDG-avid disease; three remained stable or improved (2 still on trial while one discontinued for non-oncologic reasons; DOT 225-563+), and 2 progressed (DOT 285 and 532). Despite the small sample size, Kaplan-Meier analysis showed a significant difference in progression free survival (PFS) between men with widespread (18)F-FDG-avid, oligometastatic (18)F-FDG-avid and non-(18)F-FDG-avid disease (p < 0.01). All men had (18)F-NaF-avid disease. Neither (18)F-NaF-avid disease extent nor intensity was predictive of treatment response. (18)F-FDG-PET/CT may be superior to (18)F-NaF-PET/CT and standard imaging in men with mCRPC on abiraterone and cabozantinib. (18)F-FDG-PET/CT may have potential to stratify men into 3 groups (widespread vs. oligometastatic (18)F-FDG-avid vs. non-(18)F-FDG-avid mCRPC) to tailor therapy. Further evaluation is

  4. 18F-FDG PET/CT Role in Staging of Gastric Carcinomas: Comparison with Conventional Contrast Enhancement Computed Tomography

    PubMed Central

    Altini, Corinna; Niccoli Asabella, Artor; Di Palo, Alessandra; Fanelli, Margherita; Ferrari, Cristina; Moschetta, Marco; Rubini, Giuseppe

    2015-01-01

    Abstract The purpose of the report was to evaluate the role of fluorine-18 fluoro-2-deoxy-d-glucose positron emission tomography/computed tomography (18F-FDG PET/CT) in staging gastric cancer comparing it with contrast enhancement computed tomography (CECT). This retrospective study included 45 patients who underwent performed whole body CECT and 18F-FDG PET/CT before any treatment. We calculated CECT and 18F-FDG PET/CT sensitivity, specificity, accuracy, positive and negative predictive values (PPV and NPV) for gastric, lymphnode, and distant localizations; furthermore, we compared the 2 techniques by McNemar test. The role of 18F-FDG PET/CT semiquantitative parameters in relation to histotype, grading, and site of gastric lesions were evaluated by ANOVA test. Sensitivity, specificity, accuracy, PPV and NPV of CECT, and 18F-FDG PET/CT for gastric lesion were, respectively, 92.11%, 57.14%, 86.66%, 92.11%, 57.14% and 81.58%, 85.71%, 82.22%, 96.88%, 46.15%. No differences were identified between the 2 techniques about sensitivity and specificity. No statistical differences were observed between PET parameters and histotype, grading, and site of gastric lesion. The results of CECT and 18F-FDG PET/CT about lymphnode involvement were 70.83%, 61.90%, 66.66%, 68%, 65% and 58.33%, 95.24%, 75.55%, 93.33%, 66.67%. The results of CECT and 18F-FDG PET/CT about distant metastases were 80%, 62.86%, 66.66%, 38.10%, 91.67% and 60%, 88.57%, 82.22%, 60%, 88.57%. 18FDG PET/CT specificity was significantly higher both for lymphnode and distant metastases. The 18F-FDG PET/CT is a useful tool for the evaluation of gastric carcinoma to detect primary lesion, lymphnode, and distant metastases using 1 single image whole-body technique. Integration of CECT with 18F-FDG PET/CT permits a more valid staging in these patients. PMID:25997066

  5. False-Positive Finding on 18F FDG PET/CT: Report of a Rare Case With Xanthogranulomatous Inflammation in the Spinal Epidural Space.

    PubMed

    Alam, Mohammed Shah; Guan, Wei; Zhou, Wen-Lan; Wang, Quan-Shi; Wu, Hu-Bing

    2016-09-01

    Xanthogranulomatous inflammation in the spinal epidural space is extremely rare. We report a case of a 62-year-old man with a xanthogranulomatous inflammation in the spinal epidural space mistaken for lymphoma because of its avid F FDG uptake on PET/CT. This case emphasizes the need for caution when evaluating a spinal epidural mass using F FDG PET/CT as xanthogranulomatous inflammation can induce a false-positive reading on F-FDG PET/CT. PMID:27276211

  6. The relationship between hallucinations and FDG-PET in dementia with Lewy bodies.

    PubMed

    Firbank, Michael J; Lloyd, Jim; O'Brien, John T

    2016-09-01

    Visual hallucinations are common in dementia with Lewy bodies (DLB), although their etiology is unclear. This study aimed to investigate the relationship between severity and frequency of hallucinations and regional brain glucose metabolism. We performed brain FDG-PET scanning on 28 subjects with DLB (mean age 76). The neuropsychiatric index (NPI) was used to assess frequency and severity of hallucinations. We used the SPM package to investigate voxelwise correlations between NPI hallucination score (severity x frequency) and FDG uptake relative to the cerebellum. There was a bilateral medial occipital region where reduced FDG was associated with increased hallucination severity and frequency. We conclude that the reduced occipital metabolism frequently seen in DLB is associated with frequency and severity of visual hallucinations. Further studies are required to investigate whether this is the result of deficits in top-down or bottom-up visual processing pathways. PMID:26239998

  7. 18F-FDG PET/CT and PET/MRI Perform Equally Well in Cancer: Evidence from Studies on More Than 2,300 Patients.

    PubMed

    Spick, Claudio; Herrmann, Ken; Czernin, Johannes

    2016-03-01

    (18)F-FDG PET/CT has become the reference standard in oncologic imaging against which the performance of other imaging modalities is measured. The promise of PET/MRI includes multiparametric imaging to further improve diagnosis and phenotyping of cancer. Rather than focusing on these capabilities, many investigators have examined whether (18)F-FDG PET combined with mostly anatomic MRI improves cancer staging and restaging. After a description of PET/MRI scanner designs and a discussion of technical and operational issues, we review the available literature to determine whether cancer assessments are improved with PET/MRI. The available data show that PET/MRI is feasible and performs as well as PET/CT in most types of cancer. Diagnostic advantages may be achievable in prostate cancer and in bone metastases, whereas disadvantages exist in lung nodule assessments. We conclude that (18)F-FDG PET/MRI and PET/CT provide comparable diagnostic information when MRI is used simply to provide the anatomic framework. Thus, PET/MRI could be used in lieu of PET/CT if this approach becomes economically viable and if reasonable workflows can be established. Future studies should explore the multiparametric potential of MRI. PMID:26742709

  8. Quantitative Assessment of Heterogeneity in Tumor Metabolism Using FDG-PET

    SciTech Connect

    Vriens, Dennis; Disselhorst, Jonathan A.; Oyen, Wim J.G.; Geus-Oei, Lioe-Fee de; Visser, Eric P.

    2012-04-01

    Purpose: [{sup 18}F]-fluorodeoxyglucose-positron emission tomography (FDG-PET) images are usually quantitatively analyzed in 'whole-tumor' volumes of interest. Also parameters determined with dynamic PET acquisitions, such as the Patlak glucose metabolic rate (MR{sub glc}) and pharmacokinetic rate constants of two-tissue compartment modeling, are most often derived per lesion. We propose segmentation of tumors to determine tumor heterogeneity, potentially useful for dose-painting in radiotherapy and elucidating mechanisms of FDG uptake. Methods and Materials: In 41 patients with 104 lesions, dynamic FDG-PET was performed. On MR{sub glc} images, tumors were segmented in quartiles of background subtracted maximum MR{sub glc} (0%-25%, 25%-50%, 50%-75%, and 75%-100%). Pharmacokinetic analysis was performed using an irreversible two-tissue compartment model in the three segments with highest MR{sub glc} to determine the rate constants of FDG metabolism. Results: From the highest to the lowest quartile, significant decreases of uptake (K{sub 1}), washout (k{sub 2}), and phosphorylation (k{sub 3}) rate constants were seen with significant increases in tissue blood volume fraction (V{sub b}). Conclusions: Tumor regions with highest MR{sub glc} are characterized by high cellular uptake and phosphorylation rate constants with relatively low blood volume fractions. In regions with less metabolic activity, the blood volume fraction increases and cellular uptake, washout, and phosphorylation rate constants decrease. These results support the hypothesis that regional tumor glucose phosphorylation rate is not dependent on the transport of nutrients (i.e., FDG) to the tumor.

  9. Combined Modality Treatment for PET-Positive Non-Hodgkin Lymphoma: Favorable Outcomes of Combined Modality Treatment for Patients With Non-Hodgkin Lymphoma and Positive Interim or Postchemotherapy FDG-PET

    SciTech Connect

    Halasz, Lia M.; Jacene, Heather A.; Catalano, Paul J.; Van den Abbeele, Annick D.; LaCasce, Ann; Mauch, Peter M.; Ng, Andrea K.

    2012-08-01

    Purpose: To evaluate outcomes of patients treated for aggressive non-Hodgkin lymphoma (NHL) with combined modality therapy based on [{sup 18}F]fluoro-2-deoxy-2-D-glucose positron emission tomography (FDG-PET) response. Methods and Materials: We studied 59 patients with aggressive NHL, who received chemotherapy and radiation therapy (RT) from 2001 to 2008. Among them, 83% of patients had stage I/II disease. Patients with B-cell lymphoma received R-CHOP (rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone)-based chemotherapy, and 1 patient with anaplastic lymphoma kinase-negative anaplastic T-cell lymphoma received CHOP therapy. Interim and postchemotherapy FDG-PET or FDG-PET/computed tomography (CT) scans were performed for restaging. All patients received consolidated involved-field RT. Median RT dose was 36 Gy (range, 28.8-50 Gy). Progression-free survival (PFS) and local control (LC) rates were calculated with and without a negative interim or postchemotherapy FDG-PET scan. Results: Median follow-up was 46.5 months. Thirty-nine patients had negative FDG-PET results by the end of chemotherapy, including 12 patients who had a negative interim FDG-PET scan and no postchemotherapy PET. Twenty patients were FDG-PET-positive, including 7 patients with positive interim FDG-PET and no postchemotherapy FDG-PET scans. The 3-year actuarial PFS rates for patients with negative versus positive FDG-PET scans were 97% and 90%, respectively. The 3-year actuarial LC rates for patients with negative versus positive FDG-PET scans were 100% and 90%, respectively. Conclusions: Patients who had a positive interim or postchemotherapy FDG-PET had a PFS rate of 90% at 3 years after combined modality treatment, suggesting that a large proportion of these patients can be cured with consolidated RT.

  10. 18F-FDG-PET/CT in lymphoma: two decades of experience.

    PubMed

    Alvarez Páez, A M; Nogueiras Alonso, J M; Serena Puig, A

    2012-01-01

    The use of (18)F-FDG-PET/CT has changed the management of patients with lymphoma for the last two decades. This technique improves initial staging of the disease, making a prognostic approach and appropriate treatment planning, as well as monitoring therapy response of lymphoma. However, there are still controversial issues in medical literature that impact on daily clinical practice. This comprehensive literature review summarizes the current information regarding the potential use of (18)F-FDG-PET/CT in patients with lymphoma, highlighting the main applications and the current dilemmas for the nuclear medicine physicians at the time of the evaluation of these studies, trying to standardize criteria for its assessment, particularly in restaging and therapy monitoring. PMID:22841459

  11. Small Animal Retinal Imaging

    NASA Astrophysics Data System (ADS)

    Choi, WooJhon; Drexler, Wolfgang; Fujimoto, James G.

    Developing and validating new techniques and methods for small animal imaging is an important research area because there are many small animal models of retinal diseases such as diabetic retinopathy, age-related macular degeneration, and glaucoma [1-6]. Because the retina is a multilayered structure with distinct abnormalities occurring in different intraretinal layers at different stages of disease progression, there is a need for imaging techniques that enable visualization of these layers individually at different time points. Although postmortem histology and ultrastructural analysis can be performed for investigating microscopic changes in the retina in small animal models, this requires sacrificing animals, which makes repeated assessment of the same animal at different time points impossible and increases the number of animals required. Furthermore, some retinal processes such as neurovascular coupling cannot be fully characterized postmortem.

  12. Case Reports on the Differentiation of Malignant and Benign Intratracheal Lesions by 18F-FDG PET/CT.

    PubMed

    Chun, Kyung-Ah

    2015-11-01

    Malignant tracheal tumors (primary and secondary) are rare and benign tumors of the tracheobronchial tree are also rare. Few reports have been issued on the F-fluorodeoxyglucose (F-FDG) positron emission tomography (PET) findings of tracheal tumors or benign nontumorous tracheal lesions, which have been mainly studied by computed tomography (CT). The author reports 2 cases of intratracheal lesions with quite different F-FDG PET/CT findings. The first case was of a 73-year-old woman with colon cancer treated by hemicolectomy and subsequent adjuvant chemotherapy. Follow-up F-FDG PET/CT after 6 years revealed a hypermetabolic fungating mass (SUVmax: 5.8) in the distal trachea and biopsy confirmed intratracheal metastasis. The second case involved a 61-year-old man with tongue cancer who underwent mouth floor mass excision and right supraomohyoid neck dissection with submental flap reconstruction. Tracheal lesion was incidentally found during a F-FDG PET/CT follow-up study conducted 1 year later. A benign intratracheal condition with low FDG uptake (SUVmax: 1.2) and the lesion was not visualized by neck CT 4 months later. F-FDG PET/CT uptake was helpful in differentiating benign and malignant intratracheal lesions. PMID:26554767

  13. Case Reports on the Differentiation of Malignant and Benign Intratracheal Lesions by 18F-FDG PET/CT

    PubMed Central

    Chun, Kyung-Ah

    2015-01-01

    Abstract Malignant tracheal tumors (primary and secondary) are rare and benign tumors of the tracheobronchial tree are also rare. Few reports have been issued on the 18F-fluorodeoxyglucose (18F-FDG) positron emission tomography (PET) findings of tracheal tumors or benign nontumorous tracheal lesions, which have been mainly studied by computed tomography (CT). The author reports 2 cases of intratracheal lesions with quite different 18F-FDG PET/CT findings. The first case was of a 73-year-old woman with colon cancer treated by hemicolectomy and subsequent adjuvant chemotherapy. Follow-up 18F-FDG PET/CT after 6 years revealed a hypermetabolic fungating mass (SUVmax: 5.8) in the distal trachea and biopsy confirmed intratracheal metastasis. The second case involved a 61-year-old man with tongue cancer who underwent mouth floor mass excision and right supraomohyoid neck dissection with submental flap reconstruction. Tracheal lesion was incidentally found during a 18F-FDG PET/CT follow-up study conducted 1 year later. A benign intratracheal condition with low FDG uptake (SUVmax: 1.2) and the lesion was not visualized by neck CT 4 months later. 18F-FDG PET/CT uptake was helpful in differentiating benign and malignant intratracheal lesions. PMID:26554767

  14. Diagnostic utility of FDG-PET in neurolymphomatosis: report of five cases.

    PubMed

    Kinoshita, Hisanori; Yamakado, Hodaka; Kitano, Toshiyuki; Kitamura, Akihiro; Yamashita, Hirofumi; Miyamoto, Masakazu; Hitomi, Takefumi; Okada, Tomohisa; Nakamoto, Yuji; Sawamoto, Nobukatsu; Takaori-Kondo, Akifumi; Takahashi, Ryosuke

    2016-09-01

    Neurolymphomatosis (NL) is a rare condition involving the infiltration of lymphoma cells into the peripheral nervous system. NL can be primary or secondary in the setting of an unknown or known hematologic malignancy, respectively. Here, we report five cases in which F-18 2-fluoro-2-deoxy-glucose positron emission tomography/computed tomography (F-18 FDG-PET/CT) had great value for diagnosing NL. Two cases were rare primary NL, and the other three were secondary NL. Clinical presentations were asymmetric sensorimotor disturbances in the extremities with or without involvement of cranial nerves. Furthermore, all patients experienced spontaneous pain in the face or affected extremities. Cerebrospinal fluid analysis was cytologically negative in two of five cases. Gadolinium (Gd)-enhanced magnetic resonance imaging (MRI) detected abnormalities in the cranial nerves, nerve roots, and cauda equina in all cases except case 1 and the recurrent stage of case 2. F-18 FDG-PET/CT showed clear visualization of almost all the lymphomatous involvement of peripheral nerves and other tissues in all patients. Furthermore, F-18 FDG-PET/CT detected abnormalities including asymptomatic lesions that were not detected with MRI, and also identified the appropriate lesion for diagnostic biopsy. However, as in case 3, the lesions in the left oculomotor nerve and the cauda equina were detected only with Gd-enhanced MRI, which has superior spatial resolution. In conclusion, F-18 FDG-PET/CT is a sensitive modality that can suggest the presence of malignancy and identify appropriate places for diagnostic biopsies. It is especially useful when combined with Gd-enhanced MRI, even in patients with primary NL that is usually difficult to diagnose. PMID:27286845

  15. "Bottle Brush Sign"-Spinal Meningeal Disease on 18F-FDG PET-CT Scan.

    PubMed

    Riaz, Saima; Naz, Fozia; Bashir, Humayun; Niazi, Imran Khalid

    2016-09-01

    A 30-year-old man with a history of stage IV AE diffuse large cell lymphoma of left proximal humerus presented with new onset lower limb weakness at completion of chemotherapy. The F-FDG PET-CT scan showed increased intraspinal uptake from T12 to S1 vertebrae with unique "bottle brush" appearance in keeping with spinal meningeal disease. The leptomeningeal disease was further confirmed on correlative MRI scan. PMID:27405033

  16. FDG PET/CT diagnosis of hepatic lymphoma mimicking focal fatty infiltration on CT

    PubMed Central

    Lin, Eugene; Lee, Marie; Agoff, Nicholas

    2010-01-01

    Areas of hypoattenuation in the liver which do not have mass effect are typically thought to represent focal fatty infiltration. Rarely, tumors can present without mass effect in the liver. We present a case in which areas of liver hypoattenuation which were initially thought to represent focal fatty infiltration on CT due to lack of mass effect had abnormal uptake on a FDG PET/CT exam; these areas were due to secondary hepatic involvement from non-Hodgkin’s lymphoma. PMID:22470725

  17. Zosteriform Secondary Cutaneous Diffuse Large B-Cell Lymphoma on FDG PET/CT.

    PubMed

    Liao, Chiung-Wei; Yen, Kuo-Yang; Hsieh, Te-Chun; Kao, Chia-Hung

    2016-09-01

    We present a case of a woman who had erythematous papules on the abdomen accompanied with numbness and local heat sensation. She had received chemotherapy for advanced follicular lymphoma. F-FDG PET/CT demonstrated band-like hypermetabolic lesions seemingly involving dermatomes of lower abdominal wall, which was confirmed as secondary cutaneous diffuse large B-cell lymphoma via skin biopsy. PMID:27405036

  18. (18)F-FDG PET/CT findings in a case with HIV (-) Kaposi sarcoma.

    PubMed

    Ozdemir, E; Poyraz, N Y; Keskin, M; Kandemir, Z; Turkolmez, S

    2014-01-01

    Although mucocutaneous sites are the most frequently encountered sites of involvement, Kaposi Sarcoma (KS) may also occasionally involve the breast and the skeletal, endocrine, urinary and nervous systems.. Various imaging modalities may be used to delineate the extent of the disease by detecting unexpected sites of involvement. Herein, we report a case of classical type KS, in whom staging with (18)F-FDG PET/CT imaging disclosed widespread disease and unexpected findings of bone and salivary gland involvement. PMID:24119549

  19. Stage-dependent agreement between cerebrospinal fluid proteins and FDG-PET findings in Alzheimer's disease.

    PubMed

    Yakushev, Igor; Muller, Matthias J; Buchholz, Hans-Georg; Lang, Ulrike; Rossmann, Heidi; Hampel, Harald; Schreckenberger, Mathias; Fellgiebel, Andreas

    2012-02-01

    Cerebral hypometabolism and abnormal levels of amyloid beta (Aβ), total (t-tau) and phosphorylated tau (ptau) proteins in cerebrospinal fluid (CSF) are established biomarkers of Alzheimer's disease (AD). We examined the agreement between these biomarkers in a single center study of patients with AD of severity extending over a wide range. Forty seven patients (MMSE 21.4 ± 3.6, range 13-28 points) with incipient and probable AD underwent positron emission tomography with [18F]-fluorodeoxyglucose (FDG-PET) and lumbar puncture for CSF assays of Aβ1-42, p-tau181, and t-tau. All findings were classified as either positive or negative for AD. Statistical analyses were performed for the whole sample (n=47) and for the subgroups stratified as mild (MMSE > 20 points, n=30) and moderate (MMSE < 21 points, n=17) AD. In the whole patient sample, the agreement with the FDG-PET finding was 77% (chance-corrected kappa [κ]=0.34, p=0.016) for t-tau, 68% (κ=0.10, n.s.) for p-tau181, and 68% (κ=0.04, n.s.) for Aβ1-42. No significant agreement was found in the mild AD subgroup, while there was a strong agreement for t-tau (94%, κ=0.77, p=0.001) and p-tau181 (88%, κ=0.60, p=0.014) in the moderate AD group. A significant agreement between the FDG-PET and CSF tau findings in patients with AD supports the view that both are markers of neurodegeneration. CSF tau proteins and FDG-PET might substitute each other as supportive diagnostic tools in patients with suspected moderate-to-severe Alzheimer's dementia, while this is not the case in subjects at an earlier disease stage. PMID:22044023

  20. Reference Cluster Normalization Improves Detection of Frontotemporal Lobar Degeneration by Means of FDG-PET

    PubMed Central

    Dukart, Juergen; Perneczky, Robert; Förster, Stefan; Barthel, Henryk; Diehl-Schmid, Janine; Draganski, Bogdan; Obrig, Hellmuth; Santarnecchi, Emiliano; Drzezga, Alexander; Fellgiebel, Andreas; Frackowiak, Richard; Kurz, Alexander; Müller, Karsten; Sabri, Osama; Schroeter, Matthias L.; Yakushev, Igor

    2013-01-01

    Positron emission tomography with [18F] fluorodeoxyglucose (FDG-PET) plays a well-established role in assisting early detection of frontotemporal lobar degeneration (FTLD). Here, we examined the impact of intensity normalization to different reference areas on accuracy of FDG-PET to discriminate between patients with mild FTLD and healthy elderly subjects. FDG-PET was conducted at two centers using different acquisition protocols: 41 FTLD patients and 42 controls were studied at center 1, 11 FTLD patients and 13 controls were studied at center 2. All PET images were intensity normalized to the cerebellum, primary sensorimotor cortex (SMC), cerebral global mean (CGM), and a reference cluster with most preserved FDG uptake in the aforementioned patients group of center 1. Metabolic deficits in the patient group at center 1 appeared 1.5, 3.6, and 4.6 times greater in spatial extent, when tracer uptake was normalized to the reference cluster rather than to the cerebellum, SMC, and CGM, respectively. Logistic regression analyses based on normalized values from FTLD-typical regions showed that at center 1, cerebellar, SMC, CGM, and cluster normalizations differentiated patients from controls with accuracies of 86%, 76%, 75% and 90%, respectively. A similar order of effects was found at center 2. Cluster normalization leads to a significant increase of statistical power in detecting early FTLD-associated metabolic deficits. The established FTLD-specific cluster can be used to improve detection of FTLD on a single case basis at independent centers – a decisive step towards early diagnosis and prediction of FTLD syndromes enabling specific therapies in the future. PMID:23451025

  1. Reference cluster normalization improves detection of frontotemporal lobar degeneration by means of FDG-PET.

    PubMed

    Dukart, Juergen; Perneczky, Robert; Förster, Stefan; Barthel, Henryk; Diehl-Schmid, Janine; Draganski, Bogdan; Obrig, Hellmuth; Santarnecchi, Emiliano; Drzezga, Alexander; Fellgiebel, Andreas; Frackowiak, Richard; Kurz, Alexander; Müller, Karsten; Sabri, Osama; Schroeter, Matthias L; Yakushev, Igor

    2013-01-01

    Positron emission tomography with [18F] fluorodeoxyglucose (FDG-PET) plays a well-established role in assisting early detection of frontotemporal lobar degeneration (FTLD). Here, we examined the impact of intensity normalization to different reference areas on accuracy of FDG-PET to discriminate between patients with mild FTLD and healthy elderly subjects. FDG-PET was conducted at two centers using different acquisition protocols: 41 FTLD patients and 42 controls were studied at center 1, 11 FTLD patients and 13 controls were studied at center 2. All PET images were intensity normalized to the cerebellum, primary sensorimotor cortex (SMC), cerebral global mean (CGM), and a reference cluster with most preserved FDG uptake in the aforementioned patients group of center 1. Metabolic deficits in the patient group at center 1 appeared 1.5, 3.6, and 4.6 times greater in spatial extent, when tracer uptake was normalized to the reference cluster rather than to the cerebellum, SMC, and CGM, respectively. Logistic regression analyses based on normalized values from FTLD-typical regions showed that at center 1, cerebellar, SMC, CGM, and cluster normalizations differentiated patients from controls with accuracies of 86%, 76%, 75% and 90%, respectively. A similar order of effects was found at center 2. Cluster normalization leads to a significant increase of statistical power in detecting early FTLD-associated metabolic deficits. The established FTLD-specific cluster can be used to improve detection of FTLD on a single case basis at independent centers - a decisive step towards early diagnosis and prediction of FTLD syndromes enabling specific therapies in the future. PMID:23451025

  2. Grover disease (transient acantholytic dermatosis) in acute myeloid leukemia on FDG PET/CT.

    PubMed

    Zhu, Hongyun June; Clark, Lindsey N; Deloney, Linda A; McDonald, James E

    2014-02-01

    A 48-year-old man with a newly diagnosed acute myeloid leukemia developed purpuric rash on day 6 after chemotherapy. Skin biopsy on day 8 demonstrated Grover disease. Triamcinolone treatment started on day 10 with subjective improvement on day 15. Initial FDG PET/CT on day 12 demonstrated rarely seen diffuse skin uptake that was interpreted as technical artifact and repeated on day 16. Accurately reviewing both PET and CT imaging would prevent confusion between diffuse cutaneous hypermetabolic activity and a technical artifact. Grover disease usually affects the trunk and may be related to the elimination of chemotherapy agents by sweating. PMID:24152615

  3. Primary Pulmonary Artery Sarcoma on Dual-Time Point FDG PET/CT Imaging.

    PubMed

    Li, Juan; Zhao, Qian; He, Lirong; Zhuang, Xiaoqing; Li, Fang

    2016-08-01

    A 59-year-old man presented cough, chest pain, and shortness of breath for 2 weeks and fever for 4 days. A contrast chest CT revealed a large right pulmonary artery filling defect, suggestive of pulmonary embolism that failed to respond to anticoagulation therapy. FDG PET/CT was performed to evaluate possible malignancy, which revealed intense activity in the right main pulmonary artery without any extrathoracic abnormality. The ratio of the SUVmax of this lesion to the liver was significantly increased in the delayed PET images. The pathological examination demonstrated primary pulmonary artery sarcoma. PMID:27163460

  4. 18F-FDG PET/CT Findings of Scrub Typhus.

    PubMed

    Kim, Jahae; Kwon, Seong Young; Kang, Sae-Ryung; Cho, Sang-Geon; Song, Ho-Chun

    2015-10-01

    Scrub typhus is an acute infectious disease caused by Orienta tsutsugamushi, which is clinically manifested by fever, generalized lymphadenopathy, diffuse myalgia, headache, maculopapular rash, and eschars at the site of chigger feedings. Diagnosis of scrub typhus requires compatible clinical features, history of exposure, and result of selorogic testing. In recent years, F-FDG PET/CT is seen as having increasing potential for use in examination and management of patients with infectious or inflammatory disorders. This is a PET/CT case demonstrating scrub typhus in a patient without evidence of recurrence of thyroid papillary cancer. PMID:26098289

  5. 18F-FDG PET/CT in Neurolymphomatosis: Report of 3 Cases

    PubMed Central

    Canh, Nguyen Xuan; Tan, Ngo Van; Tung, Tran Thanh; Son, Nguyen Truong; Maurea, Simone

    2014-01-01

    Neurolymphomatosis is a rare manifestation of non-Hodgkin lymphoma characterized by infiltration of peripheral nerves, nerve roots, plexus and cranial nerves by malignant lymphocytes. This report presents positron emission tomography/computed tomography (PET/CT)imaging with 2-deoxy-2-18F-fluoro-D-glucose (18F-FDG) in 3 cases of non-Hodgkin lymphoma with nerve infiltration, including one newly diagnosed lymphoma, one recurrent lymphoma in previous nerve lesions and one newly recurrent lymphoma. PET/CT could reveal the affected neural structures including cranial nerves, spinal nerve roots, brachial plexus, cervicothoracic ganglion, intercostal nerves, branches of the vagus nerve, lumbosacral plexus and sciatic nerves. There was relative concordance between PET/CT and MRI in detection of affected cranial nerves. PET/CT seemed to be better than MRI in detection of affected peripheral nerves. 18F-FDG PET/CT was a whole-body imaging technique with the ability to reveal the affected cranial nerves, peripheral nerves, nerve roots and plexus in non-Hodgkin lymphoma. A thorough understanding of disease and use of advanced imaging modalities will increasingly detect neurolymphomatosis.

  6. A new assessment model for tumor heterogeneity analysis with [18]F-FDG PET images

    PubMed Central

    Wang, Ping; Xu, Wengui; Sun, Jian; Yang, Chengwen; Wang, Gang; Sa, Yu; Hu, Xin-Hua; Feng, Yuanming

    2016-01-01

    It has been shown that the intratumor heterogeneity can be characterized with quantitative analysis of the [18]F-FDG PET image data. The existing models employ multiple parameters for feature extraction which makes it difficult to implement in clinical settings for the quantitative characterization. This article reports an easy-to-use and differential SUV based model for quantitative assessment of the intratumor heterogeneity from 3D [18]F-FDG PET image data. An H index is defined to assess tumor heterogeneity by summing voxel-wise distribution of differential SUV from the [18]F-FDG PET image data. The summation is weighted by the distance of SUV difference among neighboring voxels from the center of the tumor and can thus yield increased values for tumors with peripheral sub-regions of high SUV that often serves as an indicator of augmented malignancy. Furthermore, the sign of H index is used to differentiate the rate of change for volume averaged SUV from its center to periphery. The new model with the H index has been compared with a widely-used model of gray level co-occurrence matrix (GLCM) for image texture characterization with phantoms of different configurations and the [18]F-FDG PET image data of 6 lung cancer patients to evaluate its effectiveness and feasibility for clinical uses. The comparison of the H index and GLCM parameters with the phantoms demonstrate that the H index can characterize the SUV heterogeneity in all of 6 2D phantoms while only 1 GLCM parameter can do for 1 and fail to differentiate for other 2D phantoms. For the 8 3D phantoms, the H index can clearly differentiate all of them while the 4 GLCM parameters provide complicated patterns in the characterization. Feasibility study with the PET image data from 6 lung cancer patients show that the H index provides an effective single-parameter metric to characterize tumor heterogeneity in terms of the local SUV variation, and it has higher correlation with tumor volume change after

  7. [A Case of Metastatic Seminomatous Testicular Tumor with Complicated Diagnosis by FDG-PET].

    PubMed

    Hashizume, Akihito; Mizuno, Nobuhiko; Kawai, Masaki; Kishida, Takeshi

    2016-07-01

    18F-fluorodeoxy glucose positron emission tomography (FDG-PET) for evaluation of the post chemotherapy residual tumor of the seminomatous testicular germ cell tumor is recommended by several guidelines. We report a case whose residual tumor was evaluated by FDG PET but the results were difficult to interpret. A 41-year-old male with left seminomatous germ cell tumor of the testis and 60 mm retroperitoneal lymph node (RPLN) metastasis was referred to our hospital. The International Germ Cell Consensus Classification (IGCCC) was good prognosis. After high orchiectomy, three cycles of bleomycin, etoposide, and cisplatin (BEP) chemotherapy normalized the tumor marker and the RPLN decreased to 15 mm. The standardized uptake value (SUV) max at the RPLN by FDG-PET was 2.93. Although residual viable cells were suspected, the SUV max was relatively low. Thus surveillance without additional therapy was selected. After observation for 25 weeks, the tumor grew to 25 mm. Then four cycles of paclitaxel, ifosfamide, and cisplatin (TIP) chemotherapy were indicated for the recurrence. The RPLN was decreased to 15 mm, but the SUV max was still as high as 2.67 at 6 weeks after the last chemotherapy. We dissected the residual tumor suspecting viable cancer, but the pathological examination revealed necrotic tissue without any viable cells. He has had no signs of recurrence for 1 year and 9 months after the operation. PMID:27569358

  8. F-18-FDG-PET Confined Radiotherapy of Locally Advanced NSCLC With Concomitant Chemotherapy: Results of the PET-PLAN Pilot Trial

    SciTech Connect

    Fleckenstein, Jochen; Hellwig, Dirk; Kremp, Stephanie; Grgic, Aleksandar; Groeschel, Andreas; Kirsch, Carl-Martin; Nestle, Ursula; Ruebe, Christian

    2011-11-15

    Purpose: The integration of fluoro-deoxy-D-glucose positron emission tomography (FDG-PET) in the process of radiotherapy (RT) planning of locally advanced non-small-cell lung cancer (NSCLC) may improve diagnostic accuracy and minimize interobserver variability compared with target volume definition solely based on computed tomography. Furthermore, irradiating only FDG-PET-positive findings and omitting elective nodal regions may allow dose escalation by treating smaller volumes. The aim of this prospective pilot trial was to evaluate the therapeutic safety of FDG-PET-based RT treatment planning with an autocontour-derived delineation of the primary tumor. Methods and Materials: Eligible patients had Stages II-III inoperable NSCLC, and simultaneous, platinum-based radiochemotherapy was indicated. FDG-PET and computed tomography acquisitions in RT treatment planning position were coregistered. The clinical target volume (CTV) included the FDG-PET-defined primary tumor, which was autodelineated with a source-to-background algorithm, plus FDG-PET-positive lymph node stations. Limited by dose restrictions for normal tissues, prescribed total doses were in the range of 66.6 to 73.8 Gy. The primary endpoint was the rate of out-of-field isolated nodal recurrences (INR). Results: As per intent to treat, 32 patients received radiochemotherapy. In 15 of these patients, dose escalation above 66.6 Gy was achieved. No Grade 4 toxicities occurred. After a median follow-up time of 27.2 months, the estimated median survival time was 19.3 months. During the observation period, one INR was observed in 23 evaluable patients. Conclusions: FDG-PET-confined target volume definition in radiochemotherapy of NSCLC, based on a contrast-oriented source-to-background algorithm, was associated with a low risk of INR. It might provide improved tumor control because of dose escalation.

  9. Correlation of {sup 18}F-FDG Avid Volumes on Pre–Radiation Therapy and Post–Radiation Therapy FDG PET Scans in Recurrent Lung Cancer

    SciTech Connect

    Shusharina, Nadya Cho, Joseph; Sharp, Gregory C.; Choi, Noah C.

    2014-05-01

    Purpose: To investigate the spatial correlation between high uptake regions of 2-deoxy-2-[{sup 18}F]-fluoro-D-glucose positron emission tomography ({sup 18}F-FDG PET) before and after therapy in recurrent lung cancer. Methods and Materials: We enrolled 106 patients with inoperable lung cancer into a prospective study whose primary objectives were to determine first, the earliest time point when the maximum decrease in FDG uptake representing the maximum metabolic response (MMR) is attainable and second, the optimum cutoff value of MMR based on its predicted tumor control probability, sensitivity, and specificity. Of those patients, 61 completed the required 4 serial {sup 18}F-FDG PET examinations after therapy. Nineteen of 61 patients experienced local recurrence at the primary tumor and underwent analysis. The volumes of interest (VOI) on pretherapy FDG-PET were defined by use of an isocontour at ≥50% of maximum standard uptake value (SUV{sub max}) (≥50% of SUV{sub max}) with correction for heterogeneity. The VOI on posttherapy images were defined at ≥80% of SUV{sub max}. The VOI of pretherapy and posttherapy {sup 18}F-FDG PET images were correlated for the extent of overlap. Results: The size of VOI at pretherapy images was on average 25.7% (range, 8.8%-56.3%) of the pretherapy primary gross tumor volume (GTV), and their overlap fractions were 0.8 (95% confidence interval [CI]: 0.7-0.9), 0.63 (95% CI: 0.49-0.77), and 0.38 (95% CI: 0.19-0.57) of VOI of posttherapy FDG PET images at 10 days, 3 months, and 6 months, respectively. The residual uptake originated from the pretherapy VOI in 15 of 17 cases. Conclusions: VOI defined by the SUV{sub max}-≥50% isocontour may be a biological target volume for escalated radiation dose.

  10. Effectiveness of FDG-PET/CT for evaluating early response to induction chemotherapy in head and neck squamous cell carcinoma

    PubMed Central

    dos Anjos, Renata Fockink; dos Anjos, Dalton Alexandre; Vieira, Danielle Leal; Leite, André Ferreira; Figueiredo, Paulo Tadeu de Souza; de Melo, Nilce Santos

    2016-01-01

    Abstract Background: 18F-Fluoro-Deoxy-Glucose Positron Emission Tomography with Computed Tomography (18F-FDG PET/CT) may be a powerful tool to predict treatment outcome. We aimed to review the effectiveness of 18F-FDG PET/CT in the assessment of early response to induction chemotherapy (IC) in patients with advanced Head and Neck Squamous Cell Cancer (HNSCC) without previous treatment. Methods: PubMed, Cochrane Library, Science Direct and Web of Science were searched to May 2016. Reference lists of the included articles and additional studies identified by one nuclear medicine expert were screened for potential relevant studies that investigated the effectiveness of 18F-FDG PET/CT performed before and after IC. Three authors independently screened all retrieved articles, selected studies that met inclusion criteria and extracted data. The methodology of the selected studies was evaluated by using the risk of bias checklist of the Agency for Healthcare Research and Quality (AHRQ). Results: Seven out of 170 eligible studies met our inclusion criteria. A total of 207 advanced HNSCC patients were evaluated with 18F-FDG PET/CT at baseline and after IC in the selected articles. Six from seven studies concluded that 18F-FDG PET/CT allowed early evaluation response to IC and predicted survival outcomes. Conclusion: The present systematic review confirms the potential value of 18F-FDG PET/CT as a diagnostic tool for early IV response assessment in HNSCC patients. However, the lack of standard definitions for response criteria and heterogeneous IC protocols indicate the need to further studies in order to better define the role of 18F-FDG PET/CT in these patients. PMID:27512861

  11. FDG-PET/CT in the Assessment of Treatment Response after Oncologic Treatment of Head and Neck Squamous Cell Carcinoma

    PubMed Central

    Keski-Säntti, Harri; Mustonen, Timo; Schildt, Jukka; Saarilahti, Kauko; Mäkitie, Antti A

    2014-01-01

    BACKGROUND In many centers, 18F-fluorodeoxyglucose-positron emission tomography/computed tomography (FDG-PET/CT) is used to monitor treatment response after definitive (chemo)radiotherapy [(C)RT] for head and neck squamous cell carcinoma (HNSCC), but its usefulness remains somewhat controversial. We aimed at assessing the accuracy of FDG-PET/CT in detecting residual disease after (C)RT. METHOD All HNSCC patients with FDG-PET/CT performed to assess treatment response 10–18 weeks after definitive (C)RT at our institution during 2008–2010 were included. The patient charts were reviewed for FDG-PET/CT findings, histopathologic findings, and follow-up data. The median follow-up time for FDG-PET/CT negative patients was 26 months. RESULTS Eighty-eight eligible patients were identified. The stage distribution was as follows: I, n = 1; II, n = 15; III, n = 17; IV, n = 55. The negative predictive value, positive predictive value, specificity, sensitivity, and accuracy of FDG-PET/CT in detecting residual disease were 87%, 81%, 94%, 65%, and 85%, respectively. The corresponding specific figures for the primary tumor site were 91%, 71%, 94%, 59%, and 86% and for the neck 93%, 100%, 100%, 75%, and 94%, respectively. CONCLUSIONS In patients who have received definitive (C)RT for HNSCC, post-treatment FDG-PET/CT has good potential to guide clinical decision-making. Patients with negative scan can safely be followed up clinically only, while positive scan necessitates tissue biopsies or a neck dissection to rule out residual disease. PMID:25210484

  12. 18F FDG PET/CT Evaluation of Patients with Ovarian Carcinoma

    PubMed Central

    Mittra, Erik S.; McDougall, I. Ross; Quon, Andrew; Gambhir, Sanjiv Sam

    2009-01-01

    Purpose The role of 18F FDG PET has been studied in ovarian carcinoma, but its sensitivity and specificity calculations are based on dedicated PET acquisition, not PET/CT in the majority of the published studies. Therefore, we were prompted to review our experience with PET/CT in the management of patients with ovarian carcinoma. Materials and methods This is a retrospective study of 43 women with ovarian carcinoma, 27–80 years old (average: 53.9 ± 7.8), who had whole-body PET/CT at our institution from Jan 1st, 2003 to Aug 31st, 2006. We reviewed the patients’ outcomes from medical records and compared them to the interpretation of the PET/CT scans. Sensitivity and specificity were calculated using a 2 × 2 table with pathology results (79.1% of the patients) or clinical follow-up (20.9% of the cases) as the gold standard. Confidence interval (CI) estimations were performed using the Wilson score method. Results All patients had advanced stage ovarian cancer and the study was requested for re-staging. A total of 60 scans were performed: 30 pts had 1 scan, 9 pts had 2 scans and 4 pts had 3 scans. The administered doses of 18F FDG ranged 381.1 – 769.6 MBq (average: 569.8 ± 73.3). PET/CT had a sensitivity of 88.4% (95% CI: 75.1–95.4) and a specificity of 88.2% (95% CI: 64.4–97.9) for detection of ovarian cancer. The SUV max of the detected lesions ranged 3–27 (average: 9.4±5.9). The CA-125 tumor marker ranged 3–935 kU/ml (average: 265.2) in patients with positive scans and 4–139 kU/ml (average: 17.1) in patients with negative scans. This difference was statistically significant (P value: 0.0242). Conclusion This study confirms the good results of 18F FDG PET/CT for identification of residual/recurrent ovarian cancer, as well as for distant metastases localization. PET/CT should be an integral part in evaluation of patients with high risk ovarian cancer or rising values of tumor markers (CA-125), prior to selection of the most appropriate therapy

  13. Whole-body FDG-PET imaging for staging of Hodgkin`s disease and lymphoma

    SciTech Connect

    Hoh, C.K.; Glaspy, J.; Rosen, P.

    1997-03-01

    Accurate staging of Hodgkin`s disease (HD) and non-Hodgkin`s lymphoma (NHL) is important for treatment management. In this study, the utility of 2-[{sup 18}F]fluoro-2-deoxy-D-glucose (FDG) wholebody PET was evaluated as an imaging modality for initial staging or restaging of 7 HD and 11 NHL patients. Whole-body PET-based staging results were compared to the patient`s clinical stage based on conventional staging studies, which included combinations of CT of the chest, abdomen and pelvis, MRI scans, gallium scans, lymphangiograms, staging laparatomies and bone scans. Accurate staging was performed in 17 of 18 patients using a whole-body PET-based staging algorithm compared to the conventional staging algorithm in 15 of 18 patients. In 5 of 18 patients, whole-body PET-based staging showed additional lesions not detected by conventional staging modalities, whereas conventional staging demonstrated additional lesions in 4 of 18 patients not detected by whole-body PET. The total cost of conventional staging was $66,292 for 16 CT chest scans, 16 CT abdominal/pelvis scans, three limited MRI scans, four bone scans, give gallium scans, two laparotomies and one lymphangiogram. In contrast, scans cost $36,250 for 18 whole-body PET studies and additional selected correlative studies: one plain film radiograph, one limited CT, one bone marrow san, one upper GI and one endoscopy. A whole-body FDG-PET-based staging algorithm may be an accurate and cost-effective method for staging or restaging HD and NHL. 10 refs., 7 figs., 2 tabs.

  14. FDG-PET mapping the brain substrates of visuo-constructive processing in Alzheimer's disease.

    PubMed

    Förster, Stefan; Teipel, Stefan; Zach, Christian; Rominger, Axel; Cumming, Paul; Fougere, Christian la; Yakushev, Igor; Haslbeck, Marianne; Hampel, Harald; Bartenstein, Peter; Bürger, Katharina

    2010-05-01

    The anatomical basis of visuo-constructive impairment in AD is widely unexplored. FDG-PET can be used to determine functional neuronal networks underlying specific cognitive performance in the human brain. In the present study, we determined the pattern of cortical metabolism that was associated with visuo-constructive performance in AD. We employed two widely used visuo-constructive tests that differ in their demand on visual perception and processing capacity. Resting state FDG-PET scans were obtained in 29 probable AD patients, and cognitive tests were administered. We made a voxel-based regression analysis of FDG uptake to scores in visual test performance, using the SPM5 software. Performance in the CERAD Drawing test correlated with FDG uptake in the bilateral inferior temporal gyri, bilateral precuneus, right cuneus, right supramarginal gyrus and right middle temporal gyrus covering areas of dorsal and ventral visual streams. In contrast, performance in the more complex RBANS Figure Copy test correlated with FDG uptake in the bilateral fusiform gyri, right inferior temporal gyrus, left anterior cingulate gyrus, left parahippocampal gyrus, right middle temporal gyrus and right insula, encompassing the ventral visual stream and areas of higher-level visual processing. The study revealed neuronal networks underlying impaired visual test performance in AD. The extent of involvement of visual and higher order association cortex increased with greater test complexity. From a clinical point of view, both of these widely used visual tests evaluate the integrity of complementary cortical networks and may contribute complementary information on the integrity of visual processing in AD. PMID:19875130

  15. Radiation assessment to paediatric with F-18-FDG undergo whole-body PET/CT examination

    NASA Astrophysics Data System (ADS)

    Dhalisa, H.; Mohamad, A. S.; Rafidah, Z.

    2016-01-01

    This study was carried out on wholebody radiation dose assessment to paediatrics patient who undergo PET/CT scanner at Institut Kanser Negara. Consist of 68 patients with varies of malignancies and epilepsy disease case covering age between 2 years to 12 years old. This is a retrospective study from 2010-2014. The use of PET/CT scanner as an advanced tool has been proven to give an extra radiation dose to the patient. It is because of the radiation exposure from the combination of both CT and PET scans rather than a single CT or PET scan. Furthermore, a study on radiation dose to paediatric patient undergoing PET/CT is rare in Malaysia. So, the aim of this study is to estimate the wholebody effective dose to paediatric patient in Malaysia. Effective dose from PET scan was calculated based on the activity of F18 FDG and dose coefficient reported in International Commission on Radiological Protection (ICRP) Publication 106. Effective dose from CT was determined using k coefficient as reported in ICRP publication 102 and Dose Length Product (DLP) value. The average effective dose from PET and CT were found to be 7.05mSv and 5.77mSv respectively. The mean wholebody effective dose received by a patient with combined PETCT examination was 12.78mSv. These results could be used as reference for dosimetry of a patient undergoing PETCT examination in Malaysia.

  16. Sclerosing angiomatoid nodular transformation (SANT) of the spleen: a case report with FDG-PET findings and literature review

    PubMed Central

    Imamura, Yumi; Hatta, Kazuha; Seshimo, Akiyoshi; Sawada, Tatsuo; Abe, Koichiro; Sakai, Shuji

    2016-01-01

    We report the 18F-fluorodeoxyglucose (FDG) positron emission tomography (PET)/computed tomography (CT) findings of sclerosing angiomatoid nodular transformation (SANT) of the spleen. The patient was a 37-year-old woman with a splenic mass incidentally found on abdominal ultrasound. FDG-PET/CT showed weak FDG accumulation (maximum standardized uptake value = 3.65). An unenhanced CT scan showed a low density and well-circumscribed splenic tumor that demonstrated weak enhancement from the arterial to delayed phase. Although hemangioma or hamartoma of the spleen was preoperatively diagnosed, histopathological examination revealed SANT. Therefore, when a splenic tumor with weak contrast medium enhancement and low FDG accumulation is observed, SANT should be considered as a differential diagnosis. Although CT and magnetic resonance imaging features of SANT have been reported, there are few reports on FDG-PET/CT findings. We report the radiological features of SANT, including FDG-PET/CT, and review the literature on SANT. PMID:27570634

  17. Sclerosing angiomatoid nodular transformation (SANT) of the spleen: a case report with FDG-PET findings and literature review.

    PubMed

    Imamura, Yumi; Nakajima, Reiko; Hatta, Kazuha; Seshimo, Akiyoshi; Sawada, Tatsuo; Abe, Koichiro; Sakai, Shuji

    2016-08-01

    We report the 18F-fluorodeoxyglucose (FDG) positron emission tomography (PET)/computed tomography (CT) findings of sclerosing angiomatoid nodular transformation (SANT) of the spleen. The patient was a 37-year-old woman with a splenic mass incidentally found on abdominal ultrasound. FDG-PET/CT showed weak FDG accumulation (maximum standardized uptake value = 3.65). An unenhanced CT scan showed a low density and well-circumscribed splenic tumor that demonstrated weak enhancement from the arterial to delayed phase. Although hemangioma or hamartoma of the spleen was preoperatively diagnosed, histopathological examination revealed SANT. Therefore, when a splenic tumor with weak contrast medium enhancement and low FDG accumulation is observed, SANT should be considered as a differential diagnosis. Although CT and magnetic resonance imaging features of SANT have been reported, there are few reports on FDG-PET/CT findings. We report the radiological features of SANT, including FDG-PET/CT, and review the literature on SANT. PMID:27570634

  18. [F-18] FDG-PET/CT parameters as predictors of outcome in inoperable NSCLC patients

    PubMed Central

    Nappi, Antonio; Gallicchio, Rosj; Simeon, Vittorio; Nardelli, Anna; Pelagalli, Alessandra; Zupa, Angela; Vita, Giulia; Venetucci, Angela; Di Cosola, Michele; Barbato, Francesco; Storto, Giovanni

    2015-01-01

    Background We evaluated the prognostic significance of standardized uptake value (SUVmax), metabolic tumour volume (MTV), and total lesion glycolysis (TLG) in [F-18] FDG PET/CT findings in patients with inoperable non-small-cell lung cancer (NSCLC). Patients and methods. One hundred and three patients (mean age, 65.6 ± 16 years) underwent [F-18] FDG PET/CT before the chemotherapy. The SUVmax value, the MTV (cm3; 42% threshold) and the TLG (g) were registered. The patients were followed up to 18 months thereafter (range 12–55 months). Failure to respond without progression, progression and/or disease-related death constituted surrogate end-points. The optimal SUVmax, MTV and TLG cut-off to predict the patients’ outcome were estimated. PET/CT results were then related to disease outcome (progression free survival; PFS). Results The Kaplan-Meier survival analysis for SUVmax showed a significant shorter PFS in patients presenting with lower values as compared to those with higher (p < 0.05, log-rank test). MTV and TLG were not suitable for predicting PFS apart from the subset of patients with mediastinal nodal involvement. Conclusions Despite the availability of new tools for the quantitative assessment of disease activity on PET/CT, the SUVmax rather than MTV and TLG remains the only predictor for PFS in NSCLC patients. MTV holds a value only when concomitant nodal involvement occurs. PMID:26834517

  19. Cervix carcinoma and incidental finding of medullary thyroid carcinoma by 18F-FDG PET/CT--clinical case.

    PubMed

    Chaushev, Borislav; Bochev, Pavel; Klisarova, Anelia; Yordanov, Kaloyan; Encheva, Elitsa; Dancheva, Jivka; Yordanova, Cvetelina; Hristozov, Kiril; Krasnaliev, Ivan; Radev, Radoslav; Nenkov, Rumen

    2014-01-01

    Thyroid nodules are encountered in clinical practice during the diagnostic procedures or patients' follow-up due to other diseases quite far from the thyroid gland with prevalence 4-50% in general population, depending on age, diagnostic method and race. The prevalence of thyroid nodules increases with age and their clarification should be done for their adequate treatment. An 18F-FDG PET/CT was done with a PET/CT scanner (Philips Gemini TF), consisting of dedicated lutetium orthosilicate full ring PET scanner and 16 slice CT. The PET/CT scan of the whole-body revealed on the CT portion a hypodense nodular lesion in the left lobe of the thyroid gland with increased uptake of 18F-FDG on the PET with SUVmax 10.3 and demonstrated a complete response to the induction therapy of the main oncological disease of the patient--squamous cell carcinoma. This clinical case demonstrates that whole-body 18F-FDG-PET/CT has an increasingly important role in the early evaluation of thyroid cancer as a second independent malignant localization. Focal thyroid lesion with high risk of thyroid malignancy was incidentally found on 18F-FDG PET/CT. PMID:25088110

  20. 18F-FDG microPET imaging differentiates between septic and aseptic wound healing after orthopedic implant placement

    PubMed Central

    Odekerken, Jim C E; Brans, Boudewijn T; Welting, Tim J M; Walenkamp, Geert H I M

    2014-01-01

    Background and purpose 18F-FDG PET is a widely used tool for molecular imaging of oncological, cardiovascular, and neurological disorders. We evaluated 18F-FDG microPET as an implant osteomyelitis imaging tool using a Staphylococcus aureus-induced peroperative implant infection in rabbits. Methods Intramedullary titanium nails were implanted in contaminated and uncontaminated (control) proximal right tibiae of rabbits. Tibiae were quantitatively assessed with microPET for 18F-FDG uptake before and sequentially at 1, 3, and 6 weeks after surgery. Tracer uptake was assessed in soft tissue and bone in both treatment groups with an additional comparison between the operated and unoperated limb. MicroPET analysis was combined with radiographic assessment and complementary histology of the tibiae. Results At the first postoperative week, the 18F-FDG uptake in the contaminated implant group was significantly higher than the preoperative measurement, without a significant difference between the contaminated and uncontaminated tibiae. From the third postoperative week onward, 18F-FDG uptake allowed discrimination between osteomyelitis and postoperative aseptic bone healing, as well as quantification of the infection at distinct locations around the implant. Interpretation 18F-FDG-based microPET imaging allows differentiation between deep infection and undisturbed wound healing after implantation of a titanium intramedullary nail in this rabbit model. Furthermore, our results indicate that 18F-FDG PET may provide a tool in human clinical diagnostics and for the evaluation of antimicrobial strategies in animal models of orthopedic implant infection. PMID:24673540

  1. Small animal disease surveillance.

    PubMed

    Sánchez-Vizcaíno, Fernando; Jones, Philip H; Menacere, Tarek; Heayns, Bethaney; Wardeh, Maya; Newman, Jenny; Radford, Alan D; Dawson, Susan; Gaskell, Rosalind; Noble, Peter J M; Everitt, Sally; Day, Michael J; McConnell, Katie

    2015-12-12

    This is the first UK small animal disease surveillance report from SAVSNET. Future reports will expand to other syndromes and diseases. As data are collected for longer, the estimates of changes in disease burden will become more refined, allowing more targeted local and perhaps national interventions. Anonymised data can be accessed for research purposes by contacting the authors. SAVSNET welcomes feedback on this report. PMID:26667432

  2. Pre-radiotherapy FDG PET predicts radiation pneumonitis in lung cancer

    PubMed Central

    2014-01-01

    Background A retrospective analysis is performed to determine if pre-treatment [18 F]-2-fluoro-2-deoxyglucose positron emission tomography/computed tomography (FDG PET/CT) image derived parameters can predict radiation pneumonitis (RP) clinical symptoms in lung cancer patients. Methods and Materials We retrospectively studied 100 non-small cell lung cancer (NSCLC) patients who underwent FDG PET/CT imaging before initiation of radiotherapy (RT). Pneumonitis symptoms were evaluated using the Common Terminology Criteria for Adverse Events version 4.0 (CTCAEv4) from the consensus of 5 clinicians. Using the cumulative distribution of pre-treatment standard uptake values (SUV) within the lungs, the 80th to 95th percentile SUV values (SUV80 to SUV95) were determined. The effect of pre-RT FDG uptake, dose, patient and treatment characteristics on pulmonary toxicity was studied using multiple logistic regression. Results The study subjects were treated with 3D conformal RT (n = 23), intensity modulated RT (n = 64), and proton therapy (n = 13). Multiple logistic regression analysis demonstrated that elevated pre-RT lung FDG uptake on staging FDG PET was related to development of RP symptoms after RT. A patient of average age and V30 with SUV95 = 1.5 was an estimated 6.9 times more likely to develop grade ≥ 2 radiation pneumonitis when compared to a patient with SUV95 = 0.5 of the same age and identical V30. Receiver operating characteristic curve analysis showed the area under the curve was 0.78 (95% CI = 0.69 – 0.87). The CT imaging and dosimetry parameters were found to be poor predictors of RP symptoms. Conclusions The pretreatment pulmonary FDG uptake, as quantified by the SUV95, predicted symptoms of RP in this study. Elevation in this pre-treatment biomarker identifies a patient group at high risk for post-treatment symptomatic RP. PMID:24625207

  3. Single-scan dual-tracer FLT+FDG PET tumor characterization

    NASA Astrophysics Data System (ADS)

    Kadrmas, Dan J.; Rust, Thomas C.; Hoffman, John M.

    2013-02-01

    Rapid multi-tracer PET aims to image two or more tracers in a single scan, simultaneously characterizing multiple aspects of physiology and function without the need for repeat imaging visits. Using dynamic imaging with staggered injections, constraints on the kinetic behavior of each tracer are applied to recover individual-tracer measures from the multi-tracer PET signal. The ability to rapidly and reliably image both 18F-fluorodeoxyglucose (FDG) and 18F-fluorothymidine (FLT) would provide complementary measures of tumor metabolism and proliferative activity, with important applications in guiding oncologic treatment decisions and assessing response. However, this tracer combination presents one of the most challenging dual-tracer signal-separation problems—both tracers have the same radioactive half-life, and the injection delay is short relative to the half-life and tracer kinetics. This work investigates techniques for single-scan dual-tracer FLT+FDG PET tumor imaging, characterizing the performance of recovering static and dynamic imaging measures for each tracer from dual-tracer datasets. Simulation studies were performed to characterize dual-tracer signal-separation performance for imaging protocols with both injection orders and injection delays of 10-60 min. Better performance was observed when FLT was administered first, and longer delays before administration of FDG provided more robust signal-separation and recovery of the single-tracer imaging measures. An injection delay of 30 min led to good recovery (R > 0.96) of static image values (e.g. SUV), Knet, and K1 as compared to values from separate, single-tracer time-activity curves. Recovery of higher order rate parameters (k2, k3) was less robust, indicating that information regarding these parameters was harder to recover in the presence of statistical noise and dual-tracer effects. Performance of the dual-tracer FLT(0 min)+FDG(32 min) technique was further evaluated using PET/CT imaging studies in

  4. Investigation of partial volume correction methods for brain FDG PET studies

    SciTech Connect

    Yang, J.; Huang, S.C.; Mega, M.; Toga, A.W.; Small, G.W.; Phelps, M.E.; Lin, K.P.

    1996-12-01

    The use of positron emission tomography (PET) in quantitative fluorodeoxyglucose (FDG) studies of aging and dementia has been limited by partial volume effects. A general method for correction of partial volume effects (PVE) in PET involves the following common procedures; segmentation of MRI brain images into gray matter (GM), white matter (WM), cerebral spinal fluid (CSF), and muscle (MS) components; MRI PET registration; and generation of simulated PET images. Afterward, two different approaches can be taken. The first approach derives first a pixel-by-pixel correction map as the ratio of the measured image to the simulated image [with realistic full-width at half-maximum (FWHM)]. The correction map was applied to the MRI segmentation image. Regions of interest (ROI`s) can then be applied to give results free of partial volume effects. The second approach uses the ROI values of the simulated ``pure`` image (with negligible FWHM) and those of the simulated and the measured PET images to correct for the PVE effect. By varying the ratio of radiotracer concentrations for different tissue components, the in-plane FWHM`s of a three-dimensional point spread function, and the ROI size, the authors evaluated the performance of these two approaches in terms of their accuracy and sensitivity to different simulation configurations. The results showed that both approaches are more robust than the approach developed by Muller-Gartner et al., and the second approach is more accurate and more robust than the first. In conclusion, the authors recommend that the second approach should be used on FDG PET images to correct for partial volume effects and to determine whether an apparent change in GM radiotracer concentration is truly due to metabolic changes.

  5. The Hypermetabolic Giant: 18F-FDG avid Giant Cell Tumor identified on PET-CT

    PubMed Central

    O’Connor, Wendi; Quintana, Megan; Smith, Scott; Willis, Monte; Renner, Jordan

    2014-01-01

    An 87 year-old white female presented with a two-year history of intermittent discomfort in her left foot. PET-CT identified intense18F-fluorodeoxyglucose (FDG) uptake corresponding to the lesion. Histology of a fine needle aspiration and open biopsy were consistent with a benign giant cell tumor (GCT) of the bone. GCT of bone is an uncommon primary tumor typically presenting as a benign solitary lesion that arises in the end of the long bones. While GCT can occur throughout the axial and appendicular skeleton, it is exceedingly uncommon in the bone of the foot. While 18F-FDG has been established in detecting several malignant bone tumors, benign disease processes may also be identified. The degree of 18F-FDG activity in a benign GCT may be of an intensity that can be mistakenly interpreted as a malignant lesion. Therefore, GCT of the bone can be included in the differential diagnosis of an intensely 18F-FDG-avid neoplasm located within the tarsal bones. PMID:25426232

  6. Parallel ICA of FDG-PET and PiB-PET in three conditions with underlying Alzheimer's pathology

    PubMed Central

    Laforce, Robert; Tosun, Duygu; Ghosh, Pia; Lehmann, Manja; Madison, Cindee M.; Weiner, Michael W.; Miller, Bruce L.; Jagust, William J.; Rabinovici, Gil D.

    2014-01-01

    The relationships between clinical phenotype, β-amyloid (Aβ) deposition and neurodegeneration in Alzheimer's disease (AD) are incompletely understood yet have important ramifications for future therapy. The goal of this study was to utilize multimodality positron emission tomography (PET) data from a clinically heterogeneous population of patients with probable AD in order to: (1) identify spatial patterns of Aβ deposition measured by (11C)-labeled Pittsburgh Compound B (PiB-PET) and glucose metabolism measured by FDG-PET that correlate with specific clinical presentation and (2) explore associations between spatial patterns of Aβ deposition and glucose metabolism across the AD population. We included all patients meeting the criteria for probable AD (NIA–AA) who had undergone MRI, PiB and FDG-PET at our center (N = 46, mean age 63.0 ± 7.7, Mini-Mental State Examination 22.0 ± 4.8). Patients were subclassified based on their cognitive profiles into an amnestic/dysexecutive group (AD-memory; n = 27), a language-predominant group (AD-language; n = 10) and a visuospatial-predominant group (AD-visuospatial; n = 9). All patients were required to have evidence of amyloid deposition on PiB-PET. To capture the spatial distribution of Aβ deposition and glucose metabolism, we employed parallel independent component analysis (pICA), a method that enables joint analyses of multimodal imaging data. The relationships between PET components and clinical group were examined using a Receiver Operator Characteristic approach, including age, gender, education and apolipoprotein E ε4 allele carrier status as covariates. Results of the first set of analyses independently examining the relationship between components from each modality and clinical group showed three significant components for FDG: a left inferior frontal and temporoparietal component associated with AD-language (area under the curve [AUC] 0.82, p = 0.011), and two components associated with

  7. 18F-FDG PET/CT Imaging of Bilateral Renal Metastasis of Breast Adenoid Cystic Carcinoma.

    PubMed

    Hassoun, Hani; Alabed, Yazan Z; Karls, Shawn; Probst, Stephan; Laufer, Jerome

    2016-02-01

    We report the case of a 65-year-old woman with a history of adenoid cystic carcinoma (ACC) of the breast. Fifteen years after mastectomy, the patient underwent a right upper lobectomy for a lung mass, and biopsy indicated ACC metastasis. Ten years after lobectomy, an F-FDG PET/CT was performed for restaging to rule out further metastases. We observed intense FDG uptake in enlarged polylobulated kidneys, which was biopsy proven as ACC metastasis. PMID:26562575

  8. Cholecystokinin-Assisted Hydrodissection of the Gallbladder Fossa during FDG PET/CT-guided Liver Ablation

    SciTech Connect

    Tewari, Sanjit O.; Petre, Elena N.; Osborne, Joseph; Sofocleous, Constantinos T.

    2013-12-15

    A 68-year-old female with colorectal cancer developed a metachronous isolated fluorodeoxyglucose-avid (FDG-avid) segment 5/6 gallbladder fossa hepatic lesion and was referred for percutaneous ablation. Pre-procedure computed tomography (CT) images demonstrated a distended gallbladder abutting the segment 5/6 hepatic metastasis. In order to perform ablation with clear margins and avoid direct puncture and aspiration of the gallbladder, cholecystokinin was administered intravenously to stimulate gallbladder contraction before hydrodissection. Subsequently, the lesion was ablated successfully with sufficient margins, of greater than 1.0 cm, using microwave with ultrasound and FDG PET/CT guidance. The patient tolerated the procedure very well and was discharged home the next day.

  9. Pancreatitis Secondary to Anti-Programmed Death Receptor 1 Immunotherapy Diagnosed by FDG PET/CT.

    PubMed

    Alabed, Yazan Z; Aghayev, Ayaz; Sakellis, Christopher; Van den Abbeele, Annick D

    2015-11-01

    A 57-year-old man with metastatic melanoma developed colitis secondary to ipilimumab, a known immune-related adverse event (irAE). The patient then received pembrolizumab immunotherapy, an anti-programmed-death-receptor-1 (PD-1) antibody. Restaging FDG PET/CT study following 3 cycles of therapy demonstrated diffuse increased FDG uptake throughout the body of the pancreas associated with fat stranding in the peripancreatic region, suggestive of pembrolizumab-induced pancreatitis. Although the patient was clinically asymptomatic, diagnosis was biochemically confirmed with elevated amylase and lipase levels. In the era of immunotherapy, it will be critical to recognize irAEs early to allow prompt initiation of appropriate therapy and reduce the risk of long-term sequelae. PMID:26284765

  10. Isolated cholangiolitis revealed by 18F-FDG-PET/CT in a patient with fever of unknown origin.

    PubMed

    Codreanu, Ion; Zhuang, Hongming

    2011-01-01

    Cholangiolitis, inflammation of the cholangioles, is difficult to diagnose by conventional imaging modalities. We report a case of cholangiolitis revealed by fluorine-18 fluoro desoxyglucose positron emission tomography-computerized tomography ((18)F-FDG-PET/CT) after about 9 months of recurrent fevers. A 20 years old girl with a history of recurrent fevers and repeated workups at different hospitals, which didn't diagnosed the source of fever, was admitted with a recent episode of fever. An (18)F-FDG-PET/CT was requested, which demonstrated focal hypermetabolic activity in the lateral segment of the left lobe of the liver. A liver biopsy showed inflammation of small biliary ducts consistent of cholangiolitis. Enterococcus casseliflavus was found on performed cultures. This represents the first case of cholangiolitis revealed by (18)F-FDG-PET/CT imaging. PMID:21512668

  11. 18F-FDG PET/CT in Patients with Nodular Pulmonary Amyloidosis: Case Report and Literature Review

    PubMed Central

    Quan, Xiao-Qing; Yin, Tie-Jun; Zhang, Cun-Tai; Liu, Jian; Qiao, Li-Fen; Ke, Chang-Shu

    2014-01-01

    A 62-year-old woman was found to have multiple bilateral pulmonary nodules showing different 18F-fluorodeoxyglucose (FDG) uptakes on positron-emission tomography/computed tomography (PET/CT). Only the largest nodule in the left lower lobe showed an increased 18F-FDG uptake on PET/CT. Three nodules were surgically resected from different lobes of the left lung. Two lobes were benign and showed amyloid deposition. The largest nodule in the left lower lobe showed adenocarcinoma and a heavy amyloid deposition. Pulmonary amyloidosis should be added to the differential diagnosis for cases with multiple pulmonary nodules that show different 18F-FDG uptakes on PET/CT. To the best of our knowledge, this is the second reported case of a lung nodule consisting of adenocarcinoma and amyloid deposition. PMID:25566054

  12. Erythema nodosum associated with diffuse, large B-cell non-Hodgkin lymphoma detected by FDG PET.

    PubMed

    Cheong, Kerry A; Rodgers, Nicholas G; Kirkwood, Ian D

    2003-08-01

    A patient is described with non-Hodgkin lymphoma and erythematous skin nodules suspected to be erythema nodosum. The patient underwent serial fluorodeoxyglucose (FDG) positron emission tomography (PET), which demonstrated normalization of FDG uptake by the lymphoma after 2 cycles of chemotherapy, but there was new abnormal uptake involving the subcutaneous tissues of the lower extremities. A typical skin lesion was sampled and showed the appearance of erythema nodosum with no evidence of lymphoma. The FDG uptake gradually diminished on serial PET imaging after treatment with nonsteroidal antiinflammatory drugs. In view of the recognized association of erythema nodosum with malignancy and the differential rate of response to chemotherapy, the lesions of erythema nodosum may be a source of a false-positive PET interpretation, and histologic assessment should be considered. PMID:12897650

  13. Early recognition of aortitis of the aorta ascendens with ¹⁸F-FDG PET/CT: syphilitic?

    PubMed

    Balink, H; Spoorenberg, A; Houtman, P M; Brandenburg, A; Verberne, H J

    2013-05-01

    We present the case of a 42-year-old woman known with a human leukocyte antigen B27 positive ankylosing spondylitis. Despite treatment with a tumor necrosis factor blocking agent, the patient was not pain free and inflammation markers remained elevated. An (18)F-fluorodeoxyglucose positron emission tomography/computed tomography ((18)F-FDG PET/CT) was performed in an attempt to exclude possible other inflammatory processes. The (18)F-FDG PET/CT revealed increased metabolic activity in the ascending aortic wall, which appeared unexpectedly related to late syphilis. Based on this case and existing literature on this subject, we come to the conclusion that (18)F-FDG PET/CT can help in an early establishment of syphilitic aortitis before the possible life-threatening sequelae of syphilitic aortitis occur. PMID:23377199

  14. Impact of total activity variation in 18F-FDG injected with the overall PET image quality in oncology patients

    NASA Astrophysics Data System (ADS)

    Hishar, H.; Fathinul Fikri, A. S.; Salasiah, M.; Noramaliza, M. N.; Abdul Jalil, N.

    2013-05-01

    The preliminary study aims to investigate whether variation on dose activity 18F-FDG will influence the overall PET image quality in oncology patients. This is a retrospective analysis of 10 oncology patients who were injected with an average of 337.40 ± 38.43 MBq of 18F-FDG for PET/CT whole body examination. Patients were divided into 2 groups based on total activity of 18F-FDG injected: less than 333 MBq (302.96±12.65 MBq) (group 1) and more than 333 MBq (371.85±14.00 MBq) (group 2). Multiple Image Projection (MIP) PET images were scored visually by two qualified nuclear radiologists using a two-point scoring scale (poor and excellent). The agreement between radiologists was analysed using kappa measure of agreement (K). The prediction on poor-to-excellent PET image by the total activity of 18F-FDG injected was analysed using a Chi-squared test (x2). A p value of < 0.05 was considered significant. Agreement on PET image scoring was substantial, with a kappa value of 0.737. However, the prediction of the PET image quality by the total activity injected has been found to be insignificant (p > 0.05). Therefore, there is no strong evidence suggest that the dose injected will influence the PET image quality. Hence, it is recommended to use low-dosed of 18F-FDG technique as it also potentially yields a comparable PET image and reduces radiation burden to the patients.

  15. Application of 18F-FDG PET and diffusion weighted imaging (DWI) in multiple myeloma: comparison of functional imaging modalities

    PubMed Central

    Sachpekidis, Christos; Mosebach, Jennifer; Freitag, Martin T; Wilhelm, Thomas; Mai, Elias K; Goldschmidt, Hartmut; Haberkorn, Uwe; Schlemmer, Heinz-Peter; Delorme, Stefan; Dimitrakopoulou-Strauss, Antonia

    2015-01-01

    Aim of this prospective study was to assess the sensitivity of positron emission tomography (PET) and diffusion-weighted imaging (DWI) in detecting multiple myeloma (MM) lesions, using the well-established morphologic modalities magnetic resonance imaging (MRI) and computed tomography (CT) as the standard of reference (RS). The study included 24 MM patients (15 newly diagnosed, 9 pre-treated). All underwent 18F-FDG PET/CT and wholebody DWI. The findings in PET and DWI were compared to matching imaging findings in combined non-enhanced T1w, fat-saturated T2w (TIRM)- MRI, and low-dose CT. Patient-based analysis revealed that 15/24 patients (10 primary MM, 5 pre-treated) had myeloma lesions according to our RS. PET was positive in 13/24 patients (11 primary MM, 2 pre-treated) and DWI in 18/24 patients (12 primary MM, 6 pre-treated). Lesion-based analysis demonstrated 128 MM lesions, of which PET depicted 60/128 lesions (sensitivity 47%), while DWI depicted 99/128 lesions (sensitivity 77%). Further analysis including only the 15 untreated MM patients revealed a sensitivity of 90% for both PET and DWI and an overall concordance of PET and DWI of 72%. In conclusion, DWI was more sensitive than 18F-FDG PET in detecting myeloma lesions in a mixed population of primary and pre-treated MM patients. However, 18F-FDG PET and DWI demonstrated equivalent sensitivities in the sub-population of primary, untreated MM patients. This higher sensitivity of DWI in pre-treated patients may be due to the fact that 18F-FDG PET becomes negative earlier in the course of treatment in contrary to MRI, in which already treated lesions can remain visible. PMID:26550539

  16. Preoperative Evaluation of Renal Cell Carcinoma by Using 18F-FDG PET/CT

    PubMed Central

    Takahashi, Miwako; Kume, Haruki; Koyama, Keitaro; Nakagawa, Tohru; Fujimura, Tetsuya; Morikawa, Teppei; Fukayama, Masashi; Homma, Yukio; Ohtomo, Kuni; Momose, Toshimitsu

    2015-01-01

    Purpose This study aimed to characterize the FDG uptake of renal cell carcinoma (RCC) by the pathological subtype and nuclear grade. Patients and Methods We retrospectively identified patients who underwent 18F-FDG PET and subsequent partial or radical nephrectomy for renal tumors. The relationships of the SUV of renal tumor with subtypes, nuclear grade, and clinicopathological variables were investigated. Results Ninety-two tumors were analyzed, including 52 low-grade (G1 and G2) and 18 high-grade (G3 and G4) clear cell RCC; 7 chromophobe, 5 papillary, and 1 unclassified RCC; and 9 benign tumors (7 angiomyolipoma and 2 oncocytoma). The SUVs of high-grade clear cell RCC (mean ± SD, 6.8 ± 5.1) and papillary RCC (6.6 ± 3.7) were significantly higher than that of the controls (2.2 ± 0.3). The SUV of high-grade clear cell RCC was higher than that of low-grade tumors (median, 4.0 vs. 2.2; P < 0.001). The optimal SUV cutoff value of 3.0 helped to differentiate high-grade from low-grade clear cell RCC, with 89% sensitivity and 87% specificity. On multiple regression analysis, a high grade was the most significant predictor of SUV for clear cell RCC. Conclusions FDG uptake higher than that observed in normal kidney tissues suggests a high-grade clear cell RCC or papillary RCC subtype. FDG-PET using SUV may have a role in prediction of pathological grade of renal tumor. PMID:26164183

  17. Automatic FDG-PET-based tumor and metastatic lymph node segmentation in cervical cancer

    NASA Astrophysics Data System (ADS)

    Arbonès, Dídac R.; Jensen, Henrik G.; Loft, Annika; Munck af Rosenschöld, Per; Hansen, Anders Elias; Igel, Christian; Darkner, Sune

    2014-03-01

    Treatment of cervical cancer, one of the three most commonly diagnosed cancers worldwide, often relies on delineations of the tumour and metastases based on PET imaging using the contrast agent 18F-Fluorodeoxyglucose (FDG). We present a robust automatic algorithm for segmenting the gross tumour volume (GTV) and metastatic lymph nodes in such images. As the cervix is located next to the bladder and FDG is washed out through the urine, the PET-positive GTV and the bladder cannot be easily separated. Our processing pipeline starts with a histogram-based region of interest detection followed by level set segmentation. After that, morphological image operations combined with clustering, region growing, and nearest neighbour labelling allow to remove the bladder and to identify the tumour and metastatic lymph nodes. The proposed method was applied to 125 patients and no failure could be detected by visual inspection. We compared our segmentations with results from manual delineations of corresponding MR and CT images, showing that the detected GTV lays at least 97.5% within the MR/CT delineations. We conclude that the algorithm has a very high potential for substituting the tedious manual delineation of PET positive areas.

  18. FDG-PET/CT Brain Findings in a Patient With Macrophagic Myofasciitis.

    PubMed

    Van Der Gucht, Axel; Aoun-Sebaiti, Mehdi; Kauv, Paul; Guedj, Eric; Aouizerate, Jessie; Verger, Antoine; Gherardi, Romain K; Bachoud-Levi, Anne-Catherine; Authier, François-Jérôme; Itti, Emmanuel

    2016-03-01

    Brain Positron Emission Tomography/Computed Tomography with (18)F-fluorodeoxyglucose (FDG PET/CT) was performed in a 44-year-old woman with marked cognitive impairment, diffuse myalgias, sensory, memory and visual disorders, and chronic fatigue, presenting with histopathological features of macrophagic myofasciitis (MMF) at deltoid muscle biopsy. Cerebromedullary Magnetic Resonance Imaging (MRI), electromyography, ophthalmic examination, and cerebrospinal fluid analysis were normal. Visual analysis of FDG PET/CT images showed an atypical pattern of hypometabolism, involving symmetrically the occipital cortex, temporal lobes, and limbic system (including in particular amygdalo-hippocampal complexes), and the cerebellum. Posterior cingulate cortex and parietal areas were preserved. This pattern was confirmed by a voxel-based procedure using Statistical Parametric Mapping (SPM12) that compared a patient's images to normal reference samples from six healthy subjects with adjustment to age obtained using the same PET/CT camera. These results provide a glucose metabolism substrate for cognitive complaints in patients with long-lasting aluminium hydroxide-induced MMF. PMID:26941864

  19. Pitfalls in [18F]FDG PET imaging in gynecological malignancies.

    PubMed

    Hernandez Pampaloni, Miguel; Facchetti, Luca; Nardo, Lorenzo

    2016-06-01

    Gynecologic malignancies are the leading causes of cancer in women and they represent about 10 to 20% of all solid tumors. During the past few decades, technological advancements in the detection and staging have gained a pivotal role in all oncological processes, including the gynecological ones. Beyond ultrasound, computed tomography (CT) and magnetic resonance (MR) imaging that are conventionally used for anatomical imaging, [18F]FDG imaging and its hybrid further development as PET/CT has become a crucial tool due of its ability to combine functional metabolic and anatomic information, and the ability to image the entire whole body in a single examination. Since the introduction of integrated hybrid PET/CT systems into clinical practice the accurate analysis of the images has detected a number of limitations and pitfalls. The purpose of this review was to describe in detail the different pitfalls related to the use of [18F]FDG PET/CT in the gynecological malignancies, providing imaging examples and discussing possible ways to avoid misinterpretations. PMID:26937887

  20. Comparison of (18)F-FDG PET/CT and (68)Ga-DOTATATE PET/CT imaging in metastasized Merkel cell carcinoma.

    PubMed

    Epstude, Maximilian; Tornquist, Katharina; Riklin, Christian; di Lenardo, Francesca; Winterhalder, Ralph; Hug, Urs; Strobel, Klaus

    2013-04-01

    Merkel cell carcinoma (MCC) is a rare but very aggressive neuroendocrine tumor of the skin in elderly patients with higher mortality compared with melanoma. No evidence-based standardized chemotherapy exists for metastasized patients.We report the case of an 87-year-old patient with the history of resection of a large MCC of the parietal scalp planned for radiotherapy and staged with FDG PET/CT showing disseminated distant metastases. Ga-DOTATATE PET/CT revealed more extensive tumor load compared with FDG, and due to the intensive expression of somatostatin receptors the patient qualified for Y DOTATOC therapy. PMID:23429397

  1. Cancers of the oral cavity and oropharynx: FDG PET with contrast-enhanced CT in the posttreatment setting.

    PubMed

    King, Kevin G; Kositwattanarerk, Arpakorn; Genden, Eric; Kao, Johnny; Som, Peter M; Kostakoglu, Lale

    2011-01-01

    The combined use of fluorine 18 fluorodeoxyglucose (FDG) positron emission tomography (PET) and contrast material-enhanced computed tomography (CT) for posttreatment monitoring of cancers of the oral cavity and oropharynx has steadily increased in recent years. FDG PET/CT offers many advantages for evaluating the effects of therapy, determining whether residual or recurrent disease is present, and assessing the extent of nodal disease. Because of the high negative predictive value of this imaging test, some have advocated the deferral of neck dissection in patients with negative findings at FDG PET/CT after chemotherapy and radiation therapy; positive findings may have a similarly heavy influence on the future course of treatment. Thus, the accuracy of image interpretation is crucial. However, the interpretation of posttreatment FDG PET images is challenging, with multiple potential pitfalls and limitations that could lead to an incorrect analysis. Accuracy depends on a detailed knowledge of the patient's treatment history and a thorough understanding of the kinds of changes that might result from treatment. Awareness of the principles underlying the selection of the optimal interval between the completion of treatment and the first follow-up FDG PET/CT examination is especially important, since an interval that is too short could lead to false-positive or false-negative findings. A period of 12 weeks or more is generally recommended, but the optimal waiting period depends on the extent of therapy and other factors. If recurrence or progression is suspected during the waiting period, contrast-enhanced CT or magnetic resonance imaging should be performed without FDG PET. PMID:21415184

  2. FDG-PET and Neuropsychiatric Symptoms among Cognitively Normal Elderly Persons: The Mayo Clinic Study of Aging.

    PubMed

    Krell-Roesch, Janina; Ruider, Hanna; Lowe, Val J; Stokin, Gorazd B; Pink, Anna; Roberts, Rosebud O; Mielke, Michelle M; Knopman, David S; Christianson, Teresa J; Machulda, Mary M; Jack, Clifford R; Petersen, Ronald C; Geda, Yonas E

    2016-07-14

    One of the key research agenda of the field of aging is investigation of presymptomatic Alzheimer's disease (AD). Furthermore, abnormalities in brain glucose metabolism (as measured by FDG-PET) have been reported among cognitively normal elderly persons. However, little is known about the association of FDG-PET abnormalities with neuropsychiatric symptoms (NPS) in a population-based setting. Thus, we conducted a cross-sectional study derived from the ongoing population-based Mayo Clinic Study of Aging in order to examine the association between brain glucose metabolism and NPS among cognitively normal (CN) persons aged > 70 years. Participants underwent FDG-PET and completed the Neuropsychiatric Inventory Questionnaire (NPI-Q), Beck Depression Inventory (BDI), and Beck Anxiety Inventory (BAI). Cognitive classification was made by an expert consensus panel. We conducted multivariable logistic regression analyses to compute odds ratios (OR) and 95% confidence intervals after adjusting for age, sex, and education. For continuous variables, we used linear regression and Spearman rank-order correlations. Of 668 CN participants (median 78.1 years, 55.4% males), 205 had an abnormal FDG-PET (i.e., standardized uptake value ratio < 1.32 in AD-related regions). Abnormal FDG-PET was associated with depression as measured by NPI-Q (OR = 2.12; 1.23-3.64); the point estimate was further elevated for APOE ɛ4 carriers (OR = 2.59; 1.00-6.69), though marginally significant. Additionally, we observed a significant association between abnormal FDG-PET and depressive and anxiety symptoms when treated as continuous measures. These findings indicate that NPS, even in community-based samples, can be an important additional tool to the biomarker-based investigation of presymptomatic AD. PMID:27447426

  3. Impact of FDG-PET/CT Imaging on Nodal Staging for Head-And-Neck Squamous Cell Carcinoma

    SciTech Connect

    Murakami, Ryuji . E-mail: murakami@kaiju.medic.kumamoto-u.ac.jp; Uozumi, Hideaki; Hirai, Toshinori; Nishimura, Ryuichi; Shiraishi, Shinya; Ota, Kazutoshi D.D.S.; Murakami, Daizo; Tomiguchi, Seiji; Oya, Natsuo; Katsuragawa, Shigehiko; Yamashita, Yasuyuki

    2007-06-01

    Purpose: To evaluate the impact of 18F-fluorodeoxyglucose positron emission tomography/computed tomography (FDG-PET/CT) imaging on nodal staging for head-and-neck squamous cell carcinoma (SCC). Methods and Materials: The study population consisted of 23 patients with head-and-neck SCC who were evaluated with FDG-PET/CT and went on to neck dissection. Two observers consensually determined the lesion size and maximum standardized uptake value (SUV{sub max}) and compared the results with pathologic findings on nodal-level involvement. Two different observers (A and B) independently performed three protocols for clinical nodal staging. Methods 1, 2, and 3 were based on conventional modalities, additional visual information from FDG-PET/CT images, and FDG-PET/CT imaging alone with SUV data, respectively. Results: All primary tumors were visualized with FDG-PET/CT. Pathologically, 19 positive and 93 negative nodal levels were identified. The SUV{sub max} overlapped in negative and positive nodes <15 mm in diameter. According to receiver operating characteristics analysis, the size-based SUV{sub max} cutoff values were 1.9, 2.5, and 3.0 for lymph nodes <10 mm, 10-15 mm, and >15 mm, respectively. These cutoff values yielded 79% sensitivity and 99% specificity for nodal-level staging. For Observer A, the sensitivity and specificity in Methods 1, 2, and 3 were 68% and 94%, 68% and 99%, and 84% and 99%, respectively, and Method 3 yielded significantly higher accuracy than Method 1 (p = 0.0269). For Observer B, Method 3 yielded the highest sensitivity (84%) and specificity (99%); however, the difference among the three protocols was not statistically significant. Conclusion: Imaging with FDG-PET/CT with size-based SUV{sub max} cutoff values is an important modality for radiation therapy planning.

  4. The role of FDG-PET in defining prognosis of Hodgkin lymphoma for early-stage disease

    PubMed Central

    Kostakoglu, Lale

    2014-01-01

    Given the excellent survival rates for early-stage Hodgkin lymphoma (HL), the young age of many patients, and concerns regarding acute and late treatment-related toxicities, there is a desire to have a predictive tool that enables therapy to be tailored toward the individual patient. Early (or interim) 18F-fluorodeoxyglucose positron emission tomography with computerized tomography (FDG-PET/CT), as a test of tumor sensitivity to ongoing/planned therapy, has been shown to be prognostic for survival in HL. Based on results of interim FDG-PET/CT, therapy may be subsequently modified through minimization or via intensification for low- and high-risk patient populations, respectively (ie, response-adapted therapy). Important data have been generated to standardize the interpretability and reproducibility of interim FDG-PET/CT (eg, the Deauville 5-point system), and observational and noncontrolled prospective studies have produced evidence supporting the hypothesis that response-adapted therapy may potentially serve as a predictive tool. Furthermore, results from noninferiority phase 3 clinical trials randomizing early-stage HL patients with negative interim FDG-PET/CT to combined modality therapy versus chemotherapy alone have been reported. The current collective findings from these randomized early-stage HL studies have shown that acute relapse rates are lower with combined modality therapy, even in patients with negative interim FDG-PET/CT. Additional randomized response-adapted studies are ongoing and novel FDG-PET/CT applications involving quantitative techniques and innovative imaging modalities are being investigated to identify more robust imaging biomarkers. Treatment of early-stage HL remains a clinical management choice for physicians and patients to make with consideration of acute and long-term outcomes. PMID:25428223

  5. FDG-PET and Neuropsychiatric Symptoms among Cognitively Normal Elderly Persons: The Mayo Clinic Study of Aging

    PubMed Central

    Krell-Roesch, Janina; Ruider, Hanna; Lowe, Val J.; Stokin, Gorazd B.; Pink, Anna; Roberts, Rosebud O.; Mielke, Michelle M.; Knopman, David S.; Christianson, Teresa J.; Machulda, Mary M.; Jack, Clifford R.; Petersen, Ronald C.; Geda, Yonas E.

    2016-01-01

    One of the key research agenda of the field of aging is investigation of presymptomatic Alzheimer’s disease (AD). Furthermore, abnormalities in brain glucose metabolism (as measured by FDG-PET) have been reported among cognitively normal elderly persons. However, little is known about the association of FDG-PET abnormalities with neuropsychiatric symptoms (NPS) in a population-based setting. Thus, we conducted a cross-sectional study derived from the ongoing population-based Mayo Clinic Study of Aging in order to examine the association between brain glucose metabolism and NPS among cognitively normal (CN) persons aged > 70 years. Participants underwent FDG-PET and completed the Neuropsychiatric Inventory Questionnaire (NPI-Q), Beck Depression Inventory (BDI), and Beck Anxiety Inventory (BAI). Cognitive classification was made by an expert consensus panel. We conducted multivariable logistic regression analyses to compute odds ratios (OR) and 95% confidence intervals after adjusting for age, sex, and education. For continuous variables, we used linear regression and Spearman rank-order correlations. Of 668 CN participants (median 78.1 years, 55.4% males), 205 had an abnormal FDG-PET (i.e., standardized uptake value ratio < 1.32 in AD-related regions). Abnormal FDG-PET was associated with depression as measured by NPI-Q (OR = 2.12; 1.23–3.64); the point estimate was further elevated for APOE ɛ4 carriers (OR = 2.59; 1.00–6.69), though marginally significant. Additionally, we observed a significant association between abnormal FDG-PET and depressive and anxiety symptoms when treated as continuous measures. These findings indicate that NPS, even in community-based samples, can be an important additional tool to the biomarker-based investigation of presymptomatic AD. PMID:27447426

  6. Hodgkin lymphoma post-transplant lymphoproliferative disorder following pediatric renal transplant: serial imaging with F-18 FDG PET/CT.

    PubMed

    Makis, William; Lisbona, Robert; Derbekyan, Vilma

    2010-09-01

    Post-transplant lymphoproliferative disorder (PTLD) occurs in 1.2% of pediatric renal transplant patients, and is frequently Epstein-Barr Virus mediated. Hodgkin Lymphoma PTLD is the rarest of the 4 types of PTLDs recognized by the World Health Organization, with an incidence of <4% of all PTLD patients. It has a distinct clinical course and treatment from all other types of PTLD. This is a case of a 16-year-old girl who had a renal transplant in 2000 due to Moya Moya disease. Her first F-18 FDG PET/CT done in 2006 showed mildly FDG-avid mediastinal adenopathy (histologically nonspecific reactive nodes), however in 2009, after presenting with fevers, a repeat PET/CT showed extensive intensely FDG-avid disease. Biopsy of a supraclavicular node identified Hodgkin Lymphoma PTLD. The patient was treated with chemotherapy and reimaged, showing excellent response to therapy. In contrast, classic PTLD is treated by withdrawal of immunosuppression and administration of Rituximab. F-18 FDG PET/CT is known to be very useful in the staging and monitoring of response to therapy in the setting of classic PTLD. In this case, serial F-18 FDG PET/CT scans proved very useful in the evaluation and follow-up of the rare and distinct Hodgkin Lymphoma PTLD subtype. PMID:20706047

  7. Intra-abdominal desmoplastic small round cell tumors: CT and FDG-PET/CT findings with histopathological association

    PubMed Central

    CHEN, JINGJING; WU, ZENGJIE; SUN, BINBIN; LI, DACHENG; WANG, ZHENGUANG; LIU, FANGJUN; HUA, HUI

    2016-01-01

    Desmoplastic small round cell tumors (DSRCTs) are rare and aggressive malignant tumors. The aim of the present study was to analyze computed tomography (CT) and fluorodeoxyglucose positron emission tomography (FDG-PET)/CT imaging features of intra-abdominal desmoplastic DSRCT, and investigate the association of these features with histopathological results. The present study was a retrospective investigation of 4 patients with DSRCT. All patients underwent CT and dynamic CT, and 1 additionally underwent FDG-PET/CT scanning. Following a tumor resection, routine hematoxylin and eosin staining, and immunostaining, were performed and evaluated. Multiple large abdominopelvic masses were identified in all 4 patients; however, no indications of their site of origin were demonstrated. CT revealed soft-tissue masses with patchy foci of hypodense lesions. Contrast-enhanced CT revealed slightly or moderately heterogeneous enhancement of the lesions. Other observations from these patients included calcification (n=2), peritoneal seeding (n=3), hepatic metastasis (n=3), retroperitoneal lymphadenopathy (n=3) and ascites (n=2). FDG-PET/CT revealed multiple nodular increased FDG uptake in the abdominopelvic masses, and in the liver and peritoneum in 1 case. Intra-abdominal DSRCT demonstrated significant diagnostic characteristics on plain and contrast-enhanced CT. Multiple, bulky soft-tissue masses inside the peritoneal cavity, particularly in male adolescents and young adults, should be considered as potential cases of DSRCT. FDG-PET/CT techniques may be utilized to aid the staging of tumors. PMID:27123106

  8. A new method for quantitating total lesion glucose metabolic changes in serial tumor FDG PET studies

    SciTech Connect

    Wu, H.M.; Hoh, C.K.; Huang, S.C.; Phelps, M.E.

    1994-05-01

    Accurate quantitative FDG PET studies have the potential for important applications in clinical oncology for monitoring therapy induced changes in tumor glycolytic rates. Due to a number of technical problems that complicate the use of quantitative PET tumor imaging, methods which can maximize the accuracy and precision of such measurements are advantageous. In this study, we developed and evaluated a method for reducing the errors caused by the conventional single plane, single ROI analysis in parametric images generated from pixel by pixel Patlak graphic analysis (PGA) in FDG PET studies of melanoma patients. We compared this new method to the conventional ROI method. The new processing method involves (1) generating the correlation coefficient (r) constrained Patlak parametric images from dynamic PET data; (2) summing up all the planes which cover the lesion; (3) defining a single ROI which covers the whole lesion in the summing image and determining the total lesion glucose metabolic index (K{sub T}, ml/min/lesion). Although only a single ROI was defined on the summing image, the glucose metabolic index obtained showed negligible difference (<1%) compared to those obtained from multiple ROIs on multiple planes of unconstrained parametric images. When the dynamic PET images were rotated and translated to simulate different patient positionings between scans at different times, the results obtained from the new method showed negligible difference (<2%). In summary, we present a simple but reliable method to quantitatively monitor the total lesion glucose metabolic changes during tumor growth. The method has several advantages over the conventional single ROI, single plane evaluation: (1) less sensitive to the ROI definition; (2) smaller intra- and inter-observer variations and (3) not requiring image registrations of serial scan data.

  9. Association of Esophageal Inflammation, Obesity and Gastroesophageal Reflux Disease: From FDG PET/CT Perspective

    PubMed Central

    Lee, Yi-Chia; Wang, Shan-Ying; Chiu, Han-Mo; Tu, Chia-Hung; Wang, Hsiu-Po; Lin, Jaw-Town; Wu, Ming-Shiang; Yang, Wei-Shiung

    2014-01-01

    Objective Gastroesophageal reflux disease (GERD) is associated with bothersome symptoms and neoplastic progression into Barrett's esophagus and esophageal adenocarcinoma. We aim to determine the correlation between GERD, esophageal inflammation and obesity with 18F-Fluorodeoxyglucose (FDG) positron emission tomography/computed tomography (PET/CT). Methods We studied 458 subjects who underwent a comprehensive health check-up, which included an upper gastrointestinal endoscopy, FDG PET/CT and complete anthropometric measures. GERD symptoms were evaluated with Reflux Disease Questionnaire. Endoscopically erosive esophagitis was scored using the Los Angeles classification system. Inflammatory activity, represented by standardized uptake values (SUVmax) of FDG at pre-determined locations of esophagus, stomach and duodenum, were compared. Association between erosive esophagitis, FDG activity and anthropometric evaluation, including body mass index (BMI), waist circumference, visceral and subcutaneous adipose tissue volumes were analyzed. Results Subjects with erosive esophagitis (n = 178, 38.9%) had significantly higher SUVmax at middle esophagus (2.69±0.74 vs. 2.41±0.57, P<.001) and esophagogastric junction (3.10±0.89 vs. 2.38±0.57, P<.001), marginally higher at upper esophageal sphincter (2.29±0.42 vs. 2.21±0.48, P = .062), but not in stomach or duodenum. The severity of erosive esophagitis correlated with SUVmax and subjects with Barrett's esophagus had the highest SUVmax at middle esophagus and esophagogastric junction. Heartburn positively correlated with higher SUVmax at middle oesophagus (r = .262, P = .003). Using multivariate regression analyses, age (P = .027), total cholesterol level (P = .003), alcohol drinking (P = .03), subcutaneous adipose tissue (P<.001), BMI (P<.001) and waist circumference (P<.001) were independently associated with higher SUVmax at respective esophageal locations. Conclusions Esophageal inflammation

  10. Discussion on the alteration of FDG uptake by the breast according to the menstrual cycle in 18F-FDG PET/CT

    NASA Astrophysics Data System (ADS)

    Park, H. H.; Park, M. S.; Lee, C. H.; Cho, J. H.; Dong, K. R.; Chung, W. K.

    2012-09-01

    18F-FDG (fluorodeoxyglucose) PET (positron emission tomography)/CT (computed tomography) is a useful modality for identifying high-glucose-consuming cells, such as cancer cells, by the glucose metabolism of FDG. FDG is taken up by cancer and inflammatory cells, but occasionally there is also some FDG uptake by normal tissues as a result of their individual physiological characteristics. In particular, in fertile females, unusual FDG uptake in the breast changes according to the stages in the menstrual cycle, which can adversely affect a diagnosis. Therefore, this study examined the change in breast FDG uptake in the menstrual cycle on 18F-FDG PET/CT. One hundred and sixty females (34±3.5 years old), who had not undergone a gynecologic anamnesis and had a regular menstrual cycle over the previous 6 months, were examined from March 2010 to February 2011. The subjects were divided into the following four groups (each with 40 patients): flow phase, proliferative phase, ovulatory phase and secretory phase using Pregnancy Calculator Ver. 0.14 and history taking. Discovery Ste was used as the PET/CT. The standardized uptake values (SUVs) on the accumulated region on the breast were analyzed, and three nuclear medicine specialists performed a blind test. The SUVs on the breast were the flow phase (1.64±0.25), proliferative phase (0.93±0.28), ovulatory phase (1.66±0.26) and secretory phase (1.77±0.28). A high uptake value was observed in the secretory, flow and ovulatory phases. The FDG accumulation of the breast was divided into the following three grades compared with the lung and liver by gross analysis: the breast uptake was equal to the lung (Grade I), between the lung and liver (Grade II) and equal to or greater than the liver (Grade III). These results showed a high uptake value in the secretory, flow and ovulatory phases. In fertile females, the FDG uptake of the breast showed changes according to the menstrual cycle, which can be used to improve the diagnosis

  11. Generative FDG-PET and MRI model of aging and disease progression in Alzheimer's disease.

    PubMed

    Dukart, Juergen; Kherif, Ferath; Mueller, Karsten; Adaszewski, Stanislaw; Schroeter, Matthias L; Frackowiak, Richard S J; Draganski, Bogdan

    2013-04-01

    The failure of current strategies to provide an explanation for controversial findings on the pattern of pathophysiological changes in Alzheimer's Disease (AD) motivates the necessity to develop new integrative approaches based on multi-modal neuroimaging data that captures various aspects of disease pathology. Previous studies using [18F]fluorodeoxyglucose positron emission tomography (FDG-PET) and structural magnetic resonance imaging (sMRI) report controversial results about time-line, spatial extent and magnitude of glucose hypometabolism and atrophy in AD that depend on clinical and demographic characteristics of the studied populations. Here, we provide and validate at a group level a generative anatomical model of glucose hypo-metabolism and atrophy progression in AD based on FDG-PET and sMRI data of 80 patients and 79 healthy controls to describe expected age and symptom severity related changes in AD relative to a baseline provided by healthy aging. We demonstrate a high level of anatomical accuracy for both modalities yielding strongly age- and symptom-severity- dependant glucose hypometabolism in temporal, parietal and precuneal regions and a more extensive network of atrophy in hippocampal, temporal, parietal, occipital and posterior caudate regions. The model suggests greater and more consistent changes in FDG-PET compared to sMRI at earlier and the inversion of this pattern at more advanced AD stages. Our model describes, integrates and predicts characteristic patterns of AD related pathology, uncontaminated by normal age effects, derived from multi-modal data. It further provides an integrative explanation for findings suggesting a dissociation between early- and late-onset AD. The generative model offers a basis for further development of individualized biomarkers allowing accurate early diagnosis and treatment evaluation. PMID:23592957

  12. Estimated radiation dose to the newborn in FDG-PET studies

    SciTech Connect

    Ruotsalainen, U.; Suhonen-Polvi, H.; Eronen, E.; Kinnala, A.

    1996-02-01

    The aim of this study was to estimate the radiation dose due to intravenous injection of 2-[{sup 18}F]fluoro-2-deoxy-D-glucose (FDG) for infants studied with PET. The radioactivity concentration in the brain and bladder content was measured with PET to determine the cumulated activity in these organs in 21 infant FDG studies. The individual organ masses were estimated according to the whole-body and brain masses, and they were used to calculate the absorbed dose per unit cumulated activity (S values). For organs other than brain and bladder, the cumulated activity was defined from adult studies. For each individual patient, the absorbed dose to the brain, bladder wall and selected organs were calculated. An estimation of the effective dose was determined. Whole-body distribution of FDG in the infants differed from adults: a greater proportion of the injected activity accumulated into the brain (9% versus 7%) and less was excreted to urine (7% versus 20% respectively). The measured cumulated activity in the brain was 0.25 MBq {center_dot} h/MBq and in the bladder content 0.04 MBq {center_dot}h/MBq with a large individual variation in latter. The calculated absorbed dose was 0.24 mGy/MBq to the brain and 1.03 mGy/MBq to the bladder wall. The estimated effective dose was 0.43 mSv/MBq. The dose to the bladder wall was lower in infants as compared to adults with ordinary amounts of injected activity. The greater amount of activity remaining in the body may increase the dose to other organs. The effective dose was lower compared to adults and conventional nuclear medicine studies of infants. PET can be a valuable tool in pediatric nuclear medicine because of good resolution images, sensitive radiation measurement and a variety of tracers labeled with short-lived isotopes. 27 refs., 4 figs., 2 tabs.

  13. Fusion FDG-PET/MRI Evidence to Support Diagnosis of Frontotemporal Dementia-Related Primary Progressive Aphasia.

    PubMed

    VanDreel, Aaron; Aftab, Syed A; Sanan, Prateek; Grant, Christopher; Lu, Yang

    2016-09-01

    A 61-year-old right-handed man presented for cognitive neurological evaluation with word-finding difficulty, impaired word retrieval, impaired repetition of phrases, and stammering. Brain MRI and FDG-PET/CT were performed as initial imaging workup. Further FDG PET/MRI brain images were obtained through software fusion and revealed regional cortical atrophy with corresponding hypometabolic activity involving the posterior aspects of the left middle and inferior temporal gyri. These characteristic imaging findings are supportive of patient's diagnosis of frontotemporal dementia-related primary progressive aphasia. PMID:26859219

  14. Distant metastases in a young woman with Stewart-Treves syndrome demonstrated by an FDG-PET/CT scan.

    PubMed

    Chen, Yu-Ren; Hsieh, Te-Chun; Yen, Kuo-Yang; Kao, Chia-Hung

    2014-11-01

    This 17-year-old woman had chronic congenital lymphedema in the left lower extremity since childhood. She underwent surgeries to remove excessive lymphedematous tissues more than 15 times previously. Histopathology of the specimen from the recent surgery revealed angiosarcoma; therefore, FDG-PET/CT scan was arranged to determine the extent of tumor spread, and distant metastases were discovered. Stewart-Treves syndrome is angiosarcomas that arise secondary to chronic lymphedema. Because of the high lethality of this condition, the FDG-PET/CT scan may be a clinically useful imaging modality to detect the possible malignant transformation earlier for patients with chronic lymphedema. PMID:24561687

  15. Brain-Only Metastases Seen on FDG PET as First Relapse of Papillary Thyroid Carcinoma Two Years Post-Thyroidectomy.

    PubMed

    Naddaf, Sleiman Y; Syed, Ghulam Mustafa Shah; Hadb, Abdulrahman; Al-Thaqfi, Saif

    2016-09-01

    We report a case of a 60-year-old man diagnosed with papillary thyroid cancer who had a relapse seen only in the brain at FDG PET on standard images. Total thyroidectomy was performed in July 2013 after initial diagnosis. Patient received I ablation in December 2013, followed by external beam radiotherapy to the neck. In September 2015, the patient presented with neurological symptoms. Brain MRI showed multiple brain metastases later confirmed on histopathology. An FDG PET/CT scan was performed to evaluate the whole body in November 2015. Multiple hypermetabolic lesions were identified in the brain with no other lesion up to mid thighs. PMID:27405041

  16. Incidental Detection of Subcutaneous Myopericytoma of Trunk on FDG PET/CT and Bone Scintigraphy for Imaging of Colon Cancer.

    PubMed

    Demir, Selin Soyluoglu; Sarikaya, Ali; Aktas, Gul Ege; Oz Puyan, Fulya

    2016-08-01

    Myopericytoma is a rare type of unusual soft tissue tumor with perivascular myoid differentiation. A 53-year-old man with the diagnosis of colon cancer was referred to Tc-MDP bone scan and F-FDG PET/CT for staging. A subcutaneous mass located in right lower back with heterogeneous FDG uptake was detected on PET/CT. There was increased osteoblastic activity on MDP bone scan in the same region. Mass was resected and subsequently confirmed as myopericytoma by histopathology. PMID:27124684

  17. FDG-PET/CT predicts outcome in patients with aggressive non-Hodgkin's lymphoma and Hodgkin's disease.

    PubMed

    Querellou, Solène; Valette, Frédéric; Bodet-Milin, Caroline; Oudoux, Aurore; Carlier, Thomas; Harousseau, Jean-Luc; Chatal, Jean-François; Couturier, Olivier

    2006-11-01

    Early therapy response assessment with metabolic imaging is potentially useful to determine prognosis in aggressive lymphoma and, thus, can guide first-line therapy. Forty-eight patients with aggressive lymphoma [24 Hodgkin's disease (HD); 24 non-Hodgkin's lymphoma (NHL)] underwent fluoro-deoxyglucose positron emission tomography (FDG-PET) before chemotherapy (PET1) and at mid-treatment (PET2). Therapeutic response was evaluated using conventional methods at mid-treatment. PET2 results were related to event-free survival (EFS) and overall survival (OS) using Kaplan-Meier analyses. PET1 was positive in all patients. PET2 was negative in 38 patients (18 NHL-20 HD) and positive in 10 (6 NHL-4 HD). Of the PET-negative patients, 61 and 65% achieved complete remission, and only 50 and 25% of PET-positive patients, respectively, for NHL and HD, achieved complete remission. Significant associations were found between PET2 and EFS (p = 0.0006) and OS (p = 0.04) for NHL, and EFS (p < 0.0001) for HD (but not for OS, because no HD patient died). FDG-PET at mid-treatment can predict the outcome of patients with aggressive lymphoma and should be a useful tool to modify an ineffective therapy. PMID:16871391

  18. Secondary Hyperparathyroidism With "Superscan-Like" Hypermetabolic FDG PET/CT Pattern.

    PubMed

    Grellier, Jean-Francois; Lussato, David; Queneau, Mathieu; Guernou, Mohamed; Songy, Bernard

    2015-11-01

    A 26-year-old man with chronic terminal renal insufficiency under dialysis was referred in our institution for a checkup before kidney transplantation to ensure the absence of malignant neoplasm. The patient had a biological secondary hyperparathyroidism with highly elevated serum parathormon, and treatment with parathyroid surgery was planned before the kidney transplant. Whole-body FDG PET/CT showed no apparent malignant neoplasm, but increased metabolism of the 4 parathyroid gland and the other pitfalls of advanced secondary hyperparathyroidism on chronic renal insufficiency: pseudotumoral calcification in soft tissues, diffuse hypermetabolic bone dystrophy, and osteolytic lesion of pelvic and peripheral skeleton corresponding to brown tumors. PMID:26284774

  19. Sarcoid Pericarditis and Large Vessel Vasculitis Detected on FDG PET/CT.

    PubMed

    Patel, Darshan; Xie, Karen; Sweiss, Nadera J; Lu, Yang

    2016-08-01

    A 65-year-old woman with history of sarcoidosis, hypertension, and peripheral vascular disease presented with lower extremity claudication and low left ventricular ejection fraction of 45% on echocardiogram. Further FDG PET/CT revealed hypermetabolic bilateral chest lymphadenopathy and pulmonary nodules in a butterfly-shaped distribution pattern, which was typically seen in patients with sarcoidosis. In addition, abnormal increased radiotracer uptake was present in pericardium, and along the walls of inferior vena cava, aorta, and pulmonary artery, which correlated with delayed enhancement on further cardiac MRI. These findings were suggestive of sarcoid-related pericarditis and great vessel vasculitis. PMID:27280907

  20. 18F-FDG PET/CT Imaging of Gallbladder Adenocarcinoma - A Pictorial Review.

    PubMed

    Shaikh, Faiq; Awan, Omer; Khan, Salman A

    2015-01-01

    Gallbladder adenocarcinoma is an uncommon and serious disease. The primary disease grows rapidly with local invasion into the liver and with distant spread to lymph nodes. It is often detected late, due to which management can be challenging. Despite routine use of computed tomography (CT) and ultrasonography (US) for detection, magnetic resonance imaging (MRI) is often considered for a detailed assessment of the anatomic behavior of these tumors. We share three cases where 18-FDG PET/CT played a role in management thereof. PMID:26430572

  1. Fireworks-induced chest wall granulomatous disease: 18F-FDG PET/CT imaging.

    PubMed

    Le, Stephanie T; Nguyen, Ba Duong

    2014-04-01

    The authors present a case of 18F-FDG-avid granulomatous reaction induced by fireworks injury of the chest wall in a patient with esophageal adenocarcinoma. This hypermetabolic lesion, involving the right pectoralis muscles, appeared slightly more prominent on restaging PET/CT imaging following chemotherapy and radiation therapy. Excisional biopsy of the lesion established the diagnosis of foreign-body granulomatous-type inflammation with surrounding foci of non-polarizable black foreign material and ruled out malignancy. The patient recalled accidentally shooting himself in the chest with a Roman candle at the age of 3. PMID:23877517

  2. Renal Cell Carcinoma Arising From Renal Allograft Detected by 18F-FDG PET-CT.

    PubMed

    Guo, Yuehong; Wang, Tie

    2016-05-01

    Renal cell carcinoma arising from renal allograft is a rare condition. A 56-year-old man with a history of 3 renal transplantation due to renal failure presented poor appetite and weight loss for 3 months. Possibility of tumor of unknown origin was suspected. For this reason, an FDG PET/CT was performed, and the images showed a hypermetabolic focus in the lower pole of the left renal transplant, suggestive of a malignant lesion. Subsequent pathological examination following allograft nephrectomy confirmed grade 4 renal cell carcinoma. PMID:26825198

  3. Bone marrow glucose metabolic response to GMCSF by quantitative FDG PET imaging

    SciTech Connect

    Yao, W.J.; Hoh, C.K.; Hawkins, R.A.

    1994-05-01

    To evaluate noninvasively the recombinant granulocyte-macrophage colony-stimulating factor (GMCSF) effects on bone marrow glucose metabolism, we studied 18 patients with metastatic melanoma with quantitative FDG PET imaging. All patients received 14 days of therapy in 3 groups; group 1: 4 patients treated with GMCSF (5 ug/kg/d SQ), group 2: 8 patients treated with GMCSF (5 ug/kg/d SQ) and monoclonal antibody MAbR24, and group 3: 6 patients treated with MCSF (80 ug/kg/d IVCI) and MAbR24.

  4. Role of FDG-PET in the Implementation of Involved-Node Radiation Therapy for Hodgkin Lymphoma Patients

    SciTech Connect

    Girinsky, Théodore; Aupérin, Anne; Ribrag, Vincent; Elleuch, Manel; Fermé, Christophe; Bonniaud, Guillaume; Ruelle, Claude; Alberini, Jean-Louis; Celebic, Aljosa; Edeline, Véronique

    2014-08-01

    Purpose: This study examines the role of {sup 18}F-labeled fluorodeoxyglucose positron emission tomography (FDG-PET) in the implementation of involved-node radiation therapy (INRT) in patients treated for clinical stages (CS) I/II supradiaphragmatic Hodgkin lymphoma (HL). Methods and Material: Patients with untreated CS I/II HL enrolled in the randomized EORTC/LYSA/FIL Intergroup H10 trial and participating in a real-time prospective quality assurance program were prospectively included in this study. Data were electronically obtained from 18 French cancer centers. All patients underwent APET-computed tomography (PET-CT) and a post-chemotherapy planning CT scanning. The pre-chemotherapy gross tumor volume (GTV) and the postchemotherapy clinical target volume (CTV) were first delineated on CT only by the radiation oncologist. The planning PET was then co-registered, and the delineated volumes were jointly analyzed by the radiation oncologist and the nuclear medicine physician. Lymph nodes undetected on CT but FDG-avid were recorded, and the previously determined GTV and CTV were modified according to FDG-PET results. Results: From March 2007 to February 2010, 135 patients were included in the study. PET-CT identified at least 1 additional FDG-avid lymph node in 95 of 135 patients (70.4%; 95% confidence interval [CI]: 61.9%-77.9%) and 1 additional lymph node area in 55 of 135 patients (40.7%; 95% CI: 32.4%-49.5%). The mean increases in the GTV and CTV were 8.8% and 7.1%, respectively. The systematic addition of PET to CT led to a CTV increase in 60% of the patients. Conclusions: Pre-chemotherapy FDG-PET leads to significantly better INRT delineation without necessarily increasing radiation volumes.

  5. Pre-operative TNM staging of primary colorectal cancer by (18)F-FDG PET-CT or PET: a meta-analysis including 2283 patients.

    PubMed

    Ye, Yanwei; Liu, Tao; Lu, Lisha; Wang, Guojun; Wang, Min; Li, Jingjing; Han, Chao; Wen, Jianguo

    2015-01-01

    The aim of the present study was to perform a meta-analysis to assess the diagnostic value of fluorine-18 fluorodeoxyglucose ((18)F-FDG) PET-CT/PET in the pre-operative evaluation of TNM staging in patients with primary colorectal cancer (CRC). The Medline, Embase and Web of Knowledge were searched for studies assessing the diagnostic value of (18)F-FDG PET-CT/PET in the pre-operative evaluation of TNM staging in CRC patients. We pooled the sensitivity, specificity, positive and negative Likelihood ratio (LR+ and LR-) and Diagnostic Odds Ratio (DOR) and constructed summary receiver operating characteristic curves. A total of 28 studies including 2283 CRC patients were analyzed. The pre-operative tumor detecting rate of PET-CT was 95.35%, which was superior to CT (P < 0.05). The pooled sensitivity and specificity of pre-operative T staging by PET-CT/PET was 0.73 (95% CI: 0.65-0.81) and 0.99 (95% CI: 0.98-0.99), which the AUC and Q* were 0.96 and 0.91, respectively. Concerning pre-operative N staging, the pooled sensitivity and specificity of PET-CT/PET were 0.62 and 0.70, which the AUC and Q* were 0.76 and 0.70, respectively. As for M staging, the pooled sensitivity and specificity of PET-CT/PET were 0.91 (95% CI: 0.80-0.96) and 0.95 (95% CI: 0.91-0.98), which the AUC and Q* were 0.96 and 0.91, respectively. (18)F-FDG PET-CT/PET had good performance in the pre-operative tumor detecting rate, T staging and M staging in patients with primary CRC, which might alter the therapeutic strategy. However, the diagnostic value of (18)F-FDG PET-CT/PET in pre-operative N staging in CRC patients was not ideal. PMID:26885142

  6. Pre-operative TNM staging of primary colorectal cancer by 18F-FDG PET-CT or PET: a meta-analysis including 2283 patients

    PubMed Central

    Ye, Yanwei; Liu, Tao; Lu, Lisha; Wang, Guojun; Wang, Min; Li, Jingjing; Han, Chao; Wen, Jianguo

    2015-01-01

    The aim of the present study was to perform a meta-analysis to assess the diagnostic value of fluorine-18 fluorodeoxyglucose (18F-FDG) PET-CT/PET in the pre-operative evaluation of TNM staging in patients with primary colorectal cancer (CRC). The Medline, Embase and Web of Knowledge were searched for studies assessing the diagnostic value of 18F-FDG PET-CT/PET in the pre-operative evaluation of TNM staging in CRC patients. We pooled the sensitivity, specificity, positive and negative Likelihood ratio (LR+ and LR-) and Diagnostic Odds Ratio (DOR) and constructed summary receiver operating characteristic curves. A total of 28 studies including 2283 CRC patients were analyzed. The pre-operative tumor detecting rate of PET-CT was 95.35%, which was superior to CT (P < 0.05). The pooled sensitivity and specificity of pre-operative T staging by PET-CT/PET was 0.73 (95% CI: 0.65-0.81) and 0.99 (95% CI: 0.98-0.99), which the AUC and Q* were 0.96 and 0.91, respectively. Concerning pre-operative N staging, the pooled sensitivity and specificity of PET-CT/PET were 0.62 and 0.70, which the AUC and Q* were 0.76 and 0.70, respectively. As for M staging, the pooled sensitivity and specificity of PET-CT/PET were 0.91 (95% CI: 0.80-0.96) and 0.95 (95% CI: 0.91-0.98), which the AUC and Q* were 0.96 and 0.91, respectively. 18F-FDG PET-CT/PET had good performance in the pre-operative tumor detecting rate, T staging and M staging in patients with primary CRC, which might alter the therapeutic strategy. However, the diagnostic value of 18F-FDG PET-CT/PET in pre-operative N staging in CRC patients was not ideal. PMID:26885142

  7. Human brain development in infants with PET and FDG

    SciTech Connect

    Phelps, M.E.; Chugani, H.T.

    1985-05-01

    The authors used studies of local cerebral metabolic rate for glucose (LCMRGlc) to examine development of cerebral organization in 5 days to 1 year old children. A group (n=8) of infants with diverse pediatric disorders allowed investigation of developmental changes in LCMRGlc, while also providing relevant clinical management information. Patients consisted of questionable and definite neonatal seizures, cerebral embolism from cardiac sources, and otherwise normal infants with facial nevi with consideration of Sturge-Weber. Gradual increase in cortical LCMRGlc coincides with suppression of intrinsic subcortical reflexes present in all newborns. Two retarded children (2 years old) showed LCMRGlc developmental patterns of a few days old, which corresponded to their functional and mental status. These studies illustrate great potential of PET to study normal and altered states of human brain development.

  8. Lymph Node Metastasis from Tall-Cell Thyroid Cancer Negative on 18F-FDG PET/CT and Detected by 18F-Choline PET/CT.

    PubMed

    Piccardo, Arnoldo; Massollo, Michela; Bandelloni, Roberto; Arlandini, Anselmo; Foppiani, Luca

    2015-08-01

    A 77-year-old woman underwent thyroidectomy and (131)I remnant ablation for tall-cell differentiated cancer (DTC) of the left lobe. Detectable Tg levels (4.1 μg/L) under TSH suppression, with undetectable serum Tg-antibody levels, prompted neck ultrasonography, which revealed a lymph node in the left laterocervical region and in the right retroclavicular region. (18)F-FDG PET/CT showed uptake by the left lymph node. (18)F-choline PET/CT showed increased uptake by both lymph nodes. Histopathology revealed DTC solid metastasis in the left lymph node and solid and cystic metastasis in the right one. (18)F-choline PET/CT can locate virulent DTC recurrence, thereby increasing (18)F-FDG PET/CT information. PMID:26053727

  9. [11C]PR04.MZ, a promising DAT ligand for low concentration imaging: synthesis, efficient 11C-0-methylation and initial small animal PET studies

    SciTech Connect

    Riss, P.J.; Hooker, J.; Alexoff, D.; Kim, Sung-Won; Fowler, J.S.; Roesch, F.

    2009-05-01

    PR04.MZ was designed as a highly selective dopamine transporter inhibitor, derived from natural cocaine. Its binding profile indicates that [{sup 11}C]PR04.MZ may be suited as a PET radioligand for the non-invasive exploration of striatal and extrastriatal DAT populations. As a key feature, its structural design facilitates both, labelling with fluorine-18 at its terminally fluorinated butynyl moiety and carbon-11 at its methyl ester function. The present report concerns the efficient [{sup 11}C]MeI mediated synthesis of [{sup 11}C]PR04.MZ from an O-desmethyl precursor trifluoroacetic acid salt with Rb{sub 2}CO{sub 3} in DMF in up to 95 {+-} 5% labelling yield. A preliminary {mu}PET-experiment demonstrates the reversible, highly specific binding of [{sup 11}C]PR04.MZ in the brain of a male Sprague-Dawley rat.

  10. 123I-Mibg scintigraphy and 18F-Fdg-Pet imaging for diagnosing neuroblastoma

    PubMed Central

    Bleeker, Gitta; Tytgat, Godelieve Am; Adam, Judit A; Caron, Huib N; Kremer, Leontien Cm; Hooft, Lotty; van Dalen, Elvira C

    2015-01-01

    Background Neuroblastoma is an embryonic tumour of childhood that originates in the neural crest. It is the second most common extracranial malignant solid tumour of childhood. Neuroblastoma cells have the unique capacity to accumulate Iodine-123-metaiodobenzylguanidine (123I-MIBG), which can be used for imaging the tumour. Moreover, 123I-MIBG scintigraphy is not only important for the diagnosis of neuroblastoma, but also for staging and localization of skeletal lesions. If these are present, MIBG follow-up scans are used to assess the patient's response to therapy. However, the sensitivity and specificity of 123I-MIBG scintigraphy to detect neuroblastoma varies according to the literature. Prognosis, treatment and response to therapy of patients with neuroblastoma are currently based on extension scoring of 123I-MIBG scans. Due to its clinical use and importance, it is necessary to determine the exact diagnostic accuracy of 123I-MIBG scintigraphy. In case the tumour is not MIBG avid, fluorine-18-fluorodeoxy-glucose (18F-FDG) positron emission tomography (PET) is often used and the diagnostic accuracy of this test should also be assessed. Objectives Primary objectives: 1.1 To determine the diagnostic accuracy of 123I-MIBG (single photon emission computed tomography (SPECT), with or without computed tomography (CT)) scintigraphy for detecting a neuroblastoma and its metastases at first diagnosis or at recurrence in children from 0 to 18 years old. 1.2 To determine the diagnostic accuracy of negative 123I-MIBG scintigraphy in combination with 18F-FDG-PET(-CT) imaging for detecting a neuroblastoma and its metastases at first diagnosis or at recurrence in children from 0 to 18 years old, i.e. an add-on test. Secondary objectives: 2.1 To determine the diagnostic accuracy of 18F-FDG-PET(-CT) imaging for detecting a neuroblastoma and its metastases at first diagnosis or at recurrence in children from 0 to 18 years old. 2.2 To compare the diagnostic accuracy of 123I

  11. Early detection of Alzheimer’s disease using PiB and FDG PET

    PubMed Central

    Cohen, Ann D.; Klunk, William E.

    2014-01-01

    Use of biomarkers in the detection of early and preclinical Alzheimer’s disease (AD) has become of central importance following publication of the NIA-Alzheimer’s Association revised criteria for the diagnosis of AD, mild cognitive impairment (MCI) and preclinical AD. The use of in vivo amyloid imaging agents, such a Pittsburgh Compound-B and markers of neurodegeneration, such as fluoro-2-deoxy-D-glucose (FDG) are able to detect early AD pathological processes and subsequent neurodegeneration. Imaging with PiB and FDG thus has many potential clinical benefits: early or perhaps preclinical detection of disease and accurately distinguishing AD from dementias of other etiologies in patients presenting with mild or atypical symptoms or confounding comorbidities in which the diagnostic distinction is difficult to make clinically. From a research perspective, this allows us to study relationships between amyloid pathology and changes in cognition, brain structure, and function across the continuum from normal aging to MCI to AD. The present review focuses on use of PiB and FDG-PET and their relationship to one another. PMID:24825318

  12. Design and Characteristics of a Multichannel Front-End ASIC Using Current-Mode CSA for Small-Animal PET Imaging.

    PubMed

    Ollivier-Henry, N; Wu Gao; Xiaochao Fang; Mbow, N A; Brasse, D; Humbert, B; Hu-Guo, C; Colledani, C; Yann Hu

    2011-02-01

    This paper presents the design and characteristics of a front-end readout application-specific integrated circuit (ASIC) dedicated to a multichannel-plate photodetector coupled to LYSO scintillating crystals. In our configuration, the crystals are oriented in the axial direction readout on both sides by individual photodetector channels allowing the spatial resolution and the detection efficiency to be independent of each other. Both energy signals and timing triggers from the photodetectors are required to be read out by the front-end ASIC. A current-mode charge-sensitive amplifier is proposed for this application. This paper presents performance characteristics of a 10-channel prototype chip designed and fabricated in a 0.35-μm complementary metal-oxide semiconductor process. The main results of simulations and measurements are presented and discussed. The gain of the chip is 13.1 mV/pC while the peak time of a CR-RC pulse shaper is 280 ns. The signal-to-noise ratio is 39 dB and the rms noise is 300 μV/√(Hz). The nonlinearity is less than 3% and the crosstalk is about 0.2%. The power dissipation is less than 15 mW/channel. This prototype will be extended to a 64-channel circuit with integrated time-to-digital converter and analog-to-digital converter together for a high-sensitive small-animal positron emission tomography imaging system. PMID:23850981

  13. 18F-FDG PET/CT oncologic imaging at extended injection-to-scan acquisition time intervals derived from a single-institution 18F-FDG-directed surgery experience: feasibility and quantification of 18F-FDG accumulation within 18F-FDG-avid lesions and background tissues

    PubMed Central

    2014-01-01

    Background 18F-fluorodeoxyglucose (18F-FDG) positron emission tomography/computed tomography (PET/CT) is a well-established imaging modality for a wide variety of solid malignancies. Currently, only limited data exists regarding the utility of PET/CT imaging at very extended injection-to-scan acquisition times. The current retrospective data analysis assessed the feasibility and quantification of diagnostic 18F-FDG PET/CT oncologic imaging at extended injection-to-scan acquisition time intervals. Methods 18F-FDG-avid lesions (not surgically manipulated or altered during 18F-FDG-directed surgery, and visualized both on preoperative and postoperative 18F-FDG PET/CT imaging) and corresponding background tissues were assessed for 18F-FDG accumulation on same-day preoperative and postoperative 18F-FDG PET/CT imaging. Multiple patient variables and 18F-FDG-avid lesion variables were examined. Results For the 32 18F-FDG-avid lesions making up the final 18F-FDG-avid lesion data set (from among 7 patients), the mean injection-to-scan times of the preoperative and postoperative 18F-FDG PET/CT scans were 73 (±3, 70-78) and 530 (±79, 413-739) minutes, respectively (P < 0.001). The preoperative and postoperative mean 18F-FDG-avid lesion SUVmax values were 7.7 (±4.0, 3.6-19.5) and 11.3 (±6.0, 4.1-29.2), respectively (P < 0.001). The preoperative and postoperative mean background SUVmax values were 2.3 (±0.6, 1.0-3.2) and 2.1 (±0.6, 1.0-3.3), respectively (P = 0.017). The preoperative and postoperative mean lesion-to-background SUVmax ratios were 3.7 (±2.3, 1.5-9.8) and 5.8 (±3.6, 1.6-16.2), respectively, (P < 0.001). Conclusions 18F-FDG PET/CT oncologic imaging can be successfully performed at extended injection-to-scan acquisition time intervals of up to approximately 5 half-lives for 18F-FDG while maintaining good/adequate diagnostic image quality. The resultant increase in the 18F-FDG-avid lesion SUVmax values, decreased background SUVmax values, and

  14. Differentiation of cardiac thrombus from cardiac tumor combining cardiac MRI and 18F-FDG-PET/CT Imaging.

    PubMed

    Rinuncini, Massimo; Zuin, Marco; Scaranello, Fiorenzo; Fejzo, Majlinda; Rampin, Lucia; Rubello, Domenico; Faggian, Giuseppe; Roncon, Loris

    2016-06-01

    Radiological differentiation of an unknown cardiac masse is often a challenging issue. 18F-FDG-PET/CT imaging was performed to evaluate a left ventricle mass visualized on transthoracic echocardiogram (TTE) and cardiac magnetic resonance (CMR) in a patient with an history of ischemic heart disease. The metabolically inert area on the PET/CT, corresponding to the relatively homogenous hypodensity in the LV, was thought to represent an old organized LV thrombus. Histopathological examination confirmed the imaging diagnosis. PMID:27038712

  15. (18)F-FDG PET/CT versus bone scintigraphy in the follow-up of gastric cancer.

    PubMed

    Sollini, M; Calabrese, L; Zangheri, B; Erba, P A; Gramaglia, A; Gasparini, M

    2016-01-01

    A 53-year-old patient underwent a positron emission tomography/computed tomography with 2-fluoro-2-deoxy-d-glucose ((18)F-FDG PET/CT) in the suspicious of gastric tumor recurrence (mediastinal and abdominal lymph nodes). PET/CT identified only an area of (18)F-FDGuptake in the twelfth thoracic vertebrae. Unexpectedly, a bone scintigraphy revealed many "hot" spots changing the diagnosis (single metastasis versus plurimetastatic disease) and impacting on patient's management. PMID:26653282

  16. Intense uptake evidenced by 18F-FDG PET/CT without a corresponding CT finding--dream or reality?

    PubMed

    Caobelli, Federico; Pizzocaro, Claudio; Guerra, Ugo Paolo

    2014-01-01

    Although 18F-fluoro-deoxy-glucose (FDG) positron emission tomography (PET) has been widely validated and extensively used in the latest years in clinical practice, interpretation of PET/CT images can be affected by several pitfalls. We here present a case of intense lung uptake in a patient without a corresponding finding on CT images, probably due to a microembolism produced during the injection process and located in small vascular structures of the lung parenchyma. PMID:24610649

  17. Quantitative characterization of brain β-amyloid using a joint PiB/FDG PET image histogram

    NASA Astrophysics Data System (ADS)

    Camp, Jon J.; Hanson, Dennis P.; Holmes, David R.; Kemp, Bradley J.; Senjem, Matthew L.; Murray, Melissa E.; Dickson, Dennis W.; Parisi, Joseph; Petersen, Ronald C.; Lowe, Val J.; Robb, Richard A.

    2014-03-01

    A complex analysis performed by spatial registration of PiB and MRI patient images in order to localize the PiB signal to specific cortical brain regions has been proven effective in identifying imaging characteristics associated with underlying Alzheimer's Disease (AD) and Lewy Body Disease (LBD) pathology. This paper presents an original method of image analysis and stratification of amyloid-related brain disease based on the global spatial correlation of PiB PET images with 18F-FDG PET images (without MR images) to categorize the PiB signal arising from the cortex. Rigid registration of PiB and 18F-FDG images is relatively straightforward, and in registration the 18F-FDG signal serves to identify the cortical region in which the PiB signal is relevant. Cortical grey matter demonstrates the highest levels of amyloid accumulation and therefore the greatest PiB signal related to amyloid pathology. The highest intensity voxels in the 18F-FDG image are attributed to the cortical grey matter. The correlation of the highest intensity PiB voxels with the highest 18F-FDG values indicates the presence of β-amyloid protein in the cortex in disease states, while correlation of the highest intensity PiB voxels with mid-range 18F-FDG values indicates only nonspecific binding in the white matter.

  18. Progressing Sclerosing Mesenteritis (Mesenteric Panniculitis) Mimics Progression of Malignancy After Neoadjuvant Chemotherapy for Gastric Adenocarcinoma on Serial 18F-FDG PET/CT.

    PubMed

    Makis, William

    2016-04-01

    A 62-year-old man was diagnosed with a moderately differentiated gastric adenocarcinoma in the proximal stomach. A staging 18F-FDG PET/CT showed an intensely FDG-avid gastric mass, as well as a mildly FDG-avid misty nodular mesentery. After 3 cycles of neoadjuvant chemotherapy, a follow-up PET/CT showed partial response of the gastric primary, with increase in the size of nodules in the mesentery and increased FDG uptake, raising concern of secondary malignancy. Biopsy of the mesentery revealed xanthogranulomatous inflammation, consistent with sclerosing mesenteritis. PMID:26359565

  19. IgG4-Related Kidney Disease in a Patient With History of Breast Cancer: Findings on 18F-FDG PET/CT.

    PubMed

    Krebs, Simone; Monti, Serena; Seshan, Surya; Fox, Josef; Mannelli, Lorenzo

    2016-08-01

    A 64-year-old African American woman with history of stage III breast carcinoma, 3 years after complete response to therapy, presents with progressive fatigue, increasing arthralgia, and unintentional weight loss of 15 lb in 3 months. An F-FDG PET demonstrated new diffuse FDG avidity of the renal parenchyma, new FDG-avid foci in pancreas and lungs, and new FDG-avid lymph nodes above and below the diaphragm. While a retroperitoneal lymph node biopsy was inconclusive, a kidney biopsy resulted in diagnosis of diffuse, severe, IgG4-related tubulointerstitial nephritis. Treatment with corticosteroid led to complete resolution of the symptoms and PET findings. PMID:27187735

  20. Ovarian Hyperstimulation and Oocyte Harvesting Prior to Systemic Chemotherapy-A Possible Pitfall in 18F-FDG PET/CT Staging of Oncologic Patients.

    PubMed

    Bacanovic, Sara; Stiller, Ruth; Pircher, Magdalena; Burger, Irene A; Huellner, Martin W

    2016-08-01

    A 33-year-old woman with Hodgkin disease Ann Arbor stage IIA underwent baseline F-FDG PET/CT scanning. The scan showed gross multicystic enlargement of both ovaries and a nodule at the edge of the right ovary with intense FDG uptake (SUVmax = 14.8). Differential diagnosis would include ovarian lymphoma manifestation, endometrioma, and ovarian or pelvic neoplasia. However, chart analysis revealed previous superstimulation with gonadotropins and gonadotropin release hormone antagonist, and transvaginal oocyte retrieval the day before FDG PET/CT. This led to the diagnosis of ovarian hyperstimulation syndrome, with the FDG-avid focus representing a hemorrhagic follicle after transvaginal oocyte retrieval procedure. PMID:27124682

  1. Factors affecting bilateral temporal lobe hypometabolism on 18F-FDG PET brain scan in unilateral medial temporal lobe epilepsy.

    PubMed

    Tepmongkol, Supatporn; Srikijvilaikul, Teeradej; Vasavid, Pataramon

    2013-11-01

    Bilateral temporal lobe hypometabolism (BTH) on (18)F-FDG PET brain scan is frequently seen in unilateral medial temporal lobe epilepsy (mTLE). This study aimed to identify the factors that influence BTH in patients with mTLE in order to minimize the significant factor(s) prior to performing a FDG-PET brain scan. Forty patients with unilateral mTLE who underwent (18)F-FDG PET scan for presurgical epilepsy workup were included. Bilateral temporal lobe hypometabolism of the anterior and medial parts of the temporal lobe was identified by a semiquantitative visual scale. Lateralization of TLE was identified by either intracranial EEG (22/40 cases) and/or improvement of seizure 2 years after temporal lobectomy (37/40 cases). The factors analyzed included basic demographic characteristics (age, sex, occupation, years of education, and handedness), history related to seizure (age at epilepsy onset and epilepsy duration, history of febrile seizure and head injury, frequency of seizure with impaired cognition in the last 3 months, presence of secondarily generalized tonic-clonic seizure, automatism side, presence of postictal confusion, and side of MRI temporal abnormality), information during video-EEG monitoring (clinical lateralization, interictal scalp EEG lateralization (interictal epileptiform discharge), and ictal scalp EEG lateralization), and information during the FDG-PET study (duration from the last seizure (≤2 days or >2 days), last seizure type, and the presence of slow waves or sharp waves during the FDG uptake period). Significant factors related to BTH were analyzed using multivariate analysis. Only the ≤2-day duration from the last seizure to the PET scan shows a significant effect (p=0.021) on BTH finding with 15 times greater incidence compared to a duration >2 days. Bilateral temporal lobe hypometabolism, which causes conflict in lateralizing the epileptogenic zone in temporal lobe epilepsy, can be avoided by performing PET scan more than 2 days

  2. Human Organotypic Lung Tumor Models: Suitable For Preclinical 18F-FDG PET-Imaging

    PubMed Central

    Fecher, David; Hofmann, Elisabeth; Buck, Andreas; Bundschuh, Ralph; Nietzer, Sarah; Dandekar, Gudrun; Walles, Thorsten; Walles, Heike; Lückerath, Katharina; Steinke, Maria

    2016-01-01

    Development of predictable in vitro tumor models is a challenging task due to the enormous complexity of tumors in vivo. The closer the resemblance of these models to human tumor characteristics, the more suitable they are for drug-development and –testing. In the present study, we generated a complex 3D lung tumor test system based on acellular rat lungs. A decellularization protocol was established preserving the architecture, important ECM components and the basement membrane of the lung. Human lung tumor cells cultured on the scaffold formed cluster and exhibited an up-regulation of the carcinoma-associated marker mucin1 as well as a reduced proliferation rate compared to respective 2D culture. Additionally, employing functional imaging with 2-deoxy-2-[18F]fluoro-D-glucose positron emission tomography (FDG-PET) these tumor cell cluster could be detected and tracked over time. This approach allowed monitoring of a targeted tyrosine kinase inhibitor treatment in the in vitro lung tumor model non-destructively. Surprisingly, FDG-PET assessment of single tumor cell cluster on the same scaffold exhibited differences in their response to therapy, indicating heterogeneity in the lung tumor model. In conclusion, our complex lung tumor test system features important characteristics of tumors and its microenvironment and allows monitoring of tumor growth and -metabolism in combination with functional imaging. In longitudinal studies, new therapeutic approaches and their long-term effects can be evaluated to adapt treatment regimes in future. PMID:27501455

  3. Short-Term Practice Effects and Brain Hypometabolism: Preliminary Data from an FDG PET Study

    PubMed Central

    Duff, Kevin; Horn, Kevin P.; Foster, Norman L.; Hoffman, John M.

    2015-01-01

    Practice effects are improvements in cognitive test scores due to repeated exposure to the same tests. Typically viewed as error, short-term practice effects have been shown to provide valuable clinical information about diagnosis, prognosis, and treatment outcomes in older patients with mild cognitive impairments. This study examined short-term practice effects across one week and brain hypometabolism on fluoro-2-deoxyglucose (FDG) positron emission tomography (PET) in 25 older adults (15 intact, 10 Mild Cognitive Impairment). Averaged cerebral brain metabolism on FDG PET was correlated with multiple cognitive scores at baseline in those with Mild Cognitive Impairment, and short-term practice effects accounted for additional variance in these same subjects. The relationship between brain metabolism and cognition (either at baseline or practice effects) was minimal in the intact individuals. Although needing replication in larger samples, short-term practice effects on tests of executive functioning and memory may provide valuable information about biomarkers of Alzheimer’s disease. PMID:25908614

  4. An ¹⁸F-FDG PET study of cervical muscle in parkinsonian anterocollis.

    PubMed

    Revuelta, Gonzalo J; Montilla, Jaime; Benatar, Michael; Freeman, Alan; Wichmann, Thomas; Jinnah, Hyder A; Delong, Mahlon R; Factor, Stewart A

    2014-05-15

    The underlying etiology of parkinsonian anterocollis has been the subject of recent debate. The purpose of this study is to test the hypothesis that anterocollis in parkinsonian syndromes is associated with dystonia of the deep cervical flexors (longus colli and capitis). Eight patients with anterocollis, six in the setting of parkinsonism and two primary cervical dystonia control subjects with anterocollis underwent prospective structured clinical evaluations (interview, examination and rating scales), systematic electromyography of the cervical extensor musculature and (18)F-FDG PET/CT studies of cervical muscles to examine evidence of hypermetabolism or overactivity of deep cervical flexors. Subjects with parkinsonian anterocollis were found to have hypermetabolism of the extensor and sub-occipital muscles but not in the cervical flexors (superficial or deep). EMG abnormalities were observed in all evaluated patients, but only one patient was definitely myopathic. Meanwhile, both dystonia controls exhibited hypermetabolism of cervical flexors (including the longus colli). In conclusion, we were able to demonstrate hypermetabolism of superficial and deep cervical flexors with muscle (18)F-FDG PET/CT in dystonic anterocollis patients, but not in parkinsonian anterocollis patients. The hypermetabolic changes seen in parkinsonian anterocollis patients in posterior muscles may be compensatory. Alternative explanations for anterocollis include myopathy of the cervical extensors, or unbalanced rigidity of the cervical flexors, but this remains to be proven. PMID:24725739

  5. 18F-FDG PET/CT and pain in metastatic bone cancer

    PubMed Central

    Struck, Aaron F; Muzahir, Saima; Hall, Lance T

    2015-01-01

    This study aims to determine if the pain intensity of patients with oncologic bone metastases (BM) correlates with metabolic activity measured by 18F-FDG PET/CT. Twenty-eight patients, ages: 21-89 years (mean: 58.8) with BM were included in the study between September 2011 to September 2013. All patients completed a detailed questionnaire regarding pain symptoms on the visual analog scale (VAS), analgesic use, and areas of chronic pain, prior to obtaining an 18F-FDG PET/CT. Pain symptoms were queried for 11 body regions including limbs, head, torso, etc. and the corresponding SUVmax of BMs within that region were modeled with the corresponding clinical data using a linear mixed effects model and a linear regression model. Overall 64 areas in the 28 subjects were found to have BM. SUVmax was found to be a significant predictor of pain intensity as measured by the VAS, with a P-value of 0.045, with a modest effect-size on linear regression of R2 of 0.11. PMID:26069862

  6. Human Organotypic Lung Tumor Models: Suitable For Preclinical 18F-FDG PET-Imaging.

    PubMed

    Fecher, David; Hofmann, Elisabeth; Buck, Andreas; Bundschuh, Ralph; Nietzer, Sarah; Dandekar, Gudrun; Walles, Thorsten; Walles, Heike; Lückerath, Katharina; Steinke, Maria

    2016-01-01

    Development of predictable in vitro tumor models is a challenging task due to the enormous complexity of tumors in vivo. The closer the resemblance of these models to human tumor characteristics, the more suitable they are for drug-development and -testing. In the present study, we generated a complex 3D lung tumor test system based on acellular rat lungs. A decellularization protocol was established preserving the architecture, important ECM components and the basement membrane of the lung. Human lung tumor cells cultured on the scaffold formed cluster and exhibited an up-regulation of the carcinoma-associated marker mucin1 as well as a reduced proliferation rate compared to respective 2D culture. Additionally, employing functional imaging with 2-deoxy-2-[18F]fluoro-D-glucose positron emission tomography (FDG-PET) these tumor cell cluster could be detected and tracked over time. This approach allowed monitoring of a targeted tyrosine kinase inhibitor treatment in the in vitro lung tumor model non-destructively. Surprisingly, FDG-PET assessment of single tumor cell cluster on the same scaffold exhibited differences in their response to therapy, indicating heterogeneity in the lung tumor model. In conclusion, our complex lung tumor test system features important characteristics of tumors and its microenvironment and allows monitoring of tumor growth and -metabolism in combination with functional imaging. In longitudinal studies, new therapeutic approaches and their long-term effects can be evaluated to adapt treatment regimes in future. PMID:27501455

  7. Intraobserver and Interobserver Variability in GTV Delineation on FDG-PET-CT Images of Head and Neck Cancers

    SciTech Connect

    Breen, Stephen L. |. E-mail: Stephen.Breen@rmp.uhn.on.ca; Publicover, Julia; De Silva, Shiroma; Pond, Greg; Brock, Kristy |; O'Sullivan, Brian |; Cummings, Bernard; Dawson, Laura; Kim, John; Ringash, Jolie; Waldron, John |; Keller, Anne |; Yu, Eugene; Hendler, Aaron |

    2007-07-01

    Purpose: To determine if the addition of fluorodeoxyglucose positron emission tomography (FDG-PET) data changes primary site gross tumor volumes (GTVs) in head and neck cancers. Methods and Materials: Computed tomography (CT), contrast-enhanced CT, and FDG-PET-CT scans were obtained in 10 patients with head and neck cancers. Eight experienced observers (6 head and neck oncologists and 2 neuro-radiologists) with access to clinical and radiologic reports outlined primary site GTVs on each modality. Three cases were recontoured twice to assess intraobserver variability. The magnitudes of the GTVs were compared. Intra- and interobserver variability was assessed by a two-way repeated measures analysis of variance. Inter- and intraobserver reliability were calculated. Results: There were no significant differences in the GTVs across the image modalities when compared as ensemble averages; the Wilcoxon matched-pairs signed-rank test showed that CT volumes were larger than PET-CT. Observers demonstrated the greatest consistency and were most interchangeable on contrast-enhanced CT; they performed less reliably on PET-CT. Conclusions: The addition of PET-CT to primary site GTV delineation of head and neck cancers does not change the volume of the GTV defined by this group of expert observers in this patient sample. An FDG-PET may demonstrate differences in neck node delineation and in other disease sites.

  8. Feasibility of detecting small intestinal disease by FDG-PET/CT.

    PubMed

    Sugaya, Takeshi; Sakamoto, Setsu; Tominaga, Keiichi; Nakano, Masakazu; Sugaya, Hitoshi; Hiraishi, Hideyuki

    2015-10-01

    Positron emission tomography (PET)/computed tomography with (18)F-fluorodeoxyglucose (FDG) is widely used for the diagnosis of malignant tumors. However, we occasionally encounter cases in which pathological accumulation is indistinguishable from physiological accumulation. We conducted a retrospective study of the maximum standardized uptake value (SUVmax) and the distribution pattern of FDG accumulation in 80 evaluable patients with records of accumulation in the small intestine identified from data acquired at Dokkyo Medical University PET Center from March 2005 to December 2010. Our aim was to distinguish pathological accumulation from physiological accumulation. Nineteen of the 80 patients had lesions that required some form of treatment. These lesions were categorized as pathological accumulation, while other 65 lesions in 61 patients were categorized as physiological accumulation. Cases with diffuse accumulation in the intestinal tract were assigned to Group L (linear), all others to Group F (focal), in our analysis. Lesions were focal in 22 patients and linear in 62. The pathological accumulation group had a mean SUVmax of 12.2, which was higher than that of 5.0 in the physiological accumulation group, and included more lesions that were categorized into Group F (16 of 19 lesions). The sensitivity and specificity for detecting focal accumulation regarded as being pathological accumulation were 84% and 91%, respectively, and accuracy was 89%. The sensitivity and specificity with a cut-off SUVmax of 5.87 obtained in the ROC analysis were 84% and 78%, respectively, and accuracy was 80%. Evaluation of SUVmax in the small intestine and the distribution pattern of FDG accumulation may be useful for diagnosing lesions in the small intestine. PMID:26070746

  9. Correction for FDG PET dose extravasations: Monte Carlo validation and quantitative evaluation of patient studies

    SciTech Connect

    Silva-Rodríguez, Jesús Aguiar, Pablo; Sánchez, Manuel; Mosquera, Javier; Luna-Vega, Víctor; Cortés, Julia; Garrido, Miguel; Pombar, Miguel; Ruibal, Álvaro

    2014-05-15

    Purpose: Current procedure guidelines for whole body [18F]fluoro-2-deoxy-D-glucose (FDG)-positron emission tomography (PET) state that studies with visible dose extravasations should be rejected for quantification protocols. Our work is focused on the development and validation of methods for estimating extravasated doses in order to correct standard uptake value (SUV) values for this effect in clinical routine. Methods: One thousand three hundred sixty-seven consecutive whole body FDG-PET studies were visually inspected looking for extravasation cases. Two methods for estimating the extravasated dose were proposed and validated in different scenarios using Monte Carlo simulations. All visible extravasations were retrospectively evaluated using a manual ROI based method. In addition, the 50 patients with higher extravasated doses were also evaluated using a threshold-based method. Results: Simulation studies showed that the proposed methods for estimating extravasated doses allow us to compensate the impact of extravasations on SUV values with an error below 5%. The quantitative evaluation of patient studies revealed that paravenous injection is a relatively frequent effect (18%) with a small fraction of patients presenting considerable extravasations ranging from 1% to a maximum of 22% of the injected dose. A criterion based on the extravasated volume and maximum concentration was established in order to identify this fraction of patients that might be corrected for paravenous injection effect. Conclusions: The authors propose the use of a manual ROI based method for estimating the effectively administered FDG dose and then correct SUV quantification in those patients fulfilling the proposed criterion.

  10. Diminished glucose transport and phosphorylation in Alzheimer`s disease determined by dynamic FDG-PET

    SciTech Connect

    Piert, M.; Koeppe, R.A.; Giordani, B.; Berent, S.; Kuhl, D.E.

    1996-02-01

    Using dynamic [{sup 18}F] fluorodeoxyglucose (FDG) and PET, kinetic rate constants that describe influx (K{sub 1}) and efflux (k{sub 2}) of FDG as well s phosphorylation (k{sub 3}) and dephosphorylation (k{sub 4}) were determined in patients with probable Alzheimer`s disease and similarly aged normal controls. The regional cerebral metabolic rate for glucose (CMR{sub glu}) was calculated from individually fitted rate constants in frontal, temporal, parietal and occipital cerebral cortex, caudate nucleus, putamen, thalamus and cerebellar cortex. Dynamic PET scans were obtained in normal controls (n = 10, mean age = 67) and Alzheimer`s disease patients (n = 8, mean age = 67) for 60 min following injection of 10 mCi of FDG. The Alzheimer`s disease group was characterized by decreases of the CMR{sub glu} ranging from 13.3% in the frontal to 40.9% in the parietal cortex, which achieved significance in all regions except the thalamus. K{sub 1} was significantly reduced in the parietal (p < 0.01) and temporal cortices (p < 0.005), temporal and occipital cortex, and in the putamen and cerebellum (p < 0.05). The rate constants k{sub 2} and k{sub 4} were unchanged in the Alzheimer`s disease group. These data suggest that hypometabolism in Alzheimer`s disease is related to reduced glucose phosphorylation activity as well as diminished glucose transport, particularly in the most metabolically affected areas of the brain, the parietal and temporal cortex. 60 refs., 2 figs., 2 tabs.

  11. Is (18)F-FDG PET really a promising marker for clinically relevant atherosclerosis?

    PubMed

    Brammen, Lindsay; Palumbo, Barbara; Lupattelli, Graziana; Sinzinger, Helmut

    2014-01-01

    Bural et al (2013), retrospectively investigated 143 subjects who received whole body fluorine-18-fluorodeoxyglucose- positron emission tomography ((18)F-FDG-PET) imaging for the assessment of non-cardiovascular diseases. They reported an increase of (18)F-FDG-positive lesions in various aortic segments, which increased with age, and were more pronounced in subjects being aged below 50 years as compared to those above 50. Bural et al also found the highest segmental (18)F-FDG-uptake in the descending thoracic aorta, but not in the abdominal aorta, where the majority of the most severe atherosclerotic lesions essentially appear. In addition, they did not appreciate any significant gender difference. Despite the severe limitation that no correlation to vascular disease, risk factors, or any clinical parameter was available, this report again raises the question as to what positive (18)F-FDG imaging really reflects and whether it will ever reach the great expectations. Conventional radiotracers revealed an excellent experimental correlation, as well as morphology. Uptake ratios of symptomatic lesion vs. contralateral unaffected side were comparable between (111)In-platelets, (123)I-LDL and (18)FFDG. There was also a mass strategic correlation, but no individual prediction of events at all. Due to better statistics, image quality and solution PET imaging of atherosclerosis holds great promise. However, correlations between various tracers and vascular wall characteristics (and staining methodologies) in 1% cholesterol fed rabbits reveal that (18)F-FDG is not always the best tracer. Vascular foam cell content is reflected by (111)In-HIG > (125)I-oxLp(a) > (18)F-FDG > (125)I-LDL (Brammen L, Palumbo B, Lupattelli G et al. Unpublished data). A close correlation to Framingham risk score is for example not helpful, as this score has a low predictive value of only 0.6. The available clinical correlations between (18)F-FDG-uptake and arterial wall characteristics are poor. For

  12. A Small-Animal Pharmacokinetic/Pharmacodynamic PET Study of Central Serotonin 1A Receptor Occupancy by a Potential Therapeutic Agent for Overactive Bladder

    PubMed Central

    Nakatani, Yosuke; Suzuki, Michiyuki; Tokunaga, Masaki; Maeda, Jun; Sakai, Miyuki; Ishihara, Hiroki; Yoshinaga, Takashi; Takenaka, Osamu; Zhang, Ming-Rong; Suhara, Tetsuya; Higuchi, Makoto

    2013-01-01

    Serotonin 1A (5-HT1A) receptors have been mechanistically implicated in micturition control, and there has been a need for an appropriate biomarker surrogating the potency of a provisional drug acting on this receptor system for developing a new therapeutic approach to overactive bladder (OAB). Here, we analyzed the occupancy of 5-HT1A receptors in living Sprague-Dawley rat brains by a novel candidate drug for OAB, E2110, using positron emission tomography (PET) imaging, and assessed the utility of a receptor occupancy (RO) assay to establish a pharmacodynamic index translatable between animals and humans. The plasma concentrations inducing 50% RO (EC50) estimated by both direct and effect compartment models were in good agreement. Dose-dependent therapeutic effects of E2110 on dysregulated micturition in different rat models of pollakiuria were also consistently explained by achievement of 5-HT1A RO by E2110 in a certain range (≥ 60%). Plasma drug concentrations inducing this RO range and EC50 would accordingly be objective indices in comparing pharmacokinetics-RO relationships between rats and humans. These findings support the utility of PET RO and plasma pharmacokinetic assays with the aid of adequate mathematical models in determining the in vivo characteristics of a drug acting on 5-HT1A receptors and thereby counteracting OAB. PMID:24086433

  13. Uterine Intravenous Leiomyomatosis with Intracardiac Extension and Pulmonary Benign Metastases on FDG PET/CT: A Case Report

    PubMed Central

    Wang, Hui-Chun; Chen, Xiao-Hong; Cui, Lan-Lan

    2016-01-01

    A 48-year-old woman presented with a 50-day history of irregular vaginal bleeding and lower abdominal pain. Ultrasound indicated an extremely large occupying lesion in the pelvic cavity that was highly suggestive of malignancy. Fluorodeoxyglucose (FDG) positron emission tomography/computed tomography (PET/CT) was performed to further assess the nature of pelvic abnormality. PET/CT images demonstrated a diffusely lobulated mass ranging from cervix up to the inferior pole of kidneys with mild FDG uptake. Simultaneously, multiple nodules in bilateral lungs and a hypodense lesion in the right ventricle were shown without FDG-avidity. Based on the imaging results, the presumptive diagnosis was uterine intravenous leiomyomatosis with intracardiac extension and pulmonary benign metastases, which was subsequently confirmed by MRI and the lesion biopsy. PMID:26957916

  14. The Effect of Xanthigen on the Expression of Brown Adipose Tissue Assessed by 18F-FDG PET

    PubMed Central

    Kim, Kwang-Min; Kim, Sang-Man; Cho, Doo-Yeon; Park, Soo-Jung

    2016-01-01

    Brown adipose tissue (BAT) is related with energy expenditure, in contrary to fat-storing white adipose tissue. Recent studies have shown that cold exposure could be related with the expression of BAT in adult subjects assessed by 18F-fluorodeoxyglucose (FDG) positron emission tomography (PET). In addition, the application in previous clinical trials showed positive effect of xanthigen containing fucoxanthin and punicic acid on body weight and liver fat content. In this short-term intervention study, we evaluated the effect of xanthigen on the expression of BAT by 18F-FDG PET. Two healthy obese premenopausal women were enrolled and xanthigen 600 mg (2 capsules including fucoxanthin 3 mg, punicic acid 174 mg) was given for 3 months without dietary and exercise intervention. Body composition and dietary intake were assessed monthly. Laboratory test and 18F-FDG PET were performed before and after intervention. After intervention, there was neither weight reduction nor remarkable laboratory change. However, BAT, assessed by 18F-FDG PET, was detected in both cervical, supraclavicular and paravertebral space in one subject, even though her body weight showed mild increase. This result suggested that xanthigen can induce BAT in a healthy adult. However, a further large well-controlled study is needed. PMID:27189303

  15. Clinical, pathological and (18)F-FDG PET/CT findings in synchronous primary vaginal and endometrial cancers.

    PubMed

    Gunes, Burcak Yilmaz; Akbayır, Ozgur; Demirci, Emre; Ozaydin, Ipek

    2016-01-01

    Synchronous primary gynecologic malignancies are infrequently seen. In this report, we describe the clinical, pathological and fluorine-18-fluorodeoxyglucose positron emission tomography/computed tomography ((18)F-FDG PET/CT) findings of a patient with synchronous primary vaginal and endometrial cancers. To our knowledge, this is the first such case described in the literature. PMID:27331214

  16. Recurrent tumor vs radiation effects after Gamma Knife radiosurgery of intracerebral metastases: Diagnosis with PET-FDG

    SciTech Connect

    Mogard, J.; Kihlstroem, L.; Ericson, K. |

    1994-03-01

    Our objective was to differentiate radiation effects from tumor progression in metastases stereotaxically irradiated with the multicobalt unit (Gamma Knife). Eleven patients with stereotaxically irradiated cerebral metastases were examined with PET using [{sup 18}F]fluorodeoxyglucose (FDG) to differentiate recurrent tumor from radiation effects. Six patients had increased uptake of FDG, and clinical, radiological, and pathological findings confirmed the diagnosis of recurrent metastases. These patients had an unfavorable prognosis and were all dead within 54 weeks after radiosurgery. Five patients had lesions without an increased accumulation of FDG. Four of these patients were alive after a total follow-up of 1.7 years, while one patient died of a peptic ulcer 56 weeks after radiosurgery. Positron emission tomography with FDG was of obvious prognostic value in this small series of patients and was clearly superior to CT and MR in the distinction between tumor recurrence and radiation effects (verified necrosis in one case). 24 refs., 2 figs., 2 tabs.

  17. Development and use of a kinetic FDG-PET dataset simulated from the MNI standard brain

    NASA Astrophysics Data System (ADS)

    Schottlander, David; Guimond, Alexandre; Pan, Xiao-Bo; Brady, Michael; Declerck, Jérôme; Collins, Louis; Evans, Alan C.; Reilhac, Anthonin

    2006-03-01

    Simulated data is an important tool for evaluation of reconstruction and image processing algorithms in the frequent absence of ground truth, in-vivo data from living subjects. This is especially true in the case of dynamic PET studies, in which counting statistics of the volume can vary widely over the time-course of the acquisition. Realistic simulated data-sets which model anatomy and physiology, and make explicit the spatial and temporal image acquisition characteristics, facilitate experimentation with a wide range of the conditions anticipated in practice, and which can severely challenge algorithm performance and reliability. As a first example, we have developed a realistic dynamic FDG-PET data-set using the PET-SORTEO Monte Carlo simulation code and the MNI digital brain phantom. The phantom is a three-dimensional data-set that defines the spatial distribution of different tissues. Time activity curves were calculated using an impulse response function specified by generally accepted rate constants, convolved with an input function obtained by blood sampling, and assigned to grey and white matter tissue regions. We created a dynamic PET study using PET-SORTEO configured to simulate an ECAT Exact HR+. The resulting sinograms were reconstructed with all corrections, using variations of FBP and OSEM. Having constructed the dynamic PET data-sets, we used them to evaluate the performance of intensity-based registration as part of a tool for quantifying hyper/hypo perfusion with particular application to analysis of brain dementia scans, and a study of the stability of kinetic parameter estimation.

  18. Validation of an optimized SPM procedure for FDG-PET in dementia diagnosis in a clinical setting

    PubMed Central

    Perani, Daniela; Della Rosa, Pasquale Anthony; Cerami, Chiara; Gallivanone, Francesca; Fallanca, Federico; Vanoli, Emilia Giovanna; Panzacchi, Andrea; Nobili, Flavio; Pappatà, Sabina; Marcone, Alessandra; Garibotto, Valentina; Castiglioni, Isabella; Magnani, Giuseppe; Cappa, Stefano F.; Gianolli, Luigi

    2014-01-01

    Diagnostic accuracy in FDG-PET imaging highly depends on the operating procedures. In this clinical study on dementia, we compared the diagnostic accuracy at a single-subject level of a) Clinical Scenarios, b) Standard FDG Images and c) Statistical Parametrical (SPM) Maps generated via a new optimized SPM procedure. We evaluated the added value of FDG-PET, either Standard FDG Images or SPM Maps, to Clinical Scenarios. In 88 patients with neurodegenerative diseases (Alzheimer's Disease—AD, Frontotemporal Lobar Degeneration—FTLD, Dementia with Lewy bodies—DLB and Mild Cognitive Impairment—MCI), 9 neuroimaging experts made a forced diagnostic decision on the basis of the evaluation of the three types of information. There was also the possibility of a decision of normality on the FDG-PET images. The clinical diagnosis confirmed at a long-term follow-up was used as the gold standard. SPM Maps showed higher sensitivity and specificity (96% and 84%), and better diagnostic positive (6.8) and negative (0.05) likelihood ratios compared to Clinical Scenarios and Standard FDG Images. SPM Maps increased diagnostic accuracy for differential diagnosis (AD vs. FTD; beta 1.414, p = 0.019). The AUC of the ROC curve was 0.67 for SPM Maps, 0.57 for Clinical Scenarios and 0.50 for Standard FDG Images. In the MCI group, SPM Maps showed the highest predictive prognostic value (mean LOC = 2.46), by identifying either normal brain metabolism (exclusionary role) or hypometabolic patterns typical of different neurodegenerative conditions. PMID:25389519

  19. Voxel-based classification of FDG PET in dementia using inter-scanner normalization.

    PubMed

    Thiele, Frank; Young, Stewart; Buchert, Ralph; Wenzel, Fabian

    2013-08-15

    Statistical mapping of FDG PET brain images has become a common tool in differential diagnosis of patients with dementia. We present a voxel-based classification system of neurodegenerative dementias based on partial least squares (PLS). Such a classifier relies on image databases of normal controls and dementia cases as training data. Variations in PET image characteristics can be expected between databases, for example due to differences in instrumentation, patient preparation, and image reconstruction. This study evaluates (i) the impact of databases from different scanners on classification accuracy and (ii) a method to improve inter-scanner classification. Brain FDG PET databases from three scanners (A, B, C) at two clinical sites were evaluated. Diagnostic categories included normal controls (NC, nA=26, nB=20, nC=24 for each scanner respectively), Alzheimer's disease (AD, nA=44, nB=11, nC=16), and frontotemporal dementia (FTD, nA=13, nB=13, nC=5). Spatially normalized images were classified as NC, AD, or FTD using partial least squares. Supervised learning was employed to determine classifier parameters, whereby available data is sub-divided into training and test sets. Four different database setups were evaluated: (i) "in-scanner": training and test data from the same scanner, (ii) "x-scanner": training and test data from different scanners, (iii) "train other": train on both x-scanners, and (iv) "train all": train on all scanners. In order to moderate the impact of inter-scanner variations on image evaluation, voxel-by-voxel scaling was applied based on "ratio images". Good classification accuracy of on average 94% was achieved for the in-scanner setups. Accuracy deteriorated for setups with mismatched scanners (79-91%). Ratio-image normalization improved all results with mismatched scanners (85-92%). In conclusion, automatic classification of individual FDG PET in differential diagnosis of dementia is feasible. Accuracy can vary with respect to scanner or

  20. [Usefulness of Determining Acquisition Time by True Count Rate Measurement Method for Delivery 18F-FDG PET/CT].

    PubMed

    Miura, Shota; Odashima, Satoshi

    2016-03-01

    A stable quality of delivery 18F-fluoro-2-deoxy-D-glucose (18F-FDG) positron emission tomography/computed tomography (PET/CT) requires suitable acquisition time, which can be obtained from an accurate true count of 18F-FDG. However, the true count is influenced by body mass index (BMI) and attenuation of 18F-FDG. In order to remove these influences, we have developed a new method (actual measurement method) to measure the actual true count rate based on sub-pubic thigh, which allows us to calculate a suitable acquisition time. In this study, we aimed to verify the acquisition count through our new method in terms of two categories: (1) the accuracy of acquisition count and (2) evaluation of clinical images using physical index. Our actual measurement method was designed to obtain suitable acquisition time through the following procedure. A true count rate of sub-pubic thigh was measured through detector of PET, and used as a standard true count rate. Finally, the obtained standard count rate was processed to acquisition time. This method was retrospectively applied to 150 patients, receiving 18F-FDG administration from 109.7 to 336.8 MBq, and whose body weight ranged from 37 to 95.4 kg. The accuracy of true count was evaluated by comparing relationships of true count, relative to BMI or to administered dose of 18F-FDG. The PET/CT images obtained by our actual measurement method were assessed using physical index. Our new method resulted in accurate true count, which was not influenced by either BMI or administered dose of 18F-FDG, as well as satisfied PET/CT images with recommended criteria of physical index in all patients. PMID:27000670

  1. Detection of a metastatic lesion and tiny yolk sac tumors in two teenage patients by FDG-PET: report of two cases.

    PubMed

    Takahashi, Masataka; Kanamori, Yutaka; Takahashi, Miwako; Momose, Toshimitsu; Iwanaka, Tadashi

    2014-10-01

    We herein report the efficacy of FDG-PET for detecting yolk sac tumors in two teenage patients. One patient had a rare bone metastasis and the other had tiny recurrent lesions at the mediastinum. Both lesions were difficult to detect by conventional diagnostic modalities. In contrast, FDG-PET was very effective for detecting these lesions. Furthermore, the SUVmax of the lesion reflected the tumor activity, which was also suggested by the fluctuating values of serum alpha-fetoprotein (AFP), an established marker of yolk sac tumors. FDG-PET may be a useful procedure to detect tiny and metastatic, pediatric yolk sac tumors. PMID:23801057

  2. Usefulness of (18)F-FDG PET/CT in disease extent and treatment response assessment in a patient with syphilitic aortitis.

    PubMed

    Treglia, Giorgio; Taralli, Silvia; Maggi, Fabio; Coli, Antonella; Lauriola, Libero; Giordano, Alessandro

    2013-04-01

    A 40-year-old man was admitted to our hospital for surgical treatment of aortic insufficiency and coronary ostial stenosis. Histopathology and serological tests revealed a syphilitic aortitis. F-FDG PET/CT was performed to assess the extent of aortitis, showing increased radiopharmaceutical uptake along the ascending aortic wall. A repeated FDG PET/CT after antibiotic therapy showed a markedly reduced uptake in the aortic wall, suggesting resolution of the infection according to clinical and serological data. This case highlights the usefulness of FDG PET/CT for the assessment of disease extent and treatment response in patients with syphilitic aortitis. PMID:23143047

  3. A compact and high sensitivity positron detector using dual-layer thin GSO scintillators for a small animal PET blood sampling system

    NASA Astrophysics Data System (ADS)

    Yamamoto, Seiichi; Imaizumi, Masao; Shimosegawa, Eku; Kanai, Yasukazu; Sakamoto, Yusuke; Minato, Kotaro; Shimizu, Keiji; Senda, Michio; Hatazawa, Jun

    2010-07-01

    For quantitative measurements of small animals such as mice or rats, a compact and high sensitivity continuous blood sampling detector is required because their blood sampling volume is limited. For this purpose we have developed and tested a new positron detector. The positron detector uses a pair of dual-layer thin gadolinium orthosilicate (GSO) scintillators with different decay times. The front layer detects the positron and the background gamma photons, and the back layer detects the background gamma photons. By subtracting the count rate of the latter from that of the former, the count rate of the positrons can be estimated. The GSO for the front layer has a Ce concentration of 1.5 mol% (decay time of 35 ns), and that for the back layer has a Ce concentration of 0.5 mol% (decay time of 60 ns). By using the pulse shape analysis, the count rate of these two GSOs can be discriminated. The thickness is 0.5 mm, which is thick enough to detect positrons while minimizing the detection of the background gamma photons. These two types of thin GSOs were optically coupled to each other and connected to a metal photomultiplier tube (PMT) through triangular light guides. The signal from the PMT was digitized by 100 MHz free-running A-D converters in the data acquisition system and digitally integrated at two different integration times for the pulse shape analysis. We obtained good separation of the pulse shape distributions of these two GSOs. The energy threshold level was decreased to 80 keV, increasing the sensitivity of the detector. The sensitivity of a small diameter plastic tube was 8.6% and 24% for the F-18 and C-11 positrons, respectively. The count rate performance was linear up to ~50 kcps. The background counts from the gamma photons could be precisely corrected. The time-activity curve (TAC) of the rat artery blood was successfully obtained and showed a good correlation with that measured using a well counter. With these results, we confirmed that the

  4. A compact and high sensitivity positron detector using dual-layer thin GSO scintillators for a small animal PET blood sampling system.

    PubMed

    Yamamoto, Seiichi; Imaizumi, Masao; Shimosegawa, Eku; Kanai, Yasukazu; Sakamoto, Yusuke; Minato, Kotaro; Shimizu, Keiji; Senda, Michio; Hatazawa, Jun

    2010-07-01

    For quantitative measurements of small animals such as mice or rats, a compact and high sensitivity continuous blood sampling detector is required because their blood sampling volume is limited. For this purpose we have developed and tested a new positron detector. The positron detector uses a pair of dual-layer thin gadolinium orthosilicate (GSO) scintillators with different decay times. The front layer detects the positron and the background gamma photons, and the back layer detects the background gamma photons. By subtracting the count rate of the latter from that of the former, the count rate of the positrons can be estimated. The GSO for the front layer has a Ce concentration of 1.5 mol% (decay time of 35 ns), and that for the back layer has a Ce concentration of 0.5 mol% (decay time of 60 ns). By using the pulse shape analysis, the count rate of these two GSOs can be discriminated. The thickness is 0.5 mm, which is thick enough to detect positrons while minimizing the detection of the background gamma photons. These two types of thin GSOs were optically coupled to each other and connected to a metal photomultiplier tube (PMT) through triangular light guides. The signal from the PMT was digitized by 100 MHz free-running A-D converters in the data acquisition system and digitally integrated at two different integration times for the pulse shape analysis. We obtained good separation of the pulse shape distributions of these two GSOs. The energy threshold level was decreased to 80 keV, increasing the sensitivity of the detector. The sensitivity of a small diameter plastic tube was 8.6% and 24% for the F-18 and C-11 positrons, respectively. The count rate performance was linear up to approximately 50 kcps. The background counts from the gamma photons could be precisely corrected. The time-activity curve (TAC) of the rat artery blood was successfully obtained and showed a good correlation with that measured using a well counter. With these results, we confirmed

  5. Cerebral metabolism and perfusion in MR-negative individuals with refractory focal epilepsy assessed by simultaneous acquisition of (18)F-FDG PET and arterial spin labeling.

    PubMed

    Boscolo Galazzo, Ilaria; Mattoli, Maria Vittoria; Pizzini, Francesca Benedetta; De Vita, Enrico; Barnes, Anna; Duncan, John S; Jäger, Hans Rolf; Golay, Xavier; Bomanji, Jamshed B; Koepp, Matthias; Groves, Ashley M; Fraioli, Francesco

    2016-01-01

    The major challenge in pre-surgical epileptic patient evaluation is the correct identification of the seizure onset area, especially in MR-negative patients. In this study, we aimed to: (1) assess the concordance between perfusion, from ASL, and metabolism, from (18)F-FDG, acquired simultaneously on PET/MR; (2) verify the utility of a statistical approach as supportive diagnostic tool for clinical readers. Secondarily, we compared (18)F-FDG PET data from the hybrid PET/MR system with those acquired with PET/CT, with the purpose of validate the reliability of (18)F-FDG PET/MR data. Twenty patients with refractory focal epilepsy, negative MR and a defined electro-clinical diagnosis underwent PET/MR, immediately followed by PET/CT. Standardized uptake value ratio (SUVr) and cerebral blood flow (CBF) maps were calculated for PET/CT-PET/MR and ASL, respectively. For all techniques, z-score of the asymmetry index (zAI) was applied for depicting significant Right/Left differences. SUVr and CBF images were firstly visually assessed by two neuroimaging readers, who then re-assessed them considering zAI for reaching a final diagnosis. High agreement between (18)F-FDG PET/MR and ASL was found, showing hypometabolism and hypoperfusion in the same hemisphere in 18/20 patients, while the remaining were normal. They were completely concordant in 14/18, concordant in at least one lobe in the remaining. zAI maps improved readers' confidence in 12/20 and 15/20 patients for (18)F-FDG PET/MR and ASL, respectively. (18)F-FDG PET/CT-PET/MR showed high agreement, especially when zAI was considered. The simultaneous metabolism-perfusion acquisition provides excellent concordance on focus lateralisation and good concordance on localisation, determining useful complementary information. PMID:27222796

  6. Prognostic value of FDG-PET in Hodgkin lymphoma for posttreatment evaluation. Long term follow-up results.

    PubMed

    Molnar, Z; Simon, Z; Borbenyi, Z; Deak, B; Galuska, L; Keresztes, K; Miltenyi, Z; Marton, I; Rosta, A; Schneider, T; Tron, L; Varady, E; Illes, A

    2010-01-01

    Determining the viability of residual tumor masses is a great challenge after primary treatment of Hodgkin lymphoma. FDG-PET may play a crucial role in this procedure. In this study, files of 128 Hodgkin lymphoma patients were reviewed, who were treated in three Hungarian hematology centers between January 1995 and February 2005. CT scan showed residual tumor mass by all of them. Their median follow-up was 75.5 months from PET examination. The number of true-positive, true-negative, false-positive, false-negative subjects were 29, 83, 10, 6, respectively. Sensitivity of post-treatment FDG-PET was 83 %, specificity 93 %, positive predictive value 74 %, negative predictive value 93 %, and accuracy 88 %. The difference between the event free survival of PET positive and negative cases is highly significant (p=0.0000), according to the Mantel-Cox test. Our results in the largest cohort of patients, in accordance with literature, clearly indicates that patients with negative FDG-PET results are unlikely to progress or relapse during the longest follow-up. PMID:20429626

  7. [Extension study and evaluation of the therapeutic response in a patient with metastatic lung adenocarcinoma using sequential study with ¹⁸F-FDG PET-CT and ¹⁸F-fluoride PET-CT].

    PubMed

    Moragas, M; Soler, M; Riera, E; García, J R

    2015-01-01

    We report a case of a patient with lung adenocarcinoma and bone and extraosseus metastases studied with (18)F-FDG PET-CT, (99m)Tc-HMDP and (18)F-fluoride PET-CT. It assesses the usefulness of (18)F-FDG PET-CT for initial staging of the disease and monitoring response to therapy. For the study of the sclerotic bone metastases it shows the superiority of 99mTc-HMDP bone scintigraphy and (18)F-fluoride PET-CT over (18)F-FDG PET-CT, and (18)F-fluoride PET-CT over bone scintigraphy. It also shows the usefulness of (18)F-fluoride PET-CT for monitoring the bone metastases. PMID:24690280

  8. Evaluation of 18F-FDG PET/CT as a diagnostic imaging and staging tool for feline oral squamous cell carcinoma.

    PubMed

    Randall, E K; Kraft, S L; Yoshikawa, H; LaRue, S M

    2016-03-01

    18F-fluorodeoxyglucose positron emission tomography combined with computed tomography (18FDG-PET/CT) has been shown to be effective for staging human oral squamous cell carcinoma (SCC) but its application for cats with oral SCC is unknown. Twelve cats with biopsy-proven oral SCC were imaged with whole body 18FDG-PET/CT to determine its value as a diagnostic imaging and staging tool and fine needle aspirates were obtained of accessible regional lymph nodes. All tumors were FDG avid and conspicuous on 18FDG-PET/CT images, with an average of the maximum standardized uptake value 9.88 ± 5.33 SD (range 2.9-24.9). Soft tissue infiltrative tumors that were subtle and ill defined on CT were highly visible and more extensive on FDG-PET/CT. Tumors invading the osseous structures were more similar in extent on 18FDG-PET/CT and CT although they were more conspicuous on PET images. Three cytologically confirmed metastases were hypermetabolic on PET, while two of those metastases were equivocal on CT. PMID:23782408

  9. Predicting location of recurrence using FDG, FLT, and Cu-ATSM PET in canine sinonasal tumors treated with radiotherapy

    NASA Astrophysics Data System (ADS)

    Bradshaw, Tyler; Fu, Rau; Bowen, Stephen; Zhu, Jun; Forrest, Lisa; Jeraj, Robert

    2015-07-01

    Dose painting relies on the ability of functional imaging to identify resistant tumor subvolumes to be targeted for additional boosting. This work assessed the ability of FDG, FLT, and Cu-ATSM PET imaging to predict the locations of residual FDG PET in canine tumors following radiotherapy. Nineteen canines with spontaneous sinonasal tumors underwent PET/CT imaging with radiotracers FDG, FLT, and Cu-ATSM prior to hypofractionated radiotherapy. Therapy consisted of 10 fractions of 4.2 Gy to the sinonasal cavity with or without an integrated boost of 0.8 Gy to the GTV. Patients had an additional FLT PET/CT scan after fraction 2, a Cu-ATSM PET/CT scan after fraction 3, and follow-up FDG PET/CT scans after radiotherapy. Following image registration, simple and multiple linear and logistic voxel regressions were performed to assess how well pre- and mid-treatment PET imaging predicted post-treatment FDG uptake. R2 and pseudo R2 were used to assess the goodness of fits. For simple linear regression models, regression coefficients for all pre- and mid-treatment PET images were significantly positive across the population (P < 0.05). However, there was large variability among patients in goodness of fits: R2 ranged from 0.00 to 0.85, with a median of 0.12. Results for logistic regression models were similar. Multiple linear regression models resulted in better fits (median R2 = 0.31), but there was still large variability between patients in R2. The R2 from regression models for different predictor variables were highly correlated across patients (R ≈ 0.8), indicating tumors that were poorly predicted with one tracer were also poorly predicted by other tracers. In conclusion, the high inter-patient variability in goodness of fits indicates that PET was able to predict locations of residual tumor in some patients, but not others. This suggests not all patients would be good candidates for dose painting based on a single biological target.

  10. Predicting location of recurrence using FDG, FLT, and Cu-ATSM PET in canine sinonasal tumors treated with radiotherapy.

    PubMed

    Bradshaw, Tyler; Fu, Rau; Bowen, Stephen; Zhu, Jun; Forrest, Lisa; Jeraj, Robert

    2015-07-01

    Dose painting relies on the ability of functional imaging to identify resistant tumor subvolumes to be targeted for additional boosting. This work assessed the ability of FDG, FLT, and Cu-ATSM PET imaging to predict the locations of residual FDG PET in canine tumors following radiotherapy. Nineteen canines with spontaneous sinonasal tumors underwent PET/CT imaging with radiotracers FDG, FLT, and Cu-ATSM prior to hypofractionated radiotherapy. Therapy consisted of 10 fractions of 4.2 Gy to the sinonasal cavity with or without an integrated boost of 0.8 Gy to the GTV. Patients had an additional FLT PET/CT scan after fraction 2, a Cu-ATSM PET/CT scan after fraction 3, and follow-up FDG PET/CT scans after radiotherapy. Following image registration, simple and multiple linear and logistic voxel regressions were performed to assess how well pre- and mid-treatment PET imaging predicted post-treatment FDG uptake. R(2) and pseudo R(2) were used to assess the goodness of fits. For simple linear regression models, regression coefficients for all pre- and mid-treatment PET images were significantly positive across the population (P < 0.05). However, there was large variability among patients in goodness of fits: R(2) ranged from 0.00 to 0.85, with a median of 0.12. Results for logistic regression models were similar. Multiple linear regression models resulted in better fits (median R(2) = 0.31), but there was still large variability between patients in R(2). The R(2) from regression models for different predictor variables were highly correlated across patients (R ≈ 0.8), indicating tumors that were poorly predicted with one tracer were also poorly predicted by other tracers. In conclusion, the high inter-patient variability in goodness of fits indicates that PET was able to predict locations of residual tumor in some patients, but not others. This suggests not all patients would be good candidates for dose painting based on a single biological target. PMID

  11. [Understanding positon emission tomography (PET) with [18F]-FDG in clinical oncology. Informations dedicated to patients and relatives].

    PubMed

    Bourguet, Patrick; Brusco, Sylvie; Corone, Corinne; Devillers, Anne; Foehrenbach, Hervé; Lumbroso, Jean-Daniel; Maszelin, Philippe; Montravers, Françoise; Moretti, Jean-Luc; Rain, Jean-Didier; Talbot, Jean-Noël; Carretier, Julien; Leichtnam-Dugarin, Line; Delavigne, Valérie; Philip, Thierry; Fervers, Béatrice

    2005-07-01

    In response to the evolution of the information-seeking behaviour of patients and concerns from health professionals regarding cancer patient information, the French National Federation of Comprehensive Cancer Centres (FNCLCC) introduced, in 1998, an information and education program dedicated to patients and relatives, the SOR SAVOIR PATIENT program (SSP). The methodology of this program adheres to established quality criteria regarding the elaboration of patient information. Cancer patient information, developed in this program, is based on clinical practice guidelines produced by the FNCLCC and the twenty French regional cancer centres, the National League against Cancer, the French Hospital Federation, the National Oncology Federation of Regional and University Hospitals, the French Oncology Federation of General Hospitals, many learned societies, as well as an active participation of patients, former patients and caregivers. The guidelines, "Standards, Options: Recommendations" (SOR) are used as primary information sources. The handbook SOR SAVOIR PATIENT Understanding positron emission tomography (PET) with [18F]-FDG in clinical oncology, integrally published in this issue of the Bulletin du Cancer, is an adapted version of the clinical practice guidelines (CPG) Standards, Options and Recommendations for positron emission tomography (PET) with [18F]-FDG in clinical oncology. The main objectives of this article are to allow persons affected by cancer and their close relatives to better understand this medical imaging technique and its implementation. This document also offers health professionals a synthetic evidence-based patient information source that should help them communicate that information during the physician-patient encounter. Positron emission tomography (PET) is a scintigraphy technique using a radiotracer, [18F]-fluorodeoxyglucose (abbreviated [18F]-FDG), administered intravenously into the patient's arm. This tracer, similar to glucose (sugar

  12. Inflammatory Pseudotumor in the Epidural Space of Lumbosacral Spine on 18F-FDG PET/CT

    PubMed Central

    Kim, Jin-Suk; Park, Shin Young

    2014-01-01

    An inflammatory pseudotumor (IPT) is a rare benign lesion, characterized by non-neoplastic proliferation of inflammatory cells and presence of intermingling collagen fibers. IPT commonly occurs in the lungs and orbita, while an intraspinal IPT is extremely rare. IPT can mimic both clinically and radiologically malignant processes, and making a definitive preoperative diagnosis is often difficult. Recently, 18-fluorine fluorodeoxyglucose (18F-FDG) has been reported to accumulate in IPT in the lung, spleen, liver, pancreas, colon, orbit, mediastinum, and mesentery. However, to the best of our knowledge, accumulation of 18F-FDG has not been reported in lumbosacral intraspinal IPT. Herein, we report a case of IPT in the epidural space of the lumbar spine, using the imaging findings of 18F-FDG positron emission tomography-computed tomography (PET/CT) and contrast-enhanced magnetic resonance imaging (MRI). This is the first case of IPT in the epidural space, depicted by 18F-FDG PET/CT, which revealed a homogeneous, intense 18F-FDG uptake.

  13. FDG-PET/CT Imaging Predicts Histopathologic Treatment Responses after Neoadjuvant Therapy in Adult Primary Bone Sarcomas

    DOE PAGESBeta

    Benz, Matthias R.; Czernin, Johannes; Tap, William D.; Eckardt, Jeffrey J.; Seeger, Leanne L.; Allen-Auerbach, Martin S.; Dry, Sarah M.; Phelps, Michael E.; Weber, Wolfgang A.; Eilber, Fritz C.

    2010-01-01

    Purpose . Tmore » he aim of this study was to prospectively evaluate whether FDG-PET allows an accurate assessment of histopathologic response to neoadjuvant treatment in adult patients with primary bone sarcomas. Methods . Twelve consecutive patients with resectable, primary high grade bone sarcomas were enrolled prospectively. FDG-PET/CT imaging was performed prior to the initiation and after completion of neoadjuvant treatment. Imaging findings were correlated with histopathologic response. Results . Histopathologic responders showed significantly more pronounced decreases in tumor FDG-SUVmax from baseline to late follow up than non-responders ( 64 ± 19 % versus 29 ± 30 %, resp.; P = .03 ). Using a 60% decrease in tumor FDG-uptake as a threshold for metabolic response correctly classified 3 of 4 histopathologic responders and 7 of 8 histopathologic non-responders as metabolic responders and non-responders, respectively (sensitivity, 75%; specificity, 88%). Conclusion . These results suggest that changes in FDG-SUVmax at the end of neoadjuvant treatment can identify histopathologic responders and non-responders in adult primary bone sarcoma patients.« less

  14. Performance evaluation of the Trans-PET® BioCaliburn® LH system: a large FOV small-animal PET system

    NASA Astrophysics Data System (ADS)

    Wang, Luyao; Zhu, Jun; Liang, Xiao; Niu, Ming; Wu, Xiaoke; Kao, Chien-Min; Kim, Heejong; Xie, Qingguo

    2015-01-01

    The Trans-PET® BioCaliburn® LH is a commercial positron emission tomography (PET) system for animal imaging. The system offers a large transaxial field-of-view (FOV) of 13.0 cm to allow imaging of multiple rodents or larger animals. This paper evaluates and reports the performance characteristics of this system. Methods: in this paper, the system was evaluated for its spatial resolutions, sensitivity, scatter fraction, count rate performance and image quality in accordance with the National Electrical Manufacturers Association (NEMA) NU-4 2008 specification with modifications. Phantoms and animals not specified in the NEMA specification were also scanned to provide further demonstration of its imaging capability. Results: the spatial resolution is 1.0 mm at the center. When using a 350-650 keV energy window and a 5 ns coincidence time window, the sensitivity at the center is 2.04%. The noise equivalent count-rate curve reaches a peak value of 62 kcps at 28 MBq for the mouse-sized phantom and a peak value of 25 kcps at 31 MBq for the rat-sized phantom. The scatter fractions are 8.4% and 17.7% for the mouse- and rat-sized phantoms, respectively. The uniformity and recovery coefficients measured by using the NEMA image-quality phantom both indicate good imaging performance, even though the reconstruction algorithm provided by the vendor does not implement all desired corrections. The Derenzo-phantom images show that the system can resolve 1.0 mm diameter rods. Animal studies demonstrate the capabilities of the system in dynamic imaging and to image multiple rodents. Conclusion: the Trans-PET® BioCaliburn® LH system offers high spatial resolution, a large transaixal FOV and adequate sensitivity. It produces animal images of good quality and supports dynamic imaging. The system is an attractive imaging technology for preclinical research.

  15. Correlation between direct microscopy and FDG-PET in the study of cerebral blood flow in rats

    NASA Astrophysics Data System (ADS)

    Blagosklonov, Oleg; Podoprigora, Guennady I.; Pushkin, Sergey V.; Nartsissov, Yaroslav R.; Comas, Laurent; Cardot, Jean-Claude; Boulahdour, Hatem

    2007-07-01

    Isotope studies provide valuable data about an organ's function in vivo. Thanks to positron emission tomography (PET) using the radiolabeled natural metabolites, such as [18F]-2-fluoro-deoxy-d-glucose (FDG), biological and physiological meaning of nuclear medicine scans has been considerably increased. Therefore it is of interest to elucidate the possibilities of the technique in a study of some natural metabolites like glycine influencing the blood microcirculation. Glycine, as a medicine, was recently shown to have a positive therapeutic effect in the treatment of patients with ischemic stroke and some other neurological disorders based on vascular disturbances. By previous direct biomicroscopic investigations of pial microvessels in laboratory rats an expressed vasodilatory effect of topically applied glycine was proved. The arterioles diameters depending on initial size have been increased by 200-250% for arterioles of 20-40 μm and by 150-200% for arterioles of 50-80 μm. The PET images were acquired before and after sublingual application of glycine (200 mg). The quantitative analysis of FDG volume concentration (Bq/ml) in the rat brain demonstrated that, in studies after glycine administration, maximal, minimal and mean FDG volume concentration in the brain increased by 200-250% in comparison with the baseline data. Thus, our results revealing evident correlation between FDG-PET images and direct biomicroscopic observations confirm the great potential of molecular imaging techniques to explore in vivo process in the brain.

  16. Diagnostic accuracy of 18F-FDG PET/CT for detecting synchronous advanced colorectal neoplasia in patients with gastric cancer.

    PubMed

    Choi, Byung Wook; Kim, Hae Won; Won, Kyoung Sook; Song, Bong-Il; Cho, Kwang Bum; Bae, Sung Uk

    2016-09-01

    Preoperative screening for synchronous colorectal neoplasia (CRN) has been recommended in patients with gastric cancer because patients with gastric cancer are at increased risk for synchronous CRN. The aim of this study was to investigate the diagnostic accuracy of F-fluorodeoxyglucose (F-FDG) positron emission tomography/computed tomography (PET/CT) for detecting synchronous advanced CRN in patients with gastric cancer.A total of 256 patients who underwent colonoscopy and F-FDG PET/CT for preoperative staging were enrolled in this study. The diagnosis of focal colonic F-FDG uptake on F-FDG PET/CT image was made based on histopathologic results from the colonoscopic biopsy. The F-FDG PET/CT result was considered as true positive for advanced CRN when focal F-FDG uptake matched colorectal carcinoma or adenoma with high-grade dysplasia in the same location on colonoscopy.Synchronous advanced CRN was detected in 21 of the 256 patients (4.7%). Sensitivity, specificity, and accuracy of F-FDG PET/CT were 76.2%, 96.2%, and 94.5%. The size of CRN with a true positive result was significantly larger than that with a false negative result.F-FDG PET/CT demonstrated high diagnostic accuracy for detecting synchronous advanced CRN in patients with gastric cancer. Colonoscopy is recommended as the next diagnostic step for further evaluation of a positive F-FDG PET/CT result in patients with gastric cancer. PMID:27603371

  17. Inter-modality variation in gross tumor volume delineation in 18FDG-PET guided IMRT treatment planning for lung cancer.

    PubMed

    Song, Yulin; Chan, Maria; Burman, Chandra; Cann, Donald

    2006-01-01

    Rapid advances in 18FDG-PET/CT technology and novel co-registration algorithms have created a strong interest in 18FDG-PET/CT's application in intensity modulated radiation therapy (IMRT) and image-guided radiation therapy (IGRT). Accurate target volume delineation, particularly identification of pathologically positive lymph nodes, could translate into favorable treatment outcome. However, gross tumor volume (GTV) delineation on both CT and 18FDG-PET is very sensitive to observer variation. The objectives of the study were to investigate the inter-modality variation in gross tumor volume delineation defined by two imaging modalities for lung cancer: CT and 18FDG-PET/CT and its dosimetric implications in intensity modulated radiation therapy (IMRT). PMID:17946204

  18. Localized Airspace Consolidation of Pulmonary Alveolar Proteinosis Mimicking Malignant Lesions in 18F-FDG PET/CT Imaging: One Case Report.

    PubMed

    Wang, Yan-Li; Fang, Na; Zeng, Lei; Wu, Zeng-jie; Cui, Xin-Jian

    2015-11-01

    Pulmonary alveolar proteinosis is a rare lung disease caused by diffuse, abnormal intra-alveolar surfactant accumulation. Here, we report a case of autoimmune pulmonary alveolar proteinosis with heterogeneous accumulation of F-FDG in both lungs shown on the combined F-FDG PET/CT. PMID:26252337

  19. Glucose metabolism in nine patients with probable sporadic Creutzfeldt-Jakob disease: FDG-PET study using SPM and individual patient analysis.

    PubMed

    Renard, Dimitri; Vandenberghe, Rik; Collombier, Laurent; Kotzki, Pierre-Olivier; Pouget, Jean-Pierre; Boudousq, Vincent

    2013-12-01

    Only one large series using statistical parametric mapping (SPM) reports on FDG-PET in sporadic (Heidenhain and non-Heidenhain variant) Creutzfeldt-Jakob disease (sCJD), describing hypometabolism in bilateral parietal, frontal, and occipital cortices. Our aim was to study FDG-PET in non-Heidenhain probable sCJD patients in order to assess the most pertinent FDG-PET pattern, and to compare FDG-PET and MRI data. We used both SPM and NeuroGam(®) software analysis, compared with healthy controls, to describe the FDG-PET abnormalities. Individual FDG-PET and MRI-DWI data were compared. SPM group analysis showed lateralized hypometabolism in the medial parietal cortex, the lateral and medial frontal (sparing Brodmann's area 4 and 6 and the anterior cingulate cortex), and lateral parietal cortex, in the absence of basal ganglia or cerebellar hypometabolism. The most severe hypometabolism was seen in Brodmann's area 31, and to a lesser degree area 23 (both areas correspond to the posterior cingulate cortex) and the precuneus. On individual analysis using NeuroGam(®) software, additional variable temporal cortex and frequent basal ganglia (with caudate nucleus as the most frequently involved structure) hypometabolism was seen, in the absence of cerebellar hypometabolism. The cerebral lobe cortex was more frequently and more severely hypometabolic than basal ganglia structures. Concordance between FDG-PET and MRI abnormalities was most often present for both the cerebral lobe cortex and the basal ganglia. In the case of discordance, FDG-PET was more sensitive than MRI for the cortex, whereas MRI was more sensitive than FDG-PET for the basal ganglia. When pathological, both cortical lobe cortex and basal ganglia involvement were slightly more often lateralized on FDG-PET than on MRI. Despite the presence of overlapping features with other diseases presenting with rapidly progressive dementia, the FDG-PET pattern we found in our non-Heidenhain sCJD patients may help in the

  20. The impact of high-dose vitamin C on blood glucose testing in ¹⁸F-FDG PET imaging.

    PubMed

    Bahr, Rebekah L; Wilson, Don C

    2015-03-01

    Complementary and alternative therapies in addition to standard oncology protocols are commonly sought by cancer patients; however, few patients disclose their complementary treatments to their cancer care team. A lack of communication may result in unforeseen side effects and the potential for some alternative therapies to interfere with or inhibit conventional treatment. High-dose vitamin C therapy, in particular, may lead to an inability to measure a patient's blood glucose level before (18)F-FDG injection for PET/CT scanning. We report a case of a 52-y-old woman referred for (18)F-FDG PET/CT to evaluate the extent of recurrent colorectal cancer. The PET/CT scan immediately followed a single intravenous dose of 25 g of ascorbic acid from her naturopath. A glucometer that applies the glucose oxidase method for measuring fasting blood glucose was used, for which high doses of vitamin C are listed as a contraindication. The high concentration of ascorbic acid in the patient's blood sample interfered with the chemical reaction on the glucose strip, and therefore no blood glucose measurement could be attained. With more patients receiving alternative and complementary cancer therapies, it is important to know what the implications of orthomolecular therapy might be on routine blood glucose testing for (18)F-FDG PET scans. (18)F-FDG is in direct competition with glucose; therefore, elevated blood glucose levels will cause a decrease in (18)F-FDG absorption and may lead to a false-negative scan. PMID:25104819

  1. FDG PET/CT Response Evaluation in Malignant Pleural Mesothelioma Patients Treated with Talc Pleurodesis and Chemotherapy

    PubMed Central

    Genestreti, Giovenzio; Moretti, Andrea; Piciucchi, Sara; Giovannini, Noemi; Galassi, Riccardo; Scarpi, Emanuela; Burgio, Marco Angelo; Amadori, Dino; Sanna, Stefano; Poletti, Venerino; Matteucci, Federica; Gavelli, Giampaolo

    2012-01-01

    Purpose: Talc pleurodesis (TP) is employed worldwide for the management of persistent pneumothorax or pleural effusion, particularly of malignant origin. However, there are very little available data on 18F-fluorodeoxyglucose positron-emission tomography/computed tomography (18F FDG PET/CT) response evaluation in malignant pleural mesothelioma (MPM) patients treated with TP and chemotherapy. Methods: Patients with histologically confirmed MPM underwent TP and FDG PET/CT staging and restaging after 3-4 courses of chemotherapy. All patients fasted and received a dose of 5.18 MBq 18F-FDG per kilogram of body weight. Whole-body emission scans were acquired with and without Ordered Subset Expectation Maximization (OSEM) iterative reconstruction algorithm. Results: From January 2004 to March 2010, 8 patients with biopsy confirmed MPM (7 epithelial, 1 biphasic), with a median age of 65 years (range: 54-77), were evaluated. Median follow-up was 31 months (range: 4-44). After TP treatment, there was a mean interval of 14 days (range: 9-22) and 125 days (range: 76-162) between FDG PET/CT staging and restaging. According to modified RECIST and EORTC criteria, there was a concordance between the radiologic and metabolic SUVmean and SUVmax responses in 6 (75%) and 3 (37.5%) patients, respectively. Conclusion: TP produces an increased FDG PET uptake which may interfere with the post-chemotherapy disease evaluation. In our case series, the metabolic response measured by SUVmean seems to be in better agreement with the radiologic response compared to the SUVmax. PMID:22670158

  2. Very low-dose adult whole-body tumor imaging with F-18 FDG PET/CT

    NASA Astrophysics Data System (ADS)

    Krol, Andrzej; Naveed, Muhammad; McGrath, Mary; Lisi, Michele; Lavalley, Cathy; Feiglin, David

    2015-03-01

    The aim of this study was to evaluate if effective radiation dose due to PET component in adult whole-body tumor imaging with time-of-flight F-18 FDG PET/CT could be significantly reduced. We retrospectively analyzed data for 10 patients with the body mass index ranging from 25 to 50. We simulated F-18 FDG dose reduction to 25% of the ACR recommended dose via reconstruction of simulated shorter acquisition time per bed position scans from the acquired list data. F-18 FDG whole-body scans were reconstructed using time-of-flight OSEM algorithm and advanced system modeling. Two groups of images were obtained: group A with a standard dose of F-18 FDG and standard reconstruction parameters and group B with simulated 25% dose and modified reconstruction parameters, respectively. Three nuclear medicine physicians blinded to the simulated activity independently reviewed the images and compared diagnostic quality of images. Based on the input from the physicians, we selected optimal modified reconstruction parameters for group B. In so obtained images, all the lesions observed in the group A were visible in the group B. The tumor SUV values were different in the group A, as compared to group B, respectively. However, no significant differences were reported in the final interpretation of the images from A and B groups. In conclusion, for a small number of patients, we have demonstrated that F-18 FDG dose reduction to 25% of the ACR recommended dose, accompanied by appropriate modification of the reconstruction parameters provided adequate diagnostic quality of PET images acquired on time-of-flight PET/CT.

  3. MicroPET/CT assessment of FDG uptake in brain after long-term methylphenidate treatment in nonhuman primates.

    PubMed

    Zhang, X; Newport, G D; Callicott, R; Liu, S; Thompson, J; Berridge, M S; Apana, S M; Slikker, W; Wang, C; Paule, M G

    2016-01-01

    Methylphenidate (MPH) is a psychostimulant commonly used for the treatment of Attention-Deficit Hyperactivity Disorder (ADHD). Since the long-term effects of this drug on the central nervous system (CNS) are not well understood, we conducted microPET/CT scans on young adult male rhesus monkeys (n=4/group) to gather information on brain metabolism using the uptake of [(18)F]Fluoro-2-deoxy-2-d-glucose (FDG) as a marker. Approximately two-year old, male rhesus monkeys were treated orally with MPH twice per day, five days per week (M-F) over a 6-year period. Subjects received MPH at either 2.5 or 12.5mg/kg/dose or vehicle (Prang). To minimize the acute effects of MPH on FDG uptake, microPET/CT scans were scheduled on Mondays before their first daily dosing of the week (approximately 68h since their last treatment). FDG (370±8.88MBq) was injected intravenously and 30min later microPET/CT images were obtained over 60min. Radiolabeled tracer accumulation in regions of interest (ROIs) in the prefrontal cortex, temporal cortex, striatum and cerebellum were converted into Standard Uptake Values (SUVs). Compared to the control group, the uptake of FDG in the cerebellum was significantly decreased in both the low and high dose groups. These preliminary data demonstrate that microPET imaging is capable of distinguishing differences in retention of FDG in the brains of NHPs treated chronically with MPH and suggests that this approach may provide a minimally invasive biomarker for exploring the effects of chronic MPH treatment on aspects of brain function. PMID:27307090

  4. Lung Metastasis From Prostate Cancer Revealed by 18F-FDG PET/CT Without Osseous Metastasis on Bone Scan.

    PubMed

    Su, Hung-Yi; Chen, Meng-Lin; Hsieh, Ping-Ju; Hsieh, Teh-Sheng; Chao, Ing-Ming

    2016-05-01

    A 54-year-old man, a case of prostate cancer, underwent radical prostatectomy and hormone therapy. Elevated prostate-specific antigen level developed 7 years later, but pelvic MRI and bone scan revealed negative results. Radiotherapy was performed under the suspicion of local recurrence but in vain. F-FDG PET/CT performed 1 more year later showed 3 FDG-avid lesions in the right lung and mediastinum. Lung and lymph node metastases were proved with video-assisted thoracoscopic surgery. Bone scan remained negative at that time. PMID:26859201

  5. 18F-FDG PET/CT Metabolic Activity in a Patient With Solitary Extramedullary Plasmacytoma of the Lung.

    PubMed

    Zhang, Linqi; Zhang, Xu; Zhang, Rusen; Fan, Wei

    2016-03-01

    Extramedullary plasmacytoma is a rare variant of plasmacytoma that is frequently observed in the head and neck. Primary plasmacytoma of the lung is quite rare. A 92-year-old woman presented with chest distress for 6 months with a mass detected in the right posterior thoracic cavity. Enhanced T1-weighted image showed marked enhancement of the mass. F-FDG PET/CT showed strong FDG uptake of the lesion with SUVmax of 21.9. Thoracentesis of the tumor was subsequently performed, and pathologic analysis confirmed the diagnosis of primary pulmonary plasmacytoma. PMID:26462042

  6. Novel synthesis and initial preclinical evaluation of (18)F-[FDG] labeled rhodamine: a potential PET myocardial perfusion imaging agent.

    PubMed

    AlJammaz, Ibrahim; Al-Otaibi, Basim; AlHindas, Hussein; Okarvi, Subhani M

    2015-10-01

    Myocardial perfusion imaging is one of the most commonly performed investigations in nuclear medicine studies. Due to the clinical importance of [(18)F]-fluoro-2-deoxy-D-glucose ([(18)F]-FDG) and its availability in almost every PET center, a new radiofluorinated [(18)F]-FDG-rhodamine conjugate was synthesized using [(18)F]-FDG as a prosthetic group. In a convenient and simple one-step radiosynthesis, [(18)F]-FDG-rhodamine conjugate was prepared in quantitative radiochemical yields, with total synthesis time of nearly 20 min and radiochemical purity of greater than 98%, without the need for HPLC purification, which make these approaches amenable for automation. Biodistribution studies in normal rats at 60 min post-injection demonstrated a high uptake in the heart (>11% ID/g) and favorable pharmacokinetics. Additionally, [(18)F]-FDG-rhodamine showed an extraction value of 27.63%±5.12% in rat hearts. These results demonstrate that [(18)F]-FDG-rhodamine conjugate may be useful as an imaging agent for the positron emission tomography evaluation of myocardial perfusion. PMID:26160144

  7. Management of Mucoepidermoid Carcinoma of the Palate Utilizing 18F-FDG PET/CT

    PubMed Central

    Sudhakar, Sankaran; Velugubantla, Raga Geethika; Erva, Swathi; Chennoju, Sai kiran

    2014-01-01

    Salivary gland carcinomas are a clinically diverse group of neoplasms with histological patterns overlapping other tumors, thus complicating their diagnosis. Mucoepidermoid carcinoma (MEC), first described by Masson and Berger in 1924, is a well-recognized salivary gland neoplasm, accounting for 5–10% of all salivary gland tumors. MEC frequently involves the major salivary glands and is rarely seen involving the jaws. The biological behavior of MEC is usually more aggressive with higher nodal and metastatic status at the time of presentation, which notably reduces the survival rate. Hence, early and accurate diagnosis utilizing advanced imaging modalities can reduce its morbidity. The present case is a rare presentation of MEC involving the palate, where (18) F-fluorodeoxyglucose-positron emission tomography/computed tomography (FDG-PET/CT) was utilized for diagnosis and treatment. PMID:25558436

  8. Cerebellar glucose consumption in normal and pathologic states using fluorine-FDG and PET

    SciTech Connect

    Kushner, M.; Tobin, M.; Alavi, A.; Chawluk, J.; Rosen, M.; Fazekas, F.; Alavi, J.; Reivich, M.

    1987-11-01

    We studied cerebellar metabolism in 118 subjects including young and elderly controls and patients suffering from stroke, supratentorial brain tumor and Alzheimer's disease using fluorine-18 fluorodeoxyglucose ((/sup 18/F)FDG) and position emission tomography (PET). Alzheimer's disease and normal aging did not alter mean cerebellar metabolism. In stroke and tumor mean cerebellar metabolism was lower in the hemisphere contralateral to the supratentorial lesion. In tumor bilaterally significant reductions in absolute cerebellar metabolism also were noted, unlike stroke. Primary sensory stimulation did not alter absolute or relative cerebellar metabolism. These results show that absolute and relative values for cerebellar metabolism vary depending on the process under study. Thus, analysis schemes employing normalization of regional metabolic data to cerebellar values may be subject to error.

  9. Pitfalls and Pearls of Wisdom in 18F-FDG PET Imaging of Tumors.

    PubMed

    Britton, Tracey; Robinson, Nicholas

    2016-06-01

    (18)F-FDG PET imaging of tumors has pitfalls and pearls of wisdom that begin at the point of scheduling and continue through the patient interview, the resting phase, the scan itself, and the image review. Interviewing the patient at the time of scheduling, followed by placing a reminder phone call shortly before the appointment, can save a nuclear medicine department the financial loss of wasted doses and missed appointment slots in the schedule. The pitfalls and pearls of wisdom in tumor imaging are ever changing, and the technologist is in a constant state of inquiry about the patient's disease process and ability to comply. Consideration of each item on the worksheets in this article affects every scan. On completing this article, the reader will be able to identify questions that should be asked in the scheduling and preinjection patient interviews, interpret the answers to those questions, determine how the images may be affected, and adapt the scan. PMID:27102663

  10. Measurements of occupational exposure for a technologist performing 18F FDG PET scans.

    PubMed

    Biran, Talma; Weininger, Jolie; Malchi, Shalom; Marciano, Rami; Chisin, Roland

    2004-11-01

    Radiation doses to one PET technologist performing 100 18F FDG (18F fluorodeoxyglucose) imaging procedures were measured in a clinical setting using two types of thermoluminescent dosimeter (TLD) badges, one finger-ring TLD and one electronic pocket dosimeter (EPD). 18F FDG was handled either with unshielded or with viewing window tungsten shielded syringes. The resulting doses using unshielded syringes were 13.8 +/- 0.8 microSv/370 MBq and 14.3 +/- 0.4 microSv/370 MBq, measured with TLD 100 and with TLD 700H/600H, respectively. For the same series of measurements, the doses obtained using shielded syringes were 10.7 +/- 0.4 microSv/370 MBq and 7.2 +/- 2.1 microSv/370 MBq with TLD700H/600H and with EPD, respectively. The dose to the right hand from shielded syringes was 69.3 +/- 5.5 microSv/370 MBq. All these values are within the ICRP recommended dose limits. Extrapolated to 725 examinations per year, the resulting effective dose measured with TLD would be 10 mSv with unshielded and 7.5 mSv with shielded syringes, respectively (25% dose reduction). The doses measured by TLD were consistently higher than those measured by EPD, suggesting that EPD measurements might underestimate occupational doses. PMID:15551792

  11. Non-Hodgkin's Lymphoma of Multiple Skeletal Muscles Involvement Seen on FDG PET/CT Scans

    PubMed Central

    Dai, Yue; Sowjanya, Medapati; You, Jia; Xu, Kai

    2015-01-01

    Abstract As normal healthy skeletal muscle does not contain lymphoid tissue, extra nodal lymphoma involving multiple muscles is rare, as well. This study reports a case of non-Hodgkin's lymphoma (NHL) of multiple skeletal muscles involvement and a review of differential diagnosis of it. A 37-year-old female presented to our hospital after being diagnosed with NHL for 7 months. She had received six courses of cyclophosphamide hydroxydaunorubicin oncovin prednisolone etoposide (CHOPE) chemotherapy. Then she felt pain and noticed swelling on her left calf. The fluorodeoxyglucose (18FDG) positron emission tomography (PET)/computed tomography (CT) image showed abnormal focal FDG uptake in hypo-pharynx, which was the primary NHL and also in multiple groups of muscles in whole body. As the patient has history NHL, lymphoma of multiple muscle involvement was suspected. Finally, an ultrasound-guided tissue biopsy was performed on the left calf and histological examination yielded lymphomatous cells infiltration in the left gastrocnemius. Through this report, we emphasize that a multidisciplinary team approach with clinician, radiologist, and pathologist is essential for proper diagnosis, staging, and management of such rare lesions. PMID:25950693

  12. Statistical analysis of maximum likelihood estimator images of human brain FDG PET studies

    SciTech Connect

    Llacer, J.; Veklerov, E. ); Hoffman, E.J. . Dept. of Radiological Sciences); Nunez, J. , Facultat de Fisica); Coakley, K.J.

    1993-06-01

    The work presented in this paper evaluates the statistical characteristics of regional bias and expected error in reconstructions of real PET data of human brain fluorodeoxiglucose (FDG) studies carried out by the maximum likelihood estimator (MLE) method with a robust stopping rule, and compares them with the results of filtered backprojection (FBP) reconstructions and with the method of sieves. The task that the authors have investigated is that of quantifying radioisotope uptake in regions-of-interest (ROI's). They first describe a robust methodology for the use of the MLE method with clinical data which contains only one adjustable parameter: the kernel size for a Gaussian filtering operation that determines final resolution and expected regional error. Simulation results are used to establish the fundamental characteristics of the reconstructions obtained by out methodology, corresponding to the case in which the transition matrix is perfectly known. Then, data from 72 independent human brain FDG scans from four patients are used to show that the results obtained from real data are consistent with the simulation, although the quality of the data and of the transition matrix have an effect on the final outcome.

  13. Automated scoring system of standard uptake value for torso FDG-PET images

    NASA Astrophysics Data System (ADS)

    Hara, Takeshi; Kobayashi, Tatsunori; Kawai, Kazunao; Zhou, Xiangrong; Itoh, Satoshi; Katafuchi, Tetsuro; Fujita, Hiroshi

    2008-03-01

    The purpose of this work was to develop an automated method to calculate the score of SUV for torso region on FDG-PET scans. The three dimensional distributions for the mean and the standard deviation values of SUV were stored in each volume to score the SUV in corresponding pixel position within unknown scans. The modeling methods is based on SPM approach using correction technique of Euler characteristic and Resel (Resolution element). We employed 197 nor-mal cases (male: 143, female: 54) to assemble the normal metabolism distribution of FDG. The physique were registered each other in a rectangular parallelepiped shape using affine transformation and Thin-Plate-Spline technique. The regions of the three organs were determined based on semi-automated procedure. Seventy-three abnormal spots were used to estimate the effectiveness of the scoring methods. As a result, the score images correctly represented that the scores for normal cases were between zeros to plus/minus 2 SD. Most of the scores of abnormal spots associated with cancer were lager than the upper of the SUV interval of normal organs.

  14. 18F-FDG PET/CT as a central tool in the shift from chronic Q fever to Coxiella burnetii persistent focalized infection: A consecutive case series.

    PubMed

    Eldin, Carole; Melenotte, Cléa; Million, Matthieu; Cammilleri, Serge; Sotto, Albert; Elsendoorn, Antoine; Thuny, Franck; Lepidi, Hubert; Roblot, France; Weitten, Thierry; Assaad, Souad; Bouaziz, Anissa; Chapuzet, Claire; Gras, Guillaume; Labussiere, Anne-Sophie; Landais, Cécile; Longuet, Pascale; Masseau, Agathe; Mundler, Olivier; Raoult, Didier

    2016-08-01

    Because Q fever is mostly diagnosed serologically, localizing a persistent focus of Coxiella burnetii infection can be challenging. F-fluorodeoxyglucose positron emission tomography/computed tomography (F-FDG PET/CT) could be an interesting tool in this context.We performed a retrospective study on patients diagnosed with C burnetii infection, who had undergone F-FDG PET/CT between 2009 and 2015. When positive F-FDG PET/CT results were obtained, we tried to determine if it changed the previous diagnosis by discovering or confirming a suspected focus of C burnetii infection.One hundred sixty-seven patients benefited from F-FDG PET/CT. The most frequent clinical subgroup before F-FDG PET/CT was patients with no identified focus of infection, despite high IgG1 serological titers (34%). For 59% (n = 99) of patients, a hypermetabolic focus was identified. For 62 patients (62.6%), the positive F-FDG PET/CT allowed the diagnosis to be changed. For 24 of them, (38.7%), a previously unsuspected focus of infection was discovered. Forty-two (42%) positive patients had more than 1 hypermetabolic focus. We observed 21 valvular foci, 34 vascular foci, and a high proportion of osteoarticular localizations (n = 21). We also observed lymphadenitis (n = 27), bone marrow hypermetabolism (n = 11), and 9 pulmonary localizations.We confirmed thatF-FDG PET/CT is a central tool in the diagnosis of C burnetii focalized persistent infection. We proposed new diagnostic scores for 2 main clinical entities identified using F-FDG PET/CT: osteoarticular persistent infections and lymphadenitis. PMID:27559944

  15. Incidental finding of silent appendicitis on (18)F-FDG PET/CT in a patient with small cell lung adenocarcinoma.

    PubMed

    Bourgeois, Sophie; Van Den Berghe, Ivo; De Geeter, Frank

    2016-01-01

    We report the incidental diagnosis of acute asymptomatic appendicitis on a fluorine-18-fluorodeoxyglucose positron emission tomography with computed tomography ((18)F-FDG PET/CT) performed for staging of a non small cell lung carcinoma. The patient was asymptomatic and laboratory tests were normal. The case illustrates: a) the possibility to diagnose appendicitis on (18)F-FDG PET/CT and b) the possibility of silent acute appendicitis, although this is a rare occurrence. PMID:27331212

  16. Comparative study of 18F-DOPA, 13N-Ammonia and F18-FDG PET/CT in primary brain tumors

    PubMed Central

    Jacob, Mattakarottu J; Pandit, Aniruddha G; Jora, Charu; Mudalsha, Ravina; Sharma, Amit; Pathak, Harish C

    2011-01-01

    Aim: To determine the diagnostic reliability of 18F-FDOPA, 13N-Ammonia and F18-FDG PET/CT in primary brain tumors. We evaluated the amino acid and glucose metabolism of brain tumors by using PET with 18F-FDOPA, 13N-Ammonia and F18-FDG PET/CT. Materials and Methods: Nine patients undergoing evaluation for brain tumors were studied. Tracer uptake was quantified by the use of standardized uptake values and the ratio of tumor uptake to normal identical area of contra lateral hemisphere (T/N). In addition, PET uptake with 18F-FDOPA was quantified by use of ratio of tumor uptake to striatum uptake (T/S). The results were correlated with the patient's clinical profile. Results: Both high-grade and low-grade tumors were well visualized with 18F-FDOPA. The sensitivity for identifying tumors was substantially higher with 18F-FDOPA PET than with F18-FDG and 13N-Ammonia PET as determined by simple visual inspection. The sensitivity for identifying recurrence in low grade gliomas is higher with 13N-Ammonia than with F18-FDG. Conclusion: 18F-FDOPA PET is more reliable than F18-FDG and 13N-Ammonia PET for evaluating brain tumors. PMID:23326065

  17. Diffuse Large B-Cell Lymphoma: Prospective Multicenter Comparison of Early Interim FLT PET/CT versus FDG PET/CT with IHP, EORTC, Deauville, and PERCIST Criteria for Early Therapeutic Monitoring.

    PubMed

    Minamimoto, Ryogo; Fayad, Luis; Advani, Ranjana; Vose, Julie; Macapinlac, Homer; Meza, Jane; Hankins, Jordan; Mottaghy, Felix; Juweid, Malik; Quon, Andrew

    2016-07-01

    Purpose To compare the performance characteristics of interim fluorine 18 ((18)F) fluorodeoxyglucose (FDG) positron emission tomography (PET)/computed tomography (CT) (after two cycles of chemotherapy) by using the most prominent standardized interpretive criteria (including International Harmonization Project [IHP] criteria, European Organization for Research and Treatment of Cancer [EORTC] criteria, and PET Response Criteria in Solid Tumors (PERCIST) versus those of interim (18)F fluorothymidine (FLT) PET/CT and simple visual interpretation. Materials and Methods This HIPAA-compliant prospective study was approved by the institutional review boards, and written informed consent was obtained. Patients with newly diagnosed diffuse large B-cell lymphoma (DLBCL) underwent both FLT and FDG PET/CT 18-24 days after two cycles of rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone or rituximab, etoposide, prednisone, vincristine, cyclophosphamide, and doxorubicin. For FDG PET/CT interpretation, IHP criteria, EORTC criteria, PERCIST, Deauville criteria, standardized uptake value, total lesion glycolysis, and metabolic tumor volume were used. FLT PET/CT images were interpreted with visual assessment by two reviewers in consensus. The interim (after cycle 2) FDG and FLT PET/CT studies were then compared with the end-of-treatment FDG PET/CT studies to determine which interim examination and/or criteria best predicted the result after six cycles of chemotherapy. Results From November 2011 to May 2014, there were 60 potential patients for inclusion, of whom 46 patients (24 men [mean age, 60.9 years ± 13.7; range, 28-78 years] and 22 women [mean age, 57.2 years ± 13.4; range, 25-76 years]) fulfilled the criteria. Thirty-four patients had complete response, and 12 had residual disease at the end of treatment. FLT PET/CT had a significantly higher positive predictive value (PPV) (91%) in predicting residual disease than did any FDG PET/CT interpretation method

  18. Combined {sup 18}F-FDG-PET/CT Imaging in Radiotherapy Target Delineation for Head-and-Neck Cancer

    SciTech Connect

    Guido, Alessandra; Fuccio, Lorenzo; Rombi, Barbara; Castellucci, Paolo; Cecconi, Agnese; Bunkheila, Feisal; Fuccio, Chiara; Spezi, Emiliano; Angelini, Anna Lisa; Barbieri, Enza

    2009-03-01

    Purpose: To evaluate the effect of the use of {sup 18}F-fluorodeoxyglucose (FDG)-positron emission tomography (PET)/computed tomography (CT) in radiotherapy target delineation for head-and-neck cancer compared with CT alone. Methods and Materials: A total of 38 consecutive patients with head-and-neck cancer were included in this study. The primary tumor sites were as follow: 20 oropharyngeal tumors, 4 laryngeal tumors, 2 hypopharyngeal tumors, 2 paranasal sinuses tumors, 9 nasopharyngeal tumors, and 1 parotid gland tumor. The FDG-PET and CT scans were performed with a dedicated PET/CT scanner in one session and then fused. Subsequently, patients underwent treatment planning CT with intravenous contrast enhancement. The radiation oncologist defined all gross tumor volumes (GTVs) using both the PET/CT and CT scans. Results: In 35 (92%) of 38 cases, the CT-based GTVs were larger than the PET/CT-based GTVs. The average total GTV from the CT and PET/CT scans was 34.54 cm{sup 3} (range, 3.56-109) and 29.38 cm{sup 3} (range, 2.87-95.02), respectively (p < 0.05). Separate analyses of the difference between the CT- and PET/CT-based GTVs of the primary tumor compared with the GTVs of nodal disease were not statistically significant. The comparison between the PET/CT-based and CT-based boost planning target volumes did not show a statistically significant difference. All patients were alive at the end of the follow-up period (range, 3-38 months). Conclusion: GTVs, but not planning target volumes, were significantly changed by the implementation of combined PET/CT. Large multicenter studies are needed to ascertain whether combined PET/CT in target delineation can influence the main clinical outcomes.

  19. Multiple myeloma: 18F-FDG-PET/CT and diagnostic imaging.

    PubMed

    Mihailovic, Jasna; Goldsmith, Stanley J

    2015-01-01

    Multiple myeloma (MM) is a relatively rare hematologic disorder characterized by proliferation of plasma cells, primarily involving the bone marrow. Extramedullary involvement also occurs with poor prognosis. Asymptomatic plasma cell disorders, monoclonal gammopathy of uncertain significance, and smoldering MM, which do not require therapy, should be distinguished from symptomatic MM, which requires treatment. MM may present with CRAB, elevated Calcium levels, Renal insufficiency, Anemia, and Bone lesions (including lytic lesions and osteopenia), as well as elevated levels of serum M protein or urine M protein or both. Nonsecretory myeloma in which serum and urine M proteins are absent occurs rarely, accounting for 1%-5% of patients with myeloma, but low levels of abnormal immunoglobulins are often present. Staging of patients with MM is done according to the Durie and Salmon criteria based on laboratory testing (determination of hemoglobin, serum calcium, and serum and urine M proteins) and conventional radiography. A variety of diagnostic imaging procedures have been employed to assess the extent of disease in MM and to evaluate the response to treatment as well as provide surveillance for the detection of recurrent disease. These include whole-body x-ray, which despite its limitations is regularly used to detect lytic bone lesions; CT radiography; MRI; and a variety of radionuclide imaging procedures, with (18)F-FDG-PET/CT emerging as the radionuclide procedure of choice. Recently, the Durie-Salmon criteria have been upgrade to the Durie-Salmon PLUS system, which includes (18)F-FDG-PET/CT and MRI of the spine and pelvis. PMID:25475376

  20. Temporal subtraction system on torso FDG-PET scans based on statistical image analysis

    NASA Astrophysics Data System (ADS)

    Shimizu, Yusuke; Hara, Takeshi; Fukuoka, Daisuke; Zhou, Xiangrong; Muramatsu, Chisako; Ito, Satoshi; Hakozaki, Kenta; Kumita, Shin-ichiro; Ishihara, Kei-ichi; Katafuchi, Tetsuro; Fujita, Hiroshi

    2013-02-01

    Diagnostic imaging on FDG-PET scans was often used to evaluate chemotherapy results of cancer patients. Radiologists compare the changes of lesions' activities between previous and current examinations for the evaluation. The purpose of this study was to develop a new computer-aided detection (CAD) system with temporal subtraction technique for FDGPET scans and to show the fundamental usefulness based on an observer performance study. Z-score mapping based on statistical image analysis was newly applied to the temporal subtraction technique. The subtraction images can be obtained based on the anatomical standardization results because all of the patients' scans were deformed into standard body shape. An observer study was performed without and with computer outputs to evaluate the usefulness of the scheme by ROC (receiver operating characteristics) analysis. Readers responded as confidence levels on a continuous scale from absolutely no change to definitely change between two examinations. The recognition performance of the computer outputs for the 43 pairs was 96% sensitivity with 31.1 false-positive marks per scan. The average of area-under-the-ROC-curve (AUC) from 4 readers in the observer performance study was increased from 0.85 without computer outputs to 0.90 with computer outputs (p=0.0389, DBM-MRMC). The average of interpretation time was slightly decreased from 42.11 to 40.04 seconds per case (p=0.625, Wilcoxon test). We concluded that the CAD system for torso FDG-PET scans with temporal subtraction technique might improve the diagnostic accuracy of radiologist in cancer therapy evaluation.

  1. The Role of 18F-FDG-PET and PET/CT in Patients with Colorectal Liver Metastases Undergoing Selective Internal Radiation Therapy with Yttrium-90: A First Evidence-Based Review

    PubMed Central

    Annunziata, Salvatore; Treglia, Giorgio; Galiandro, Federica

    2014-01-01

    Purpose. To provide a first evidence-based review of the literature on the role of fluorine-18-fluorodeoxyglucose positron emission tomography and positron emission tomography/computed tomography (FDG-PET and PET/CT) in patients with colorectal liver metastases (CRLM) undergoing selective internal radiation therapy (SIRT) with yttrium-90 (90Y) microspheres. Methods. A comprehensive computer literature search was conducted to find relevant published articles on whole-body FDG-PET or PET/CT in patients with CRLM undergoing SIRT. Results. We identified 19 studies including 833 patients with CRLM undergoing SIRT. The role of FDG-PET or PET/CT was analysed in treatment planning, treatment response evaluation, and as prognostic tool. Conclusion. FDG-PET and PET/CT provide additional information in treatment evaluation of CRLM patients treated with SIRT and may have a role in treatment planning and patient selection. FDG-PET/CT is emerging as good prognostic tool in these patients. PMID:24672385

  2. Nonparametric Residue Analysis of Dynamic PET Data With Application to Cerebral FDG Studies in Normals.

    PubMed

    O'Sullivan, Finbarr; Muzi, Mark; Spence, Alexander M; Mankoff, David M; O'Sullivan, Janet N; Fitzgerald, Niall; Newman, George C; Krohn, Kenneth A

    2009-06-01

    Kinetic analysis is used to extract metabolic information from dynamic positron emission tomography (PET) uptake data. The theory of indicator dilutions, developed in the seminal work of Meier and Zierler (1954), provides a probabilistic framework for representation of PET tracer uptake data in terms of a convolution between an arterial input function and a tissue residue. The residue is a scaled survival function associated with tracer residence in the tissue. Nonparametric inference for the residue, a deconvolution problem, provides a novel approach to kinetic analysis-critically one that is not reliant on specific compartmental modeling assumptions. A practical computational technique based on regularized cubic B-spline approximation of the residence time distribution is proposed. Nonparametric residue analysis allows formal statistical evaluation of specific parametric models to be considered. This analysis needs to properly account for the increased flexibility of the nonparametric estimator. The methodology is illustrated using data from a series of cerebral studies with PET and fluorodeoxyglucose (FDG) in normal subjects. Comparisons are made between key functionals of the residue, tracer flux, flow, etc., resulting from a parametric (the standard two-compartment of Phelps et al. 1979) and a nonparametric analysis. Strong statistical evidence against the compartment model is found. Primarily these differences relate to the representation of the early temporal structure of the tracer residence-largely a function of the vascular supply network. There are convincing physiological arguments against the representations implied by the compartmental approach but this is the first time that a rigorous statistical confirmation using PET data has been reported. The compartmental analysis produces suspect values for flow but, notably, the impact on the metabolic flux, though statistically significant, is limited to deviations on the order of 3%-4%. The general

  3. Use of an in-field-of-view shield to improve count rate performance of the single crystal layer high-resolution research tomograph PET scanner for small animal brain scans.

    PubMed

    Boellaard, R; de Jong, H W A M; Molthoff, C F M; Buijs, F; Lenox, M; Nutt, R; Lammertsma, A A

    2003-12-01

    The count rate performance of the single LSO crystal layer high-resolution research tomograph (HRRT-S) PET scanner is limited by the processing speed of its electronics. Therefore, the feasibility of using an in-field-of-view (in-FOV) shield to improve the noise equivalent count rates (NECR) for small animal brain studies was investigated. The in-FOV shield consists of a lead tube of 12 cm length, 6 cm inner diameter and 9 mm wall thickness. It is large enough to shield the activity in the body of a rat or mouse. First, the effect of this shield on NECR was studied. Secondly, a number of experiments were performed to assess the effects of the shield on the accuracy of transmission scan data and, next, on reconstructed activity distribution in the brain. For activities below 150 MBq NECR improved only by 5-10%. For higher activities NECR maxima of 1.2E4 cps at 200 MBq and 2.2E4 cps at 370 MBq were found without and with shield, respectively. Listmode data taken without shield, however, were corrupted for activities above 75 MBq due to data overrun problems (time tag losses) of the electronics. When the shield was used data overrun was avoided up to activities of 150 MBq. For the unshielded part of the phantom, transmission scan data were the same with and without shield. The estimated scatter contribution was approximately 8.5% without and 5.5% with shield. Reconstructed emission data showed a difference up to 5% in the unshielded part of the phantom at 5 mm or more from the edge of the shielding. Of this 5% about 3% results from the difference in the uncorrected scatter contribution. In conclusion, an in-FOV shield can be used successfully in an HRRT PET scanner to improve NECR and accuracy of small animal brain studies. The latter is especially important when high activities are required for tracers with low brain uptake or when multiple animals are scanned simultaneously. PMID:14703172

  4. A Dual Tracer 18F-FCH/18F-FDG PET Imaging of an Orthotopic Brain Tumor Xenograft Model.

    PubMed

    Fu, Yilong; Ong, Lai-Chun; Ranganath, Sudhir H; Zheng, Lin; Kee, Irene; Zhan, Wenbo; Yu, Sidney; Chow, Pierce K H; Wang, Chi-Hwa

    2016-01-01

    Early diagnosis of low grade glioma has been a challenge to clinicians. Positron Emission Tomography (PET) using 18F-FDG as a radio-tracer has limited utility in this area because of the high background in normal brain tissue. Other radiotracers such as 18F-Fluorocholine (18F-FCH) could provide better contrast between tumor and normal brain tissue but with high incidence of false positives. In this study, the potential application of a dual tracer 18F-FCH/18F-FDG-PET is investigated in order to improve the sensitivity of PET imaging for low grade glioma diagnosis based on a mouse orthotopic xenograft model. BALB/c nude mice with and without orthotopic glioma xenografts from U87 MG-luc2 glioma cell line are used for the study. The animals are subjected to 18F-FCH and 18F-FDG PET imaging, and images acquired from two separate scans are superimposed for analysis. The 18F-FCH counts are subtracted from the merged images to identify the tumor. Micro-CT, bioluminescence imaging (BLI), histology and measurement of the tumor diameter are also conducted for comparison. Results show that there is a significant contrast in 18F-FCH uptake between tumor and normal brain tissue (2.65 ± 0.98), but with a high false positive rate of 28.6%. The difficulty of identifying the tumor by 18F-FDG only is also proved in this study. All the tumors can be detected based on the dual tracer technique of 18F-FCH/18F-FDG-PET imaging in this study, while the false-positive caused by 18F-FCH can be eliminated. Dual tracer 18F-FCH/18F-FDG PET imaging has the potential to improve the visualization of low grade glioma. 18F-FCH delineates tumor areas and the tumor can be identified by subtracting the 18F-FCH counts. The sensitivity was over 95%. Further studies are required to evaluate the possibility of applying this technique in clinical trials. PMID:26844770

  5. A Dual Tracer 18F-FCH/18F-FDG PET Imaging of an Orthotopic Brain Tumor Xenograft Model

    PubMed Central

    Ranganath, Sudhir H.; Zheng, Lin; Kee, Irene; Zhan, Wenbo; Yu, Sidney; Chow, Pierce K. H.; Wang, Chi-Hwa

    2016-01-01

    Early diagnosis of low grade glioma has been a challenge to clinicians. Positron Emission Tomography (PET) using 18F-FDG as a radio-tracer has limited utility in this area because of the high background in normal brain tissue. Other radiotracers such as 18F-Fluorocholine (18F-FCH) could provide better contrast between tumor and normal brain tissue but with high incidence of false positives. In this study, the potential application of a dual tracer 18F-FCH/18F-FDG-PET is investigated in order to improve the sensitivity of PET imaging for low grade glioma diagnosis based on a mouse orthotopic xenograft model. BALB/c nude mice with and without orthotopic glioma xenografts from U87 MG-luc2 glioma cell line are used for the study. The animals are subjected to 18F-FCH and 18F-FDG PET imaging, and images acquired from two separate scans are superimposed for analysis. The 18F-FCH counts are subtracted from the merged images to identify the tumor. Micro-CT, bioluminescence imaging (BLI), histology and measurement of the tumor diameter are also conducted for comparison. Results show that there is a significant contrast in 18F-FCH uptake between tumor and normal brain tissue (2.65 ± 0.98), but with a high false positive rate of 28.6%. The difficulty of identifying the tumor by 18F-FDG only is also proved in this study. All the tumors can be detected based on the dual tracer technique of 18F-FCH/ 18F-FDG-PET imaging in this study, while the false-positive caused by 18F-FCH can be eliminated. Dual tracer 18F-FCH/18F-FDG PET imaging has the potential to improve the visualization of low grade glioma. 18F-FCH delineates tumor areas and the tumor can be identified by subtracting the 18F-FCH counts. The sensitivity was over 95%. Further studies are required to evaluate the possibility of applying this technique in clinical trials. PMID:26844770

  6. Fat-constrained 18F-FDG PET reconstruction using Dixon MR imaging and the origin ensemble algorithm

    NASA Astrophysics Data System (ADS)

    Wülker, Christian; Heinzer, Susanne; Börnert, Peter; Renisch, Steffen; Prevrhal, Sven

    2015-03-01

    Combined PET/MR imaging allows to incorporate the high-resolution anatomical information delivered by MRI into the PET reconstruction algorithm for improvement of PET accuracy beyond standard corrections. We used the working hypothesis that glucose uptake in adipose tissue is low. Thus, our aim was to shift 18F-FDG PET signal into image regions with a low fat content. Dixon MR imaging can be used to generate fat-only images via the water/fat chemical shift difference. On the other hand, the Origin Ensemble (OE) algorithm, a novel Markov chain Monte Carlo method, allows to reconstruct PET data without the use of forward- and back projection operations. By adequate modifications to the Markov chain transition kernel, it is possible to include anatomical a priori knowledge into the OE algorithm. In this work, we used the OE algorithm to reconstruct PET data of a modified IEC/NEMA Body Phantom simulating body water/fat composition. Reconstruction was performed 1) natively, 2) informed with the Dixon MR fat image to down-weight 18F-FDG signal in fatty tissue compartments in favor of adjacent regions, and 3) informed with the fat image to up-weight 18F-FDG signal in fatty tissue compartments, for control purposes. Image intensity profiles confirmed the visibly improved contrast and reduced partial volume effect at water/fat interfaces. We observed a 17+/-2% increased SNR of hot lesions surrounded by fat, while image quality was almost completely retained in fat-free image regions. An additional in vivo experiment proved the applicability of the presented technique in practice, and again verified the beneficial impact of fat-constrained OE reconstruction on PET image quality.

  7. Impact of FDG-PET/CT on Radiotherapy Volume Delineation in Non-Small-Cell Lung Cancer and Correlation of Imaging Stage With Pathologic Findings

    SciTech Connect

    Faria, Sergio L. Menard, Sonia; Devic, Slobodan; Sirois, Christian; Souhami, Luis; Lisbona, Robert; Freeman, Carolyn R.

    2008-03-15

    Purpose: Fluorodeoxyglucose-positron emission tomography (FDG-PET)/computed tomography (CT) is more accurate than CT in determining the extent of non-small-cell lung cancer. We performed a study to evaluate the impact of FDG-PET/CT on the radiotherapy volume delineation compared with CT without using any mathematical algorithm and to correlate the findings with the pathologic examination findings. Methods and Materials: A total of 32 patients with proven non-small-cell lung cancer, pathologic specimens from the mediastinum and lung primary, and pretreatment chest CT and FDG-PET/CT scans were studied. For each patient, two data sets of theoretical gross tumor volumes were contoured. One set was determined using the chest CT only, and the second, done separately, was based on the co-registered FDG-PET/CT data. The disease stage of each patient was determined using the TNM staging system for three data sets: the CT scan only, FDG-PET/CT scan, and pathologic findings. Results: Pathologic examination altered the CT-determined stage in 22 (69%) of 32 patients and the PET-determined stage in 16 (50%) of 32 patients. The most significant alterations were related to the N stage. PET altered the TNM stage in 15 (44%) of 32 patients compared with CT alone, but only 7 of these 15 alterations were confirmed by the pathologic findings. With respect to contouring the tumor volume for radiotherapy, PET altered the contour in 18 (56%) of 32 cases compared with CT alone. Conclusion: The contour of the tumor volume of non-small-cell lung cancer patients with co-registered FDG-PET/CT resulted in >50% alterations compared with CT targeting, findings similar to those of other publications. However, the significance of this change is unknown. Furthermore, pathologic examination showed that PET is not always accurate and histologic examination should be obtained to confirm the findings of PET whenever possible.

  8. Radiation exposure to nuclear medicine staffs during 18F-FDG PET/CT procedures at Ramathibodi Hospital

    NASA Astrophysics Data System (ADS)

    Donmoon, T.; Chamroonrat, W.; Tuntawiroon, M.

    2016-03-01

    The aim of this study is to estimate the whole body and finger radiation doses per study received by nuclear medicine staff involved in dispensing, administration of 18F-FDG and interacting with radioactive patients during PET/CT imaging procedures in a PET/CT facility. The whole-body doses received by radiopharmacists, technologists and nurses were measured by electronic dosimeter and the finger doses by ring dosimeter during a period of 4 months. In 70 PET/CT studies, the mean whole-body dose per study to radiopharmacist, technologist, and nurse were 1.07±0.09, 1.77±0.46, μSv, and not detectable respectively. The mean finger doses per study received by radiopharmacist, technologist, and nurse were 265.65±107.55, 4.84±1.08 and 19.22±2.59 μSv, respectively. The average time in contact with 18F-FDG was 5.88±0.03, 39.06±1.89 and 1.21±0.02 minutes per study for radiopharmacist, technologist and nurse respectively. Technologists received highest mean effective whole- body dose per study and radiopharmacist received the highest finger dose per study. When compared with the ICRP dose limit, each individual worker can work with many more 18F- FDG PET/CT studies for a whole year without exceeding the occupational dose limits. This study confirmed that low levels of radiation does are received by our medical personnel involved in 18F-FDG PET/CT procedures.

  9. FDG-PET/CT Limited to the Thorax and Upper Abdomen for Staging and Management of Lung Cancer

    PubMed Central

    Postema, Jan W. A.; Schreurs, Wendy M. J.; Lafeber, Albert; Hendrickx, Baudewijn W.; Oyen, Wim J. G.; Vogel, Wouter V.

    2016-01-01

    Purpose This study evaluates the diagnostic accuracy of [F-18]-fluorodeoxyglucose-positron emission tomography/computed tomography (FDG-PET/CT) of the chest/upper abdomen compared to the generally performed scan from head to upper thighs, for staging and management of (suspected) lung cancer in patients with no history of malignancy or complaints outside the thorax. Methods FDG-PET/CT scans of 1059 patients with suspected or recently proven lung cancer, with no history of malignancy or complaints outside the thorax, were analysed in a retrospective multi-centre trial. Suspect FDG-avid lesions in the chest and upper abdomen, the head and neck area above the shoulder line and in the abdomen and pelvis below the caudal tip of the liver were noted. The impact of lesions detected in the head and neck area and abdomen and pelvis on additional diagnostic procedures, staging and treatment decisions was evaluated. Results The head and neck area revealed additional suspect lesions in 7.2%, and the abdomen and pelvis in 15.8% of patients. Imaging of the head and neck area and the abdomen and pelvic area showed additional lesions in 19.5%, inducing additional diagnostic procedures in 7.8%. This resulted in discovery of additional lesions considered malignant in 10.7%, changing patient management for lung cancer in 1.2%. In (suspected) lung cancer, PET/CT limited to the chest and upper abdomen resulted in correct staging in 98.7% of patients, which led to the identical management as full field of view PET in 98.8% of patients. Conclusion High value of FDG-PET/CT for staging and correct patient management is already achieved with chest and upper abdomen. Findings in head and neck area and abdomen and pelvis generally induce investigations with limited or no impact on staging and treatment of NSCLC, and can be interpreted accordingly. PMID:27556809

  10. Advances in Small Animal Imaging Systems

    NASA Astrophysics Data System (ADS)

    Loudos, George K.

    2007-11-01

    The rapid growth in genetics and molecular biology combined with the development of techniques for genetically engineering small animals has led to an increased interest in in vivo laboratory animal imaging during the past few years. For this purpose, new instrumentation, data acquisition strategies, and image processing and reconstruction techniques are being developed, researched and evaluated. The aim of this article is to give a short overview of the state of the art technologies for high resolution and high sensitivity molecular imaging techniques, primarily positron emission tomography (PET) and single photon emission computed tomography (SPECT). The basic needs of small animal imaging will be described. The evolution in instrumentation in the past two decades, as well as the commercially available systems will be overviewed. Finally, the new trends in detector technology and preliminary results from challenging applications will be presented. For more details a number of references are provided.

  11. Advances in Small Animal Imaging Systems

    SciTech Connect

    Loudos, George K.

    2007-11-26

    The rapid growth in genetics and molecular biology combined with the development of techniques for genetically engineering small animals has led to an increased interest in in vivo laboratory animal imaging during the past few years. For this purpose, new instrumentation, data acquisition strategies, and image processing and reconstruction techniques are being developed, researched and evaluated. The aim of this article is to give a short overview of the state of the art technologies for high resolution and high sensitivity molecular imaging techniques, primarily positron emission tomography (PET) and single photon emission computed tomography (SPECT). The basic needs of small animal imaging will be described. The evolution in instrumentation in the past two decades, as well as the commercially available systems will be overviewed. Finally, the new trends in detector technology and preliminary results from challenging applications will be presented. For more details a number of references are provided.

  12. State of the art imaging of multiple myeloma: comparative review of FDG PET/CT imaging in various clinical settings.

    PubMed

    Mesguich, Charles; Fardanesh, Reza; Tanenbaum, Lawrence; Chari, Ajai; Jagannath, Sundar; Kostakoglu, Lale

    2014-12-01

    18-Flurodeoxyglucose Positron Emission Tomography with computed tomography (FDG PET/CT) and Magnetic Resonance Imaging (MRI) have higher sensitivity and specificity than whole-body X-ray (WBXR) survey in evaluating disease extent in patients with multiple myeloma (MM). Both modalities are now recommended by the Durie-Salmon Plus classification although the emphasis is more on MRI than PET/CT. The presence of extra-medullary disease (EMD) as evaluated by PET/CT imaging, initial SUVmax and number of focal lesions (FL) are deemed to be strong prognostic parameters at staging. MRI remains the most sensitive technique for the detection of diffuse bone marrow involvement in both the pre and post-therapy setting. Compression fractures are best characterized with MRI signal changes, for determining vertebroplasty candidates. While PET/CT allows for earlier and more specific evaluation of therapeutic efficacy compared to MRI, when signal abnormalities persist years after treatment. PET/CT interpretation, however, can be challenging in the vertebral column and pelvis as well as in cases with post-therapy changes. Hence, a reading approach combining the high sensitivity of MRI and superior specificity of FDG PET/CT would be preferred to increase the diagnostic accuracy. In summary, the established management methods in MM, mainly relying on biological tumor parameters should be complemented with functional imaging data, both at staging and restaging for optimal management of MM. PMID:25308249

  13. TH-E-BRF-10: Interim Esophageal Cancer Response Assessment Via 18FDG-PET Scanning During Radiation Therapy

    SciTech Connect

    Higgins, K; Wu, Q; Perez, B; Czito, B; Palta, M; Willett, C; Das, S

    2014-06-15

    Purpose: Local failure occurs in a large proportion of esophageal cancer patients treated with chemoradiation. The treatment strategy for non-responders could potentially be modified if they are identified during therapy. This work investigates the utility of an interim 18FDG-PET scan acquired during the course of therapy as a predictor of pathological response post-therapy. Methods: Fifteen patients underwent 18FDG-PET scanning prior to radiation therapy (RT) and once during RT, after delivery of ∼32 Gy. The physician-contoured GTV on the planning CT scan was used to automatically segment a PET-based GTV on the pre-RT PET (GTV-pre-PET) as the volume with >40% of the maximum GTV PET SUV value. The pre- and intra-RT CTs were deformably registered to each other to transfer the GTV-pre-PET to the intra-RT PET (GTV-intra-PET). The fractional decrease in the maximum SUV, mean SUV and the SUV to the highest intensity 10% – 90% volumes from GTV-pre-PET to GTV-intra-PET were compared to pathological response assessed at the time of post-RT surgery. Results: Based on post-treatment pathology of 15 patients, 7 were classified as achieving favorable response (treatment effect grade ≤ 1) and 8 as unfavorable response (treatment effect grade > 1). Neither fractional decrease in maximum SUV nor mean SUV were significant between the favorable and unfavorable groups. However, the fractional decrease in SUV20% (SUV to the highest 20% volume) was significant (p = 0.02), with an area under the Receiver Operating Characteristics (ROC) curve of 0.84. An optimal cutoff value of 0.46 for this metric was able to distinguish between the two groups with 71% sensitivity (favorable) and 88% specificity (unfavorable). Conclusion: The fractional decrease in SUV to the volume with highest 20% intensity from pre- to intra-RT 18FDG-PET imaging may be used to distinguish between favorable and unfavorable responders with high sensitivity and specificity.

  14. 11C-choline vs. 18F-FDG PET/CT in assessing bone involvement in patients with multiple myeloma

    PubMed Central

    Nanni, Cristina; Zamagni, Elena; Cavo, Michele; Rubello, Domenico; Tacchetti, Paola; Pettinato, Cinzia; Farsad, Mohsen; Castellucci, Paolo; Ambrosini, Valentina; Montini, Gian Carlo; Al-Nahhas, Adil; Franchi, Roberto; Fanti, Stefano

    2007-01-01

    Background Multiple Myeloma (MM) is a B cell neoplasm causing lytic or osteopenic bone abnormalities. Whole body skeletal survey (WBSS), Magnetic resonance (MR) and 18F-FDG PET/CT are imaging techniques routinely used for the evaluation of bone involvement in MM patients. Aim As MM bone lesions may present low 18F-FDG uptake; the aim of this study was to assess the possible added value and limitations of 11C-Choline to that of 18F-FDG PET/CT in patients affected with MM. Methods Ten patients affected with MM underwent a standard 11C-Choline PET/CT and an 18F-FDG PET/CT within one week. The results of the two scans were compared in terms of number, sites and SUVmax of lesions. Results Four patients (40%) had a negative concordant 11C-Choline and 18F-FDG PET/CT scans. Two patients (20%) had a positive 11C-Choline and 18F-FDG PET/CT scans that identified the same number and sites of bone lesions. The remaining four patients (40%) had a positive 11C-Choline and 18F-FDG PET/CT scan, but the two exams identified different number of lesions. Choline showed a mean SUVmax of 5 while FDG showed a mean SUVmax of 3.8 (P = 0.042). Overall, 11C-Choline PET/CT scans detected 37 bone lesions and 18F-FDG PET/CT scans detected 22 bone lesions but the difference was not significant (P = 0.8). Conclusion According to these preliminary data, 11C-Choline PET/CT appears to be more sensitive than 18F-FDG PET/CT for the detection of bony myelomatous lesions. If these data are confirmed in larger series of patients, 11C-Choline may be considered a more appropriate functional imaging in association with MRI for MM bone staging. PMID:17584499

  15. Incidental Detection of a Hodgkin Lymphoma on 18F-Choline PET/CT and Comparison With 18F-FDG in a Patient With Prostate Cancer.

    PubMed

    Goineau, Aurore; Colombié, Mathilde; Rousseau, Caroline; Sadot-Lebouvier, Sophie; Supiot, Stéphane

    2015-08-01

    Combined PET/CT scanning with (18)F-FDG is in current use in Hodgkin lymphoma. New tracers have been developed, such as (18)F-choline in prostate cancer. Its use is under investigation in other solid tumors (eg, brain, liver, lung). We report a case of Hodgkin lymphoma incidentally detected on (18)F-choline PET/CT in a prostate cancer patient and show a comparison with (18)F-FDG PET/CT. (18)F-choline PET/CT detected more lymph node lesions than the (18)F-FDG PET/CT for this patient. Comparative studies of the 2 tracers might help fine-tune treatments and, in particular, delineate target zones in radiation therapy. PMID:26018683

  16. The use of FDG-PET in diffuse large B cell lymphoma (DLBCL): predicting outcome following first line therapy.

    PubMed

    Coughlan, Monica; Elstrom, Rebecca

    2014-01-01

    Positron emission tomography (PET) using 18fluoro-2-deoxyglucose (FDG) has become a standard clinical tool for staging and response assessment in aggressive lymphomas. The use of PET scans in clinical trials is still under exploration, however. In this review, we examine current data regarding PET in DLBCL, and its potential applicability to development of a surrogate endpoint to expedite clinical trial conduct. Interim PET scanning in DLBCL shows mixed results, with qualitative assessment variably associated with outcome. Addition of quantitative assessment might improve predictive power of interim scans. Data from multiple retrospective studies support that PET-defined response at end of treatment correlates with outcome in DLBCL. Optimal technical criteria for standardization of acquisition and criteria for interpretation of scans require further study. Prospective studies to define the correlation of PET-defined response and time-dependent outcomes such as progression free survival (PFS) and overall survival (OS), critical for development of PET as a surrogate endpoint for clinical trials, are ongoing. In conclusion, evolving data regarding utility of PET in predictcing outcome of patients with DLBCL show promise to support the use of PET as a surrogate endpoint in clinical trials of DLBCL in the future. PMID:25608713

  17. FDG-PET-Based Radiotherapy Planning in Lung Cancer: Optimum Breathing Protocol and Patient Positioning-An Intraindividual Comparison

    SciTech Connect

    Grgic, Aleksandar

    2009-01-01

    Purpose: Fluoro-2-deoxy-D-glucose (FDG)-positron emission tomography (PET) and PET/computed tomography (CT) are increasingly used for radiotherapy (RT) planning in patients with non-small-cell lung carcinoma. The planning process often is based on separately acquired FDG-PET/CT and planning CT scans. We compared intraindividual differences between PET acquired in diagnostic (D-PET) and RT treatment position (RT-PET) coregistered with planning CTs acquired using different breathing protocols. Methods and Materials: Sixteen patients with non-small-cell lung carcinoma underwent two PET acquisitions (D-PET and RT-PET) and three planning CT acquisitions (expiration [EXP], inspiration [INS], and mid-breath hold [MID]) on the same day. All scans were rigidly coregistered, resulting in six fused data sets: D-INS, D-EXP, D-MID, RT-INS, RT-EXP, and RT-MID. Fusion accuracy was assessed by three readers at eight anatomic landmarks, lung apices, aortic arch, heart, spine, sternum, carina, diaphragm, and tumor, by using an alignment score ranging from 1 (no alignment) to 5 (exact alignment). Results: The RT-PET showed better alignment with any CT than D-PET (p < 0.001). With regard to breathing, RT-MID showed the best mean alignment score (3.7 {+-} 1.0), followed by RT-EXP (3.5 {+-} 0.9) and RT-INS (3.0 {+-} 0.8), with all differences significant (p < 0.001). Comparing alignment scores with regard to anatomic landmarks, the largest deviations were found at the diaphragm, heart, and apices. Overall, there was fair agreement ({kappa} = 0.48; p < 0.001) among the three readers. Conclusions: Significantly better fusion of PET and planning CT can be reached with PET acquired in the RT position. The best intraindividual fusion results are obtained with the planning CT performed during mid-breath hold. Our data justify the acquisition of a separate planning PET in RT treatment position if only a diagnostic PET scan is available.

  18. Early detection of intravascular large B-cell lymphoma by 18FDG-PET/CT with diffuse FDG uptake in the lung without respiratory symptoms or chest CT abnormalities

    PubMed Central

    Shiiba, Masato; Izutsu, Koji; Ishihara, Makiko

    2014-01-01

    Intravascular large B-cell lymphoma (IVLBCL) is a rare and aggressive subtype of systemic extranodal non-Hodgkin diffuse large B-cell lymphoma (DLBCL). We report a rare case of IVLBCL who showed diffuse 18F-fluorodeoxyglucose (FDG) uptake in the lung in FDG-positron emission tomography/computed tomography (PET/CT) without respiratory symptoms or chest CT abnormalities. Serum biochemical studies showed a raised level of lactate dehydrogenase (LDH) and serum soluble interleukin-2 receptor (sIL-2R), which suggested the presence of malignant lymphoma strongly. A non-contrast CT showed no abnormalities in the lung fields, no lymphadenopathy was found. FDG-PET/CT revealed diffuse FDG uptake in the both lungs and in spleen as well as multiple hot spots in the liver. Under the suspicion of IVLBCL especially by the diffuse FDG uptake in the lung, a random skin biopsy was performed from three regions, the left forearm, right abdomen and left thigh in which there had been no evidence of FDG uptake. The definite diagnosis of IVLBCL was made based on the pathological analysis of the specimen from the left thigh. She achieved complete remission (CR) after combined chemoimmunotherapy. FDG-PET/CT was useful for the early detection of IVLBCL even without respiratory symptoms or any abnormal findings by chest CT.

  19. Is [F-18]-fluorodeoxyglucose FDG-PET/CT better than ct alone for the preoperative lymph node staging of muscle invasive bladder cancer?

    PubMed Central

    Uttam, Mete; Pravin, Nayak; Anish, Bhattacharya; Nandita, Kakkar; Arup, Mandal

    2016-01-01

    ABSTRACT Objective: To evaluate whether the use of [F-18]-FDG-PET/CT can accurately predict pelvic lymph node metastasis in patients with muscle invasive TCC of the bladder undergoing radical cystectomy. Materials and Methods: Fifteen patients with muscle invasive bladder cancer had undergone FDG-PET/CT scan from the skull base to the mid-thighs after IV injection of 6.5MBq (Mega-Becquerel)/Kg of FDG. After intravenous hydration IV furosemide was given to overcome the difficulties posed by urinary excretion of 18F-FDG. PET/CT data were analyzed as PET and CT images studied separately as well as fused PET/CT images. The imaging findings were correlated with the histopathology of the nodes (gold standard). Results: CT and FDG-PET had demonstrated positive lymph nodes in 9 & 8 patients respectively. Among the 15 patients 3 had documented metastasis on histopathology. Both CT and PET could detect the nodes in all these 3 patients (100% sensitivity). Nodes were histologically negative amongst 6&5 patients who had node involvement by CT and PET respectively. Therefore, specificity, positive predictive value (PPV) & negative predictive value (NPV) for CT and PET/CT were 50%, 33.3%, 100% and 58.3%, 37.5%, 100% respectively. Conclusion: The theoretical advantage of this cutting edge technology for whole body imaging has not been translated into clinical practice as we found minimal advantage of combined FDG-PET/CT over CT alone for nodal staging of muscle invasive bladder cancer. This may be due to substantial overlap between standardized uptake values (SUVs) from active inflammatory processes with those of malignant lesion. PMID:27256176

  20. Assessment of the biodistribution of an [18F]FDG-loaded perfluorocarbon double emulsion using dynamic micro-PET in rats

    PubMed Central

    Fabiilli, Mario L.; Piert, Morand R.; Koeppe, Robert A.; Sherman, Phillip S.; Quesada, Carole A.; Kripfgans, Oliver D.

    2013-01-01

    Perfluorocarbon (PFC) double emulsions loaded with a water-soluble, therapeutic agent can be triggered by ultrasound in a process known as acoustic droplet vaporization (ADV). Elucidating the stability and biodistribution of these sonosensitive vehicles and encapsulated agents are critical in developing targeted drug delivery strategies using ultrasound. [18F]fluorodeoxyglucose (FDG) was encapsulated in a PFC double emulsion and the in vitro diffusion of FDG was assessed using a Franz diffusion cell. Using dynamic micro positron emission tomography (micro-PET) and direct tissue sampling, the biodistribution of FDG administered as a solution (i.e. non-emulsified) or as an emulsion was studied in Fisher 344 rats (n = 6) bearing subcutaneous 9L gliosarcoma. Standardized uptake values (SUVs) and area under the curve of the SUV (AUCSUV) of FDG were calculated for various tissues. The FDG flux from the emulsion decreased by up to a factor of 6.9 compared to the FDG solution. FDG uptake, calculated from the AUCSUV, decreased by 36% and 44% for brain and tumor, respectively, when comparing FDG solution versus FDG emulsion (p < 0.01). Decreases in AUCSUV in highly metabolic tissues such as brain and tumor demonstrated retention of FDG within the double emulsion. No statistically significant differences in lung AUCSUV were observed, suggesting minimal accumulation of the emulsion in the pulmonary capillary bed. The liver AUCSUV increased by 356% for the FDG emulsion, thus indicating significant hepatic retention of the emulsion. PMID:23613440

  1. Summary of the UPICT Protocol for 18F-FDG PET/CT Imaging in Oncology Clinical Trials.

    PubMed

    Graham, Michael M; Wahl, Richard L; Hoffman, John M; Yap, Jeffrey T; Sunderland, John J; Boellaard, Ronald; Perlman, Eric S; Kinahan, Paul E; Christian, Paul E; Hoekstra, Otto S; Dorfman, Gary S

    2015-06-01

    The Uniform Protocols for Imaging in Clinical Trials (UPICT) (18)F-FDG PET/CT protocol is intended to guide the performance of whole-body FDG PET/CT studies within the context of single- and multiple-center clinical trials of oncologic therapies by providing acceptable (minimum), target, and ideal standards for all phases of imaging. The aim is to minimize variability in intra- and intersubject, intra- and interplatform, interexamination, and interinstitutional primary or derived data. The goal of this condensed version of the much larger document is to make readers aware of the general content and subject area. The document has several main subjects: context of the imaging protocol within the clinical trial; site selection, qualification, and training; subject scheduling; subject preparation; imaging-related substance preparation and administration; imaging procedure; image postprocessing; image analysis; image interpretation; archiving and distribution of data; quality control; and imaging-associated risks and risk management. PMID:25883122

  2. Summary of the UPICT Protocol for 18F-FDG PET/CT Imaging in Oncology Clinical Trials

    PubMed Central

    Graham, Michael M.; Wahl, Richard L.; Hoffman, John M.; Yap, Jeffrey T.; Sunderland, John J.; Boellaard, Ronald; Perlman, Eric S.; Kinahan, Paul E.; Christian, Paul E.; Hoekstra, Otto S.; Dorfman, Gary S.

    2015-01-01

    The Uniform Protocols for Imaging in Clinical Trials (UPICT) 18F-FDG PET/CT protocol is intended to guide the performance of whole-body FDG PET/CT studies within the context of single- and multiple-center clinical trials of oncologic therapies by providing acceptable (minimum), target, and ideal standards for all phases of imaging. The aim is to minimize variability in intra- and intersubject, intra- and inter-platform, interexamination, and interinstitutional primary or derived data. The goal of this condensed version of the much larger document is to make readers aware of the general content and subject area. The document has several main subjects: context of the imaging protocol within the clinical trial; site selection, qualification, and training; subject scheduling; subject preparation; imaging-related substance preparation and administration; imaging procedure; image postprocessing; image analysis; image interpretation; archiving and distribution of data; quality control; and imaging-associated risks and risk management. PMID:25883122

  3. Sclerosing hemangioma of the lung showing strong FDG avidity on PET scan: Case report and review of the current literature

    PubMed Central

    Patrini, Davide; Shukla, Rajeev; Lawrence, David; Borg, Elaine; Hayward, Martin; Panagiotopoulos, Nikolaos

    2015-01-01

    Sclerosing Hemangioma is a rare lung tumor with polymorphic histologic features that usually occurs in middle aged women. Based on many immunohistochemical and ultrastructural studies, it is most probably derived from undifferentiated respiratory epithelial cells. Symptoms are usually due to enlargement of the tumor and compression of the surrounding tissues. Occurrence of multiple lesions or metastasis is extremely rare although some authors consider sclerosing hemangioma as a potentially low grade malignancy tumor. It usually presents with low to moderate uptake on FDG PET imaging. We present a case of sclerosing hemangioma with strong FDG avidity on PET scan in a 41 year old lady with history of haemoptysis. A full review of the literature on this topic was performed. PMID:27222778

  4. FDG-PET/CT and CT Findings of a Benign Solitary Fibrous Tumor of the Kidney; Correlation with Pathology.

    PubMed

    Nakajima, Reiko; Abe, Koichiro; Kondo, Tsunenori; Nagashima, Yoji; Kimura, Ken; Fukushima, Kenji; Momose, Mitsuru; Kondo, Chisato; Tanabe, Kazunari; Sakai, Shuji

    2015-01-01

    Herein, we report the F-18 fluorodeoxyglucose ((18)F-FDG) positron emission tomography (PET)/computed tomography (CT) findings of a benign solitary fibrous tumor (SFT) of the kidney. The patient was a 63-year-old woman with a mass in the right kidney (10×9.7 cm), incidentally found on CT images. The CT scan showed a lobulated tumor arising from the hilum of the right kidney. The tumor consisted of two components with different patterns of enhancement. Most of the tumor demonstrated moderate enhancement from the corticomedullary to nephrographic phase. A small nodular component at the caudal portion of the tumor showed avid enhancement in the corticomedullary phase and rapid washout in the nephrographic phase in contrast-enhanced CT. FDG-PET/CT was performed and showed weak FDG accumulation (SUVmax=2.30 and 1.91 in the main and small caudal components). Although renal cell carcinoma was preoperatively diagnosed, histopathological examination revealed renal SFT, with no malignant potential. Therefore, when a renal tumor with contrast-medium enhancement and low FDG accumulation is demonstrated, SFT should be considered as a differential diagnosis in addition to renal cell carcinoma. PMID:27408891

  5. Isolated skeletal muscle metastatic deposit in a patient with micropapillary carcinoma thyroid identified by 18F FDG PET CT.

    PubMed

    Sarma, Manjit; Sonik, Bhavya; Subramanyam, Padma; Sundaram, Palaniswamy Shanmuga

    2015-03-01

    Micropapillary carcinoma of thyroid is said to be low risk differentiated thyroid malignancy with excellent prognosis. We report the identification of an isolated FDG avid muscle deposit in a treated case of micropapillary carcinoma of the right lobe and widely invasive follicular carcinoma of the left lobe thyroid gland. Patient was found to have an elevated thyroglobulin level with negative iodine scan (TENIS syndrome) on follow up at 6 months. An 18F FDG PET CT (18 fluorine-fluorodeoxyglucose positron emission computed tomography) whole body study revealed a solitary FDG avid deltoid muscle deposit which was histopathologically confirmed to be metastatic papillary carcinoma. While follicular carcinoma is known to have distant metastases, this may be the first reported case of solitary skeletal metastases from micropapillary carcinoma of thyroid and probably the second reported skeletal muscle deposit from DTC detected on 18F FDG PET CT done following elevated thyroglobulin level and negative 131 iodine WB scan (TENIS). This case also assumes importance because it demonstrates possibility of metastases even from a micropapillary carcinoma in contrast to American Thyroid Association guidelines (2009) which suggests that micropapillary carcinoma of thyroid does not merit further treatment after a Total Thyroidectomy. PMID:25698468

  6. FDG-PET/CT and CT Findings of a Benign Solitary Fibrous Tumor of the Kidney; Correlation with Pathology

    PubMed Central

    Nakajima, Reiko; Abe, Koichiro; Kondo, Tsunenori; Nagashima, Yoji; Kimura, Ken; Fukushima, Kenji; Momose, Mitsuru; Kondo, Chisato; Tanabe, Kazunari; Sakai, Shuji

    2015-01-01

    Herein, we report the F-18 fluorodeoxyglucose (18F-FDG) positron emission tomography (PET)/computed tomography (CT) findings of a benign solitary fibrous tumor (SFT) of the kidney. The patient was a 63-year-old woman with a mass in the right kidney (10×9.7 cm), incidentally found on CT images. The CT scan showed a lobulated tumor arising from the hilum of the right kidney. The tumor consisted of two components with different patterns of enhancement. Most of the tumor demonstrated moderate enhancement from the corticomedullary to nephrographic phase. A small nodular component at the caudal portion of the tumor showed avid enhancement in the corticomedullary phase and rapid washout in the nephrographic phase in contrast-enhanced CT. FDG-PET/CT was performed and showed weak FDG accumulation (SUVmax=2.30 and 1.91 in the main and small caudal components). Although renal cell carcinoma was preoperatively diagnosed, histopathological examination revealed renal SFT, with no malignant potential. Therefore, when a renal tumor with contrast-medium enhancement and low FDG accumulation is demonstrated, SFT should be considered as a differential diagnosis in addition to renal cell carcinoma. PMID:27408891

  7. Right Limbic FDG-PET Hypometabolism Correlates with Emotion Recognition and Attribution in Probable Behavioral Variant of Frontotemporal Dementia Patients

    PubMed Central

    Cerami, Chiara; Dodich, Alessandra; Iannaccone, Sandro; Marcone, Alessandra; Lettieri, Giada; Crespi, Chiara; Gianolli, Luigi; Cappa, Stefano F.; Perani, Daniela

    2015-01-01

    The behavioural variant of frontotemporal dementia (bvFTD) is a rare disease mainly affecting the social brain. FDG-PET fronto-temporal hypometabolism is a supportive feature for the diagnosis. It may also provide specific functional metabolic signatures for altered socio-emotional processing. In this study, we evaluated the emotion recognition and attribution deficits and FDG-PET cerebral metabolic patterns at the group and individual levels in a sample of sporadic bvFTD patients, exploring the cognitive-functional correlations. Seventeen probable mild bvFTD patients (10 male and 7 female; age 67.8±9.9) were administered standardized and validated version of social cognition tasks assessing the recognition of basic emotions and the attribution of emotions and intentions (i.e., Ekman 60-Faces test-Ek60F and Story-based Empathy task-SET). FDG-PET was analysed using an optimized voxel-based SPM method at the single-subject and group levels. Severe deficits of emotion recognition and processing characterized the bvFTD condition. At the group level, metabolic dysfunction in the right amygdala, temporal pole, and middle cingulate cortex was highly correlated to the emotional recognition and attribution performances. At the single-subject level, however, heterogeneous impairments of social cognition tasks emerged, and different metabolic patterns, involving limbic structures and prefrontal cortices, were also observed. The derangement of a right limbic network is associated with altered socio-emotional processing in bvFTD patients, but different hypometabolic FDG-PET patterns and heterogeneous performances on social tasks at an individual level exist. PMID:26513651

  8. Metabolic Response on Post-therapy FDG-PET Predicts Patterns of Failure After Radiotherapy for Cervical Cancer

    SciTech Connect

    Schwarz, Julie K.; Siegel, Barry A.; Dehdashti, Farrokh; Grigsby, Perry W.

    2012-05-01

    Purpose: To determine the patterns of failure in patients with cervical cancer treated with definitive radiotherapy and evaluated for metabolic response with early posttherapy {sup 18}F-fluorodeoxyglucose positron emission tomography (FDG-PET). Methods and Materials: The records of 238 patients with cervical cancer were reviewed. All patients were treated with a combination of external radiotherapy and intracavitary brachytherapy. Two hundred and nineteen patients (92%) received concurrent chemotherapy. All patients underwent pretreatment FDG-PET, and posttherapy FDG-PET was performed within 8-16 weeks of the completion of radiotherapy. Posttherapy FDG-PET results were categorized as complete metabolic response (CMR), partial metabolic response (PMR), and progressive disease (PD). Failure patterns were categorized as none, isolated local failure (central pelvis {+-} pelvic lymph nodes), distant failure, or combined local plus distant failure. Results: Of the 91 patients (38%) who had a recurrence, 22 had isolated local failures, and 69 had distant failures (49 distant failures and 20 combined local plus distant failures). Of the 173 patients with a CMR, 40 (23%) experienced treatment failure. All 25 patients with PD experienced treatment failure, which was distant in 24 patients (96%). Among the 40 patients with PMR, no failure has been observed for 14 patients (35%). Of the 26 failures within the PMR group, 15 (58%) were limited to the pelvis. Differences in the patterns of failure between the three groups (CMR, PMR, PD) were statistically significant (chi-square test; p < 0.0001). Conclusions: The majority of failures after definitive radiotherapy for cervical cancer include distant failures, even in the setting of concurrent chemotherapy. PMR within the cervix or lymph nodes is more commonly associated with isolated local recurrence.

  9. [Findings of the (18)F-FDG PET-CT in a cardiac angiosarcoma complicated by a cardiac rupture].

    PubMed

    Santiago-Chinchilla, Alicia; Ruiz-Carazo, Eduardo; Moral-Ruiz, Antonio; Testart Dardel, Nathalie; Martínez-Martínez, Alberto; López-Fernández, Silvia

    2014-01-01

    Primary malignant tumors of the heart are a rare condition. The most common type is the cardiac angiosarcoma. The symptoms of this disease are very nonspecific and can be very difficult to diagnose by conventional imaging techniques. We report the case of a male patient with cardiac angiosarcoma who also had a rare complication, this being cardiac rupture, which required the use of (18)F-FDG PET-CT to demonstrate the mass malignancy and to reach a definitive diagnosis. PMID:23810660

  10. Extensive tumor thrombus in a case of carcinoma lung detected by F18-FDG-PET/CT.

    PubMed

    Mudalsha, Ravina; Jacob, Mj; Pandit, Ag; Jora, Charu

    2011-04-01

    Tumor thrombus is a rare complication of solid cancers, mainly seen in cases of renal cell carcinoma, wilm's tumor, testicular carcinoma, adrenal cortical carcinoma and hepatocellular carcinoma.[1] Tumor thrombus in inferior vena cava is a rare complication of primary carcinoma lung. It should be identified so as to rule out venous thromboembolism and avoiding unnecessary anticoagulant therapy. We describe a case where F18-Fluorodeoxyglucose (FDG) positron emission tomography - computed tomography (PET/CT) helped to identify extensive tumor thrombus. PMID:22174524

  11. Extensive tumor thrombus in a case of carcinoma lung detected by F18-FDG-PET/CT

    PubMed Central

    Mudalsha, Ravina; Jacob, MJ; Pandit, AG; Jora, Charu

    2011-01-01

    Tumor thrombus is a rare complication of solid cancers, mainly seen in cases of renal cell carcinoma, wilm's tumor, testicular carcinoma, adrenal cortical carcinoma and hepatocellular carcinoma.[1] Tumor thrombus in inferior vena cava is a rare complication of primary carcinoma lung. It should be identified so as to rule out venous thromboembolism and avoiding unnecessary anticoagulant therapy. We describe a case where F18-Fluorodeoxyglucose (FDG) positron emission tomography - computed tomography (PET/CT) helped to identify extensive tumor thrombus. PMID:22174524

  12. Prognostic Utility of Squamous Cell Carcinoma Antigen in Carcinoma of the Cervix: Association With Pre- and Posttreatment FDG-PET

    SciTech Connect

    Olsen, Jeffrey R.; Dehdashti, Farrokh; Siegel, Barry A.; Zighelboim, Israel; Grigsby, Perry W.; Schwarz, Julie K.

    2011-11-01

    Purpose: Squamous cell carcinoma antigen (SCC Ag) is a serum biomarker for squamous cell carcinoma (SCC) of the cervix. We investigated the prognostic significance of SCC Ag levels before and at the completion of chemoradiotherapy and compared these levels with the results of pre- and posttreatment positron emission tomography/computed tomography (PET/CT) using [{sup 18}F]fluorodeoxyglucose (FDG). Methods and Materials: The records of 63 women who underwent definitive chemoradiotherapy for SCC of the cervix were reviewed. SCC Ag levels were obtained before and at the completion of radiotherapy. Patients were divided into two groups on the basis of their pretreatment SCC Ag level (>30 ng/mL vs. {<=}30 ng/mL). Pre- and posttreatment FDG-PET/CT characteristics and progression-free survival (PFS) were analyzed according to SCC Ag groups. Results: Median follow-up was 12 months. Women with SCC Ag >30 ng/mL at diagnosis had more advanced lymph node disease on pretreatment FDG-PET/CT than those with SCC Ag {<=}30 ng/mL (p = .002). Women whose SCC Ag normalized at the completion of chemoradiotherapy were more likely to have a complete metabolic response on their 3-month posttreatment FDG-PET/CT than those whose SCC Ag did not normalize (p = .006). The 2-year PFS was 73% for patients with a SCC Ag level {<=}30 ng/mL at diagnosis compared with 0% for those with a SCC Ag level >30 ng/mL at diagnosis (p < .0001). The 2-year PFS was 62% for patients whose SCC Ag normalized at the completion of chemoradiotherapy compared with 0% for those whose SCC Ag did not normalize (p = .0004). Conclusion: Elevated SCC Ag at diagnosis and failure of the SCC Ag to normalize at the completion of treatment are associated with incomplete metabolic response and decreased PFS.

  13. Posttreatment FDG-PET Uptake in the Supraglottic and Glottic Larynx Correlates With Decreased Quality of Life After Chemoradiotherapy

    SciTech Connect

    Dornfeld, Ken Hopkins, Shane; Simmons, Joel; Spitz, Douglas R.; Menda, Yusuf; Graham, Michael; Smith, Russell; Funk, Gerry; Karnell, Lucy; Karnell, Michael; Dornfeld, Maude; Yao Min; Buatti, John

    2008-06-01

    Purpose: Inflammation and increased metabolic activity associated with oxidative stress in irradiated normal tissues may contribute to both complications following radiotherapy and increased glucose uptake as detected by posttherapy fluorodeoxyglucose (FDG)-PET imaging. We sought to determine whether increased glucose uptake in normal tissues after chemoradiotherapy is associated with increased toxicity. Methods and Materials: Consecutive patients with locoregionally advanced head and neck cancers treated with intensity-modulated radiation therapy and free of recurrence at 1 year were studied. FDG-PET imaging was obtained at 3 and 12 months posttreatment. Standardized uptake value (SUV) levels were determined at various head and neck regions. Functional outcome was measured using a quality of life questionnaire and weight loss and type of diet tolerated 1 year after therapy. A one-tailed Pearson correlation test was used to examine associations between SUV levels and functional outcome measures. Results: Standardized uptake value levels in the supraglottic and glottic larynx from FDG-PET imaging obtained 12 months posttreatment were inversely associated with quality of life measures and were correlated with a more restricted diet 1 year after therapy. SUV levels at 3 months after therapy did not correlate with functional outcome. Increases in SUV levels in normal tissues between 3 and 12 months were commonly found in the absence of recurrence. Conclusion: Altered metabolism in irradiated tissues persists 1 year after therapy. FDG-PET scans may be used to assess normal tissue damage following chemoradiotherapy. These data support investigating hypermetabolic conditions associated with either inflammation, oxidative stress, or both, as causal agents for radiation-induced normal tissue damage.

  14. Posttransplant Lymphoproliferative Disorder of the Thorax: CT and FDG-PET Features in a Single Tertiary Referral Center.

    PubMed

    Yoon, Ga Young; Kim, Mi Young; Huh, Joo Rryung; Jo, Kyung-Wook; Shim, Tae Sun

    2015-08-01

    To investigate the chest computed tomography (CT) and F-18 fluoro-2-deoxy-D-glucose positron emission tomographic (FDG-PET) findings of posttransplant lymphoproliferative disorder (PTLD) in the thorax.From November 2004 to February 2013, the cases of 12 adult patients (3 female and 9 male, age range 34-68, and median age 46 years) with proven PTLD were retrospectively reviewed. The transplanted organs included the kidney (5/12), liver (4/12), heart (1/12), combined kidney and pancreas (1/12), and hematopoietic stem cell (1/12). We investigated the relationship of the Epstein-Barr virus (EBV) to the patients' long-term follow-up, and evaluated the characteristics of the lesions on the chest CT and FDG-PET. The lesions were classified into 2 patterns: that of lymph node and lung involvement.The interval between the transplantation and the onset of PTLD was 2 to 128 months (median, 49). Positive EBV-encoded RNA in the pathologic specimens was found in 10 patients (83.3%). Eight patients were positive for EBV PCR in their blood, and 3 patients showed seroconversion without antiviral therapy. The responses to treatment were complete in 7 cases (58.3%), partial remission in 4 cases (33.3%), and undetermined in 1 case (8.3%). The more common chest CT patterns showed lymph node involvement (10/12) rather than lung involvement (3/12). The median maximum-standardized uptake value on the FDG-PET scans was 7.7 (range, 2.7-25.5).In patients with PTLD involving the thorax, lymphadenopathy was the more common manifestation on the chest CT rather than lung involvement. The lesions showed hypermetabolism on FDG-PET. PMID:26252295

  15. Effect of 18F-FDG uptake time on lesion detectability in PET imaging of early stage breast cancer

    PubMed Central

    Wangerin, Kristen A.; Muzi, Mark; Peterson, Lanell M.; Linden, Hannah M.; Novakova, Alena; O'Sullivan, Finbarr; Kurland, Brenda F.; Mankoff, David A.; Kinahan, Paul E.

    2016-01-01

    Prior reports have suggested that delayed FDG-PET oncology imaging can improve the contrast-to-noise ratio (CNR) for known lesions. Our goal was to estimate realistic bounds for lesion detectability for static measurements with one to four hours between FDG injection and image acquisition. Tumor and normal tissue kinetic model parameters were estimated from dynamic PET studies of patients with early stage breast cancer. These were used to generate time-activity curves (TACs) out to four hours, for which we assumed both nonreversible and reversible models with different rates of FDG dephosphorylation (k4). For each pair of tumor and normal tissue TACs, 600 PET sinogram realizations were generated, and images were reconstructed using OSEM. Test statistics for each tumor and normal tissue region of interest were output from the computer model observers and evaluated using an ROC analysis with the calculated AUC providing a measure of lesion detectability. For the nonreversible model (k4 = 0), the AUC increased in 11/23 (48%) of patients for one to two hours after the current standard post-radiotracer injection imaging window of one hour. This improvement was driven by increased tumor/normal tissue contrast before the impact of increased noise due to radiotracer decay began to dominate the imaging signal. As k4 was increased from 0 to 0.01 min−1, the time of maximum detectability shifted earlier, as the decreasing FDG concentration in the tumor lowered the CNR. These results imply that delayed PET imaging may reveal low-conspicuity lesions that would have otherwise gone undetected. PMID:26807443

  16. Can calcified pulmonary metastases detected by (18)F-FDG PET/CT suggest the primary tumor?

    PubMed

    Hong, Chae Moon; Ahn, Byeong Cheol

    2016-01-01

    Many calcified nodules are encountered on the (18)F-FDG PET/CT scan and even though most of them are benign, the possibility of calcified pulmonary metastases (CPM) should be considered. The CT portion can often differentiate benign diseases due to their morphology. Measuring SUVmax is very important. Understanding the mechanism of calcification in malignant metastatic pulmonary lesions may be useful to suggest their origin. PMID:27035906

  17. Dual-time-point FDG-PET/CT Imaging of Temporal Bone Chondroblastoma: A Report of Two Cases

    PubMed Central

    Toriihara, Akira; Tsunoda, Atsunobu; Takemoto, Akira; Kubota, Kazunori; Machida, Youichi; Tateishi, Ukihide

    2015-01-01

    Temporal bone chondroblastoma is an extremely rare benign bone tumor. We encountered two cases showing similar imaging findings on computed tomography (CT), magnetic resonance imaging (MRI), and dual-time-point 18F-fluorodeoxyglucose (18F-FDG) positron emission tomography (PET)/CT. In both cases, CT images revealed temporal bone defects and sclerotic changes around the tumor. Most parts of the tumor showed low signal intensity on T2-weighted MRI images and non-uniform enhancement on gadolinium contrast-enhanced T1-weighted images. No increase in signal intensity was noted in diffusion-weighted images. Dual-time-point PET/CT showed markedly elevated 18F-FDG uptake, which increased from the early to delayed phase. Nevertheless, immunohistochemical analysis of the resected tumor tissue revealed weak expression of glucose transporter-1 and hexokinase II in both tumors. Temporal bone tumors, showing markedly elevated 18F-FDG uptake, which increases from the early to delayed phase on PET/CT images, may be diagnosed as malignant bone tumors. Therefore, the differential diagnosis should include chondroblastoma in combination with its characteristic findings on CT and MRI. PMID:27408892

  18. Usefulness of (18)F-FDG PET/CT in recurrent basal cell carcinoma: Report of a case.

    PubMed

    Ayala, S; Perlaza, P; Puig, S; Prats, E; Vidal-Sicart, S

    2016-01-01

    We analyze the case of a patient with left periorbital infiltrating basal cell carcinoma treated with surgical excision in October 2010. Surgery included orbital exenteration and reconstruction using skin graft and radiotherapy. In May 2013 a MR imaging showed a mass in the left orbital fossa, suggesting a recurrence in the graft. A basal cell carcinoma recurrence with perineural invasion was confirmed in the biopsy. On (18)F-FDG PET/CT performed, a hypermetabolic activity was observed in the left periorbital area with extension to surrounding sinus and bones. The use of (18)F-FDG PET/CT in patients with advanced basal cell carcinoma has not been fully explored due to the rarity of this entity. This case demonstrates the usefulness of this technique to determine the extent of non-melanocytic recurrent skin tumors, and its value in the staging and treatment control, supporting the incorporation of (18)F-FDG PET/CT in the management of advanced basal cell carcinoma. PMID:26522004

  19. Dual-time-point FDG-PET/CT Imaging of Temporal Bone Chondroblastoma: A Report of Two Cases.

    PubMed

    Toriihara, Akira; Tsunoda, Atsunobu; Takemoto, Akira; Kubota, Kazunori; Machida, Youichi; Tateishi, Ukihide

    2015-01-01

    Temporal bone chondroblastoma is an extremely rare benign bone tumor. We encountered two cases showing similar imaging findings on computed tomography (CT), magnetic resonance imaging (MRI), and dual-time-point (18)F-fluorodeoxyglucose ((18)F-FDG) positron emission tomography (PET)/CT. In both cases, CT images revealed temporal bone defects and sclerotic changes around the tumor. Most parts of the tumor showed low signal intensity on T2-weighted MRI images and non-uniform enhancement on gadolinium contrast-enhanced T1-weighted images. No increase in signal intensity was noted in diffusion-weighted images. Dual-time-point PET/CT showed markedly elevated (18)F-FDG uptake, which increased from the early to delayed phase. Nevertheless, immunohistochemical analysis of the resected tumor tissue revealed weak expression of glucose transporter-1 and hexokinase II in both tumors. Temporal bone tumors, showing markedly elevated (18)F-FDG uptake, which increases from the early to delayed phase on PET/CT images, may be diagnosed as malignant bone tumors. Therefore, the differential diagnosis should include chondroblastoma in combination with its characteristic findings on CT and MRI. PMID:27408892

  20. [18F]FDG imaging of head and neck tumours: comparison of hybrid PET and morphological methods.

    PubMed

    Dresel, S; Grammerstorff, J; Schwenzer, K; Brinkbäumer, K; Schmid, R; Pfluger, T; Hahn, K

    2003-07-01

    The aim of this study was to evaluate fluorine-18 fluorodeoxyglucose ([(18)F]FDG) imaging of head and neck tumours using a second- or third-generation hybrid PET device. Results were compared with the findings of spiral computed tomography (CT) and magnetic resonance imaging (MRI), and, as regards lymph node metastasis, the ultrasound findings. A total of 116 patients with head and neck tumours (83 males and 33 females aged 27-88 years) were examined using a hybrid PET scanner after injection of 185-350 MBq of [(18)F]FDG (Picker Prism 2000 XP-PCD, Marconi Axis gamma-PET(2) AZ). Hybrid PET examinations were performed in list mode using an axial filter. Reconstruction of data was performed iteratively. Ninety-six patients underwent CT using a multislice technique (Siemens Somatom Plus 4, Marconi MX 8000), 18 patients underwent MRI and 100 patients were examined by ultrasound. All findings were verified by histology, which was considered the gold standard, or, in the event of negative histology, by follow-up. Correct diagnosis of the primary or recurrent lesion was made in 73 of 85 patients using the hybrid PET scanner, in 50 of 76 patients on CT and in 7 of 10 patients on MRI. Hybrid PET successfully visualised metastatic disease in cervical lymph nodes in 28 of 34 patients, while 23 of 31 were correctly diagnosed with CT, 3 of 4 with MRI and 30 of 33 with ultrasound. False positive results regarding lymph node metastasis were seen in three patients with hybrid PET, in 14 patients with CT and in 13 patients with ultrasound. MRI yielded no false positive results concerning lymph node metastasis. In one patient, unrecognised metastatic lesions were seen on hybrid PET elsewhere in the body (lung: n=1; bone: n=1). Additional malignant lesions at sites other than the head and neck tumour were found in three patients (one patient with lung cancer, one patient with pelvic metastasis due to a carcinoma of the prostate and one patient with pulmonary metastasis due to breast

  1. Prognostic Value of Quantitative Metabolic Metrics on Baseline Pre-Sunitinib FDG PET/CT in Advanced Renal Cell Carcinoma

    PubMed Central

    Minamimoto, Ryogo; Barkhodari, Amir; Harshman, Lauren; Srinivas, Sandy; Quon, Andrew

    2016-01-01

    Purpose The objective of this study was to prospectively evaluate various quantitative metrics on FDG PET/CT for monitoring sunitinib therapy and predicting prognosis in patients with metastatic renal cell cancer (mRCC). Methods Seventeen patients (mean age: 59.0 ± 11.6) prospectively underwent a baseline FDG PET/CT and interim PET/CT after 2 cycles (12 weeks) of sunitinib therapy. We measured the highest maximum standardized uptake value (SUVmax) of all identified lesions (highest SUVmax), sum of SUVmax with maximum six lesions (sum of SUVmax), total lesion glycolysis (TLG) and metabolic tumor volume (MTV) from baseline PET/CT and interim PET/CT, and the % decrease in highest SUVmax of lesion (%Δ highest SUVmax), the % decrease in sum of SUVmax, the % decrease in TLG (%ΔTLG) and the % decrease in MTV (%ΔMTV) between baseline and interim PET/CT, and the imaging results were validated by clinical follow-up at 12 months after completion of therapy for progression free survival (PFS). Results At 12 month follow-up, 6/17 (35.3%) patients achieved PFS, while 11/17 (64.7%) patients were deemed to have progression of disease or recurrence within the previous 12 months. At baseline, PET/CT demonstrated metabolically active cancer in all cases. Using baseline PET/CT alone, all of the quantitative imaging metrics were predictive of PFS. Using interim PET/CT, the %Δ highest SUVmax, %Δ sum of SUVmax, and %ΔTLG were also predictive of PFS. Otherwise, interim PET/CT showed no significant difference between the two survival groups regardless of the quantitative metric utilized including MTV and TLG. Conclusions Quantitative metabolic measurements on baseline PET/CT appears to be predictive of PFS at 12 months post-therapy in patients scheduled to undergo sunitinib therapy for mRCC. Change between baseline and interim PET/CT also appeared to have prognostic value but otherwise interim PET/CT after 12 weeks of sunitinib did not appear to be predictive of PFS. PMID:27123976

  2. A FDG-PET Study of Metabolic Networks in Apolipoprotein E ε4 Allele Carriers.

    PubMed

    Yao, Zhijun; Hu, Bin; Zheng, Jiaxiang; Zheng, Weihao; Chen, Xuejiao; Gao, Xiang; Xie, Yuanwei; Fang, Lei

    2015-01-01

    Recently, some studies have applied the graph theory in brain network analysis in Alzheimer's disease (AD) and Mild Cognitive Impairment (MCI). However, relatively little research has specifically explored the properties of the metabolic network in apolipoprotein E (APOE) ε4 allele carriers. In our study, all the subjects, including ADs, MCIs and NCs (normal controls) were divided into 165 APOE ε4 carriers and 165 APOE ε4 noncarriers. To establish the metabolic network for all brain regions except the cerebellum, cerebral glucose metabolism data obtained from FDG-PET (18F-fluorodeoxyglucose positron emission tomography) were segmented into 90 areas with automated anatomical labeling (AAL) template. Then, the properties of the networks were computed to explore the between-group differences. Our results suggested that both APOE ε4 carriers and noncarriers showed the small-world properties. Besides, compared with APOE ε4 noncarriers, the carriers showed a lower clustering coefficient. In addition, significant changes in 6 hub brain regions were found in between-group nodal centrality. Namely, compared with APOE ε4 noncarriers, significant decreases of the nodal centrality were found in left insula, right insula, right anterior cingulate, right paracingulate gyri, left cuneus, as well as significant increases in left paracentral lobule and left heschl gyrus in APOE ε4 carriers. Increased local short distance interregional correlations and disrupted long distance interregional correlations were found, which may support the point that the APOE ε4 carriers were more similar with AD or MCI in FDG uptake. In summary, the organization of metabolic network in APOE ε4 carriers indicated a less optimal pattern and APOE ε4 might be a risk factor for AD. PMID:26161964

  3. A FDG-PET Study of Metabolic Networks in Apolipoprotein E ε4 Allele Carriers

    PubMed Central

    Yao, Zhijun; Hu, Bin; Zheng, Jiaxiang; Zheng, Weihao; Chen, Xuejiao; Gao, Xiang; Xie, Yuanwei; Fang, Lei

    2015-01-01

    Recently, some studies have applied the graph theory in brain network analysis in Alzheimer's disease (AD) and Mild Cognitive Impairment (MCI). However, relatively little research has specifically explored the properties of the metabolic network in apolipoprotein E (APOE) ε4 allele carriers. In our study, all the subjects, including ADs, MCIs and NCs (normal controls) were divided into 165 APOE ε4 carriers and 165 APOE ε4 noncarriers. To establish the metabolic network for all brain regions except the cerebellum, cerebral glucose metabolism data obtained from FDG-PET (18F-fluorodeoxyglu-cose positron emission tomography) were segmented into 90 areas with automated anatomical labeling (AAL) template. Then, the properties of the networks were computed to explore the between-group differences. Our results suggested that both APOE ε4 carriers and noncarriers showed the small-world properties. Besides, compared with APOE ε4 noncarriers, the carriers showed a lower clustering coefficient. In addition, significant changes in 6 hub brain regions were found in between-group nodal centrality. Namely, compared with APOE ε4 noncarriers, significant decreases of the nodal centrality were found in left insula, right insula, right anterior cingulate, right paracingulate gyri, left cuneus, as well as significant increases in left paracentral lobule and left heschl gyrus in APOE ε4 carriers. Increased local short distance interregional correlations and disrupted long distance interregional correlations were found, which may support the point that the APOE ε4 carriers were more similar with AD or MCI in FDG uptake. In summary, the organization of metabolic network in APOE ε4 carriers indicated a less optimal pattern and APOE ε4 might be a risk factor for AD. PMID:26161964

  4. Assessment of outcomes with delayed 18F-FDG PET-CT response assessment in head and neck squamous cell carcinoma

    PubMed Central

    Slevin, F; Subesinghe, M; Ramasamy, S; Sen, M; Scarsbrook, A F

    2015-01-01

    Objective: To assess the accuracy of a 4-month post-(chemo)radiotherapy 18-fludeoxyglucose (18F-FDG) positron emission tomography (PET)-CT for head and neck squamous cell carcinoma (HNSCC). Methods: 105 patients who underwent a baseline and response assessment 18F-FDG PET-CT scan between 2008 and April 2013 were identified. 18F-FDG PET-CT outcomes were analysed with reference to clinicopathological outcomes. Results: 79 of 105 (75%) 18F-FDG PET-CT scans demonstrated a complete metabolic response; 19 of 101 (19%) for assessable primary tumours were positive; and 19 of 93 (20%) for patients with nodal disease were equivocal (n = 10) or positive (n = 9). The sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) for primary and nodal disease were 90%, 89%, 47%, 99% and 91%, 89%, 53% and 99%, respectively. Eight of nine patients with a positive nodal response scan had clinicopathological evidence of residual nodal disease (PPV, 89%). 2 of 10 patients with equivocal nodal responses had clinicopathological evidence of residual nodal disease (PPV, 20%). Conclusion: 18F-FDG PET-CT 4 months post treatment has a very high NPV. A positive 18F-FDG PET-CT has a high PPV for residual nodal disease. By contrast, patients who have an equivocal nodal response have a low PPV. Advances in knowledge: Response assessment 18F-FDG PET-CT is a valuable tool in guiding the selective use of neck dissection following (chemo)radiotherapy for HNSCC. An equivocal lymph node response has a limited predictive value for persistent disease, and optimal management remains a clinical challenge. PMID:26081447

  5. Monitoring Afatinib Treatment in HER2-Positive Gastric Cancer with 18F-FDG and 89Zr-Trastuzumab PET

    PubMed Central

    Janjigian, Yelena Y.; Viola-Villegas, Nerissa; Holland, Jason P.; Divilov, Vadim; Carlin, Sean D.; Gomes-DaGama, Erica M.; Chiosis, Gabriela; Carbonetti, Gregory; de Stanchina, Elisa; Lewis, Jason S.

    2016-01-01

    We evaluated the ability of the PET imaging agent 89Zr-trastuzumab to delineate HER2-positive gastric cancer and to monitor the pharmacodynamic effects of the epidermal growth factor receptor (EGFR)/human epidermal growth factor receptor 2 (HER2) tyrosine kinase inhibitor afatinib. Methods Using 89Zr-trastuzumab, 18F-FDG, or 3′-deoxy-3′-18F-fluorothymidine (18F-FLT PET), we imaged HER2-positive NCI-N87 and HER2-negative MKN74 gastric cancer xenografts in mice. Next, we examined the pharmacodynamic effects of afatinib in NCI-N87 xenografts using 89Zr-trastuzumab and 18F-FDG PET and comparing imaging results to changes in tumor size and in protein expression as monitored by Western blot and histologic studies. Results Although 18F-FDG uptake in NCI-N87 tumors did not change, a decrease in 89Zr-trastuzumab uptake was observed in the afatinib-treated versus control groups (3.0 ± 0.0 percentage injected dose per gram (%ID/g) vs. 21.0 ± 3.4%ID/g, respectively; P < 0.05). 89Zr-trastuzumab PET results corresponded with tumor reduction, apoptosis, and downregulation of HER2 observed on treatment with afatinib. Downregulation of total HER2, phosphorylated (p)-HER2, and p-EGFR occurred within 24 h of the first dose of afatinib, with a sustained effect over 21 d of treatment. Conclusion Afatinib demonstrated antitumor activity in HER2-positive gastric cancer in vivo. 89Zr-trastuzumab PET specifically delineated HER2-positive gastric cancer and can be used to measure the pharmacodynamic effects of afatinib. PMID:23578997

  6. Prognostic value of interim 18F-FDG PET/CT in diffuse large B-cell lymphoma

    PubMed Central

    Ying, Zhitao; Wang, Xuejuan; Song, Yuqin; Zheng, Wen; Wang, Xiaopei; Xie, Yan; Lin, Ningjing; Tu, Meifeng; Ping, Lingyan; Liu, Weiping; Deng, Lijuan; Zhang, Chen; Yang, Zhi

    2013-01-01

    Objective Diffuse large B-cell lymphoma (DLBCL) is a heterogeneous disease. The prognostic factor currently used is not accurate enough to predict the outcomes of patients with DLBCL. The prognostic significance of interim PET/CT in DLBCL remains controversial. The aim of this study is to determine the predictive value of interim 18F-FDG PET/CT after first-line treatment in patients with DLBCL. Methods Thirty-two patients with DLBCL underwent baseline, interim and post-treatment 18F-FDG PET/CT scans. Imaging results were analyzed for the survival of patients via software SPSS 13.0, retrospectively. Results Thirty-one of the 32 patients were treated with R-CHOP regimen, and interim 18F-FDG PET/CT of 24 patients was performed after 2 cycles of treatment. After a median follow-up period of 16.7 months, the 2-year progression-free survival (PFS) rates were significantly different between the groups above and below SUVmax cut-off value of 2.5 (P=0.039). No significant differences were found in the 2-year PFS rates if SUVmax cut-off values were set as 2.0 and 3.0, respectively (P=0.360; P=0.113). Conclusions Interim PET/CT could predict the prognosis of DLBCL patients with the SUVmax cut-off value of 2.5, but more clinical data should be concluded to confirm this conclusion. Key Words Fludeoxyglucose F18; lymphoma; large cell; diffuse; prognosis; standard utility value PMID:23372347

  7. Evaluation of muscle metabolic activity in the lower limb of a transfemoral amputee using a prosthesis by using (18)F-FDG PET imaging--an application of PET imaging to rehabilitation.

    PubMed

    Shinozaki, Tetsuya; Suzuki, Keiko; Yamaji, Takehiko; Ichikawa, Akihiro; Inoue, Tomio; Takagishi, Kenji; Endo, Keigo

    2004-07-01

    This study used FDG PET to evaluate the lower limb muscles metabolic activities of transfemoral amputees during walking with prostheses. As a preliminary study, FDG PET was applied for two normal adult volunteers to evaluate muscle activity in the lower extremities after gait exercise. This same method was applied for two amputee volunteers with prostheses. We found that FDG accumulated more in both gluteus medius muscles after gait exercise compared to other muscles in normal adult volunteers. In the skilled amputee volunteer, FDG uptake increased in the adductor and gluteus medius in the amputated side, while in the unskilled the adductor, gluteus maximus, and gluteus medius showed increased FDG uptake only in the normal side. This result suggests that basic metabolic changes such as an increase in oxidative metabolism and less reliance on glycolytic activity would occur as a result of skeletal muscle training in amputees. PMID:15183449

  8. Relation Between F-18 FDG Uptake of PET/CT and BRAFV600E Mutation in Papillary Thyroid Cancer

    PubMed Central

    Yoon, Seokho; An, Young-Sil; Lee, Su Jin; So, Eu Young; Kim, Jang-Hee; Chung, Yoon-Sok; Yoon, Joon-Kee

    2015-01-01

    Abstract BRAFV600E mutation and F-18 fluorodeoxyglucose (FDG) uptake are potential prognostic factors of papillary thyroid cancer (PTC). This study was performed to investigate the relationship between the BRAFV600E mutation and F-18 FDG uptake in PTC. We retrospectively included 169 PTC patients who underwent F-18 FDG positron emission tomography/computed tomography (PET/CT) before thyroidectomy from May 2009 to August 2012. Subjects were classified into overt PTC (>1 cm, n = 76) and papillary thyroid microcarcinoma (PTMC, n = 93) groups. Univariate and multivariate analyses were performed to assess the relationship between maximum standardized uptake value (SUVmax) of the primary tumors and clinicopathologic variables. The BRAFV600E mutation was detected in 82.2% (139/169). In all subjects, the BRAFV600E mutation and tumor size were independently related to SUVmax by multivariate analysis (P = 0.048 and P < 0.001, respectively). SUVmax was significantly higher in tumors with the BRAFV600E mutation than in those with wild-type BRAF (9.4 ± 10.9 vs 5.0 ± 4.1, P < 0.001). Similarly, in overt PTC group, the BRAFV600E mutation and tumor size were independently correlated with SUVmax (P = 0.032 and P = 0.001, respectively). By contrast, in PTMC group, only tumor size was significantly associated with SUVmax (P = 0.010). The presence of the BRAFV600E mutation is independently associated with high F-18 FDG uptake on preoperative PET/CT in patients with overt PTC, but this relationship was not evident in PTMC. This study provides a better understanding of the relationship between F-18 FDG uptake and BRAFV600E mutation in patients with PTC. PMID:26632889

  9. Effectiveness of Breast MRI and 18F-FDG PET/CT for the Preoperative Staging of Invasive Lobular Carcinoma versus Ductal Carcinoma

    PubMed Central

    Jung, Na Young; Kim, Sung Hun; Seo, Ye Young; Oh, Jin Kyoung; Choi, Hyun Su; You, Won Jong

    2015-01-01

    Purpose We evaluated the utility of magnetic resonance imaging (MRI) and 18F-fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG PET/CT) for the preoperative staging of invasive lobular carcinoma (ILC) of the breast and compared the results with those of invasive ductal carcinoma (IDC). Methods The study included pathologically proven 32 ILCs and 73 IDCs. We compared clinical and histopathological characteristics and the diagnostic performances of MRI and 18F-FDG PET/CT for the primary mass, additional ipsilateral and/or contralateral lesion(s), and axillary lymph node metastasis between the ILC and IDC groups. Results Primary ILCs were greater in size, but demonstrated lower maximum standardized uptake values than IDCs. All primary masses were detected on MRI. The detection rate for ILCs (75.0%) was lower than that for IDCs (83.6%) on 18F-FDG PET/CT, but the difference was not significant. For additional ipsilateral lesion(s), the sensitivities and specificities of MRI were 87.5% and 58.3% for ILC and 100.0% and 66.7% for IDC, respectively; whereas the sensitivities and specificities of 18F-FDG PET/CT were 0% and 91.7% for ILC and 37.5% and 94.7% for IDC, respectively. The sensitivity of 18F-FDG PET/CT for ipsilateral lesion(s) was significantly lower in the ILC group than the IDC group. The sensitivity for ipsilateral lesion(s) was significantly higher with MRI; however, specificity was higher with 18F-FDG PET/CT in both tumor groups. There was no significant difference in the diagnostic performance for additional contralateral lesion(s) or axillary lymph node metastasis on MRI or 18F-FDG PET/CT for ILC versus IDC. Conclusion The MRI and 18F-FDG PET/CT detection rates for the primary cancer do not differ between the ILC and IDC groups. Although 18F-FDG PET/CT demonstrates lower sensitivity for primary and additional ipsilateral lesions, it shows higher specificity for additional ipsilateral lesions, and could play a complementary role in

  10. A radiomics model from joint FDG-PET and MRI texture features for the prediction of lung metastases in soft-tissue sarcomas of the extremities

    NASA Astrophysics Data System (ADS)

    Vallières, M.; Freeman, C. R.; Skamene, S. R.; El Naqa, I.

    2015-07-01

    This study aims at developing a joint FDG-PET and MRI texture-based model for the early evaluation of lung metastasis risk in soft-tissue sarcomas (STSs). We investigate if the creation of new composite textures from the combination of FDG-PET and MR imaging information could better identify aggressive tumours. Towards this goal, a cohort of 51 patients with histologically proven STSs of the extremities was retrospectively evaluated. All patients had pre-treatment FDG-PET and MRI scans comprised of T1-weighted and T2-weighted fat-suppression sequences (T2FS). Nine non-texture features (SUV metrics and shape features) and forty-one texture features were extracted from the tumour region of separate (FDG-PET, T1 and T2FS) and fused (FDG-PET/T1 and FDG-PET/T2FS) scans. Volume fusion of the FDG-PET and MRI scans was implemented using the wavelet transform. The influence of six different extraction parameters on the predictive value of textures was investigated. The incorporation of features into multivariable models was performed using logistic regression. The multivariable modeling strategy involved imbalance-adjusted bootstrap resampling in the following four steps leading to final prediction model construction: (1) feature set reduction; (2) feature selection; (3) prediction performance estimation; and (4) computation of model coefficients. Univariate analysis showed that the isotropic voxel size at which texture features were extracted had the most impact on predictive value. In multivariable analysis, texture features extracted from fused scans significantly outperformed those from separate scans in terms of lung metastases prediction estimates. The best performance was obtained using a combination of four texture features extracted from FDG-PET/T1 and FDG-PET/T2FS scans. This model reached an area under the receiver-operating characteristic curve of 0.984 ± 0.002, a sensitivity of 0.955 ± 0.006, and a specificity of 0.926 ± 0.004 in bootstrapping

  11. A radiomics model from joint FDG-PET and MRI texture features for the prediction of lung metastases in soft-tissue sarcomas of the extremities.

    PubMed

    Vallières, M; Freeman, C R; Skamene, S R; El Naqa, I

    2015-07-21

    This study aims at developing a joint FDG-PET and MRI texture-based model for the early evaluation of lung metastasis risk in soft-tissue sarcomas (STSs). We investigate if the creation of new composite textures from the combination of FDG-PET and MR imaging information could better identify aggressive tumours. Towards this goal, a cohort of 51 patients with histologically proven STSs of the extremities was retrospectively evaluated. All patients had pre-treatment FDG-PET and MRI scans comprised of T1-weighted and T2-weighted fat-suppression sequences (T2FS). Nine non-texture features (SUV metrics and shape features) and forty-one texture features were extracted from the tumour region of separate (FDG-PET, T1 and T2FS) and fused (FDG-PET/T1 and FDG-PET/T2FS) scans. Volume fusion of the FDG-PET and MRI scans was implemented using the wavelet transform. The influence of six different extraction parameters on the predictive value of textures was investigated. The incorporation of features into multivariable models was performed using logistic regression. The multivariable modeling strategy involved imbalance-adjusted bootstrap resampling in the following four steps leading to final prediction model construction: (1) feature set reduction; (2) feature selection; (3) prediction performance estimation; and (4) computation of model coefficients. Univariate analysis showed that the isotropic voxel size at which texture features were extracted had the most impact on predictive value. In multivariable analysis, texture features extracted from fused scans significantly outperformed those from separate scans in terms of lung metastases prediction estimates. The best performance was obtained using a combination of four texture features extracted from FDG-PET/T1 and FDG-PET/T2FS scans. This model reached an area under the receiver-operating characteristic curve of 0.984 ± 0.002, a sensitivity of 0.955 ± 0.006, and a specificity of 0.926 ± 0.004 in bootstrapping

  12. The role of early 18F-FDG PET/CT in therapeutic management and ongoing risk stratification of high/intermediate-risk thyroid carcinoma.

    PubMed

    Triviño Ibáñez, E M; Muros, M A; Torres Vela, E; Llamas Elvira, J M

    2016-03-01

    Little is known about the role in ongoing risk stratification of fluorine-18-fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG PET/CT) performed early after radioactive iodine (RAI) ablation in differentiated thyroid carcinoma (DTC). The aim of the study is to investigate whether 18F-FDG PET/CT performed early after RAI ablation is useful to detect disease and to influence therapy and ongoing risk stratification. Patients with high/intermediate risk of recurrent DTC were included. 18F-FDG PET/CT scan was performed within 6 months after RAI ablation. We confirmed results with other imaging techniques, pathology reports, or follow-up. We classified the patient response as excellent, acceptable, or incomplete. Modified Hicks criteria were used to evaluate clinical impact. We included 81 patients with high/intermediate risk of recurrent DTC. Forty-one (50.6 %) had positive uptake in 18F-FDG PET/CT, with negative (131)I whole-body scan ((131)I WBS). Sensitivity, specificity, and diagnostic accuracy of 18F-FDG PET/CT were 92.5, 90.2, and 91.4 %, respectively. 18F-FDG PET/CT results had an impact on therapy in 38.3 % of patients. One year after initial therapy, 45.7 % showed excellent response, 8.6 % acceptable response, and 45.7 % incomplete response. A statistically significant relationship was found between negative 18F-FDG PET/CT and excellent response (80 vs. 12.2 %, p < 0.001; OR 52.8). 18F-FDG PET/CT scan performed early in surveillance of patients with high/intermediate-risk thyroid carcinoma provides important additional information not available with conventional follow-up methods and had a high impact on therapy. A negative 18F-FDG PET/CT predicts an excellent response to therapy in the new ongoing risk stratification. PMID:26224589

  13. Relationship between Tumor Heterogeneity Measured on FDG-PET/CT and Pathological Prognostic Factors in Invasive Breast Cancer

    PubMed Central

    Soussan, Michael; Orlhac, Fanny; Boubaya, Marouane; Zelek, Laurent; Ziol, Marianne; Eder, Véronique; Buvat, Irène

    2014-01-01

    Background There is currently little support to understand which pathological factors led to differences in tumor texture as measured from FDG PET/CT images. We studied whether tumor heterogeneity measured using texture analysis in FDG-PET/CT images is correlated with pathological prognostic factors in invasive breast cancer. Methods Fifty-four patients with locally advanced breast cancer who had an initial FDG-PET/CT were retrospectively included. In addition to SUVmax, three robust textural indices extracted from 3D matrices: High-Gray-level Run Emphasis (HGRE), Entropy and Homogeneity were studied. Univariate and multivariate logistic regression was used to identify PET parameters associated with poor prognosis pathological factors: hormone receptor negativity, presence of HER-2 and triple negative phenotype. Receiver operating characteristic (ROC) curves and the (AUC) analysis, and reclassification measures, were performed in order to evaluate the performance of combining texture analysis and SUVmax for characterizing breast tumors. Results Tumor heterogeneity, measured with HGRE, was higher in negative estrogen receptor (p = 0.039) and negative progesterone receptor tumors (p = 0.036), and in Scarff-Bloom-Richardson grade 3 tumors (p = 0.047). None of the PET indices could identify HER-2 positive tumors. Only SUVmax was positively correlated with Ki-67 (p<0.0004). Triple negative breast cancer (TNBC) exhibited higher SUVmax (Odd Ratio = 1.22, 95%CI [1.06–1.39],p = 0.004), lower Homogeneity (OR = 3.57[0.98–12.5],p = 0.05) and higher HGRE (OR = 8.06[1.88–34.51],p = 0.005) than non-TNBC. Multivariate analysis showed that HGRE remained associated with TNBC (OR = 5.27[1.12–1.38],p = 0.03) after adjustment for SUVmax. Combining SUVmax and HGRE yielded in higher area under the ROC curves (AUC) than SUVmax for identifying TNBC: AUC =  0.83 and 0.77, respectively. Probability of correct classification also

  14. Two-Time-Point FDG PET/CT: Liver SULmean Repeatability

    PubMed Central

    Tahari, Abdel K.; Paidpally, Vasavi; Chirindel, Alin; Wahl, Richard L.; Subramaniam, Rathan M.

    2016-01-01

    OBJECTIVE The purpose of this study was to evaluate the repeatability of liver mean standardized uptake value normalized to lean body mass (SULmean) in the same patients at different time points within the right lobe of the liver at 18F-FDG PET/CT, in a clinical setting. MATERIALS AND METHODS Two PET/CT studies performed on two different dates from each of 130 patients who had normal livers according to structural imaging were included in this reader study. The mean (± SD) length of time between the studies was 235 ± 192 days. SULmean was measured with a 30-mm diameter spherical volume of interest (VOI) placed within the right lobe of the liver (above, below, and at the level of the main portal vein) by two expert readers. ANOVA, intraclass correlation coefficient (ICC), and Bland-Altman analysis were performed. RESULTS The ICC for the first and second set of studies varied between 0.487 and 0.535 for reader 1 and between 0.472 and 0.545 for reader 2. The mean percentage variation for SULmean between the two time scans for the VOIs placed above, below, and at the level of the main portal vein were 3.55% ± 23.19%, 4.65% ± 23.87%, and 4.30% ± 23.03%, respectively, for reader 1 and 4.49% ± 23.23%, 4.33% ± 23.74%, and 4.48% ± 23.01%, respectively, for reader 2. Using 95% CI, the reference range for intrapatient variations between the studies in liver SULmean was −0.5 to 0.60. CONCLUSION There is only fair repeatability of liver SULmean measured between two time points in the same patient in a clinical setting. Scan-to-scan intrapatient variation in absolute liver SULmean was −0.5 to 0.60. PMID:25615764

  15. Central modulation in cluster headache patients treated with occipital nerve stimulation: an FDG-PET study

    PubMed Central

    2011-01-01

    Background Occipital nerve stimulation (ONS) has raised new hope for drug-resistant chronic cluster headache (drCCH), a devastating condition. However its mode of action remains elusive. Since the long delay to meaningful effect suggests that ONS induces slow neuromodulation, we have searched for changes in central pain-control areas using metabolic neuroimaging. Methods Ten drCCH patients underwent an 18FDG-PET scan after ONS, at delays varying between 0 and 30 months. All were scanned with ongoing ONS (ON) and with the stimulator switched OFF. Results After 6-30 months of ONS, 3 patients were pain free and 4 had a ≥ 90% reduction of attack frequency (responders). In all patients compared to controls, several areas of the pain matrix showed hypermetabolism: ipsilateral hypothalamus, midbrain and ipsilateral lower pons. All normalized after ONS, except for the hypothalamus. Switching the stimulator ON or OFF had little influence on brain glucose metabolism. The perigenual anterior cingulate cortex (PACC) was hyperactive in ONS responders compared to non-responders. Conclusions Metabolic normalization in the pain neuromatrix and lack of short-term changes induced by the stimulation might support the hypothesis that ONS acts in drCCH through slow neuromodulatory processes. Selective activation in responders of PACC, a pivotal structure in the endogenous opioid system, suggests that ONS could restore balance within dysfunctioning pain control centres. That ONS is nothing but a symptomatic treatment might be illustrated by the persistent hypothalamic hypermetabolism, which could explain why autonomic attacks may persist despite pain relief and why cluster attacks recur shortly after stimulator arrest. PET studies on larger samples are warranted to confirm these first results. PMID:21349186

  16. Polysplenia Syndrome With Splenic and Skeletal Muscle Metastases From Thyroid Carcinoma Evaluated by FDG PET/CT: Case Report and Literature Review: A Care-Compliant Article.

    PubMed

    Li, Zu-Gui; Lin, Zhi-Chun; Mu, Hai-Yu

    2016-01-01

    Polysplenia syndrome (PSS) is a rare congenital abnormality. Metastases to spleen and skeletal muscle from differentiated thyroid cancer (DTC) are also extremely rare. Our case report aims to present an interesting case of PSS associated with splenic metastasis (SM) and skeletal muscle metastasis (SMM) from advanced papillary thyroid carcinoma which was evaluated on fluorodeoxyglucose (FDG) positron emission tomography/computed tomography (PET/CT). An 84-year-old Chinese man was admitted with the history of multiple enlarged masses in bilateral neck, right axillary, and inguinal areas for >2 months. The results of ultrasonography examination were highly suggestive of malignancy. The histological results of the following biopsy were consistent with papillary thyroid carcinoma with involvement of multiple regional lymph nodes. He was referred for an FDG PET/CT imaging to evaluate the situation. FDG PET/CT showed that an intense FDG-avid thyroid mass with widespread regional lymph node involvement and distant metastases in the body. Unexpected sites of metastases were detected in the spleens and skeletal muscles. Most interestingly, FDG PET/CT imaging also described the typical imaging findings of PSS including the 2 right-sided spleens, azygos and hemiazygos continuation of inferior vena cava (IVC), right-sided stomach, middle line liver, a short pancreas, preduodenal portal vein (PPV), and malrotation of gut. Whole body FDG PET/CT imaging can accurately evaluate the situation of DTC by detecting regional lymph node involvement, common and rare sites of distant metastases which are closely related to staging, management, and prognosis of this disease. Whole-body FDG PET/CT is also valuable in demonstrating the typical imaging features of PSS. PMID:26825891

  17. Selecting radiomic features from FDG-PET images for cancer treatment outcome prediction.

    PubMed

    Lian, Chunfeng; Ruan, Su; Denœux, Thierry; Jardin, Fabrice; Vera, Pierre

    2016-08-01

    As a vital task in cancer therapy, accurately predicting the treatment outcome is valuable for tailoring and adapting a treatment planning. To this end, multi-sources of information (radiomics, clinical characteristics, genomic expressions, etc) gathered before and during treatment are potentially profitable. In this paper, we propose such a prediction system primarily using radiomic features (e.g., texture features) extracted from FDG-PET images. The proposed system includes a feature selection method based on Dempster-Shafer theory, a powerful tool to deal with uncertain and imprecise information. It aims to improve the prediction accuracy, and reduce the imprecision and overlaps between different classes (treatment outcomes) in a selected feature subspace. Considering that training samples are often small-sized and imbalanced in our applications, a data balancing procedure and specified prior knowledge are taken into account to improve the reliability of the selected feature subsets. Finally, the Evidential K-NN (EK-NN) classifier is used with selected features to output prediction results. Our prediction system has been evaluated by synthetic and clinical datasets, consistently showing good performance. PMID:27236221

  18. Age and sex differences in cerebral glucose consumption measured by pet using (18-F) fluorodeoxyglucose (FDG)

    SciTech Connect

    Duara, R.; Barker, W.; Chang, J.; Apicella, A.; Finn, R.; Gilson, A.

    1985-05-01

    Resting cerebral glucose metabolic rates (CMRglc) were measured in 23 subjects by PET using FDG. Subjects were divided into several groups (mean age +- S.D.) 5 young males (YM) (27 +- 6); 6 young females (YF)(33 +9); 5 elderly males (EM)(73 +- 5); 7 elderly females (EF)(69 +- 7). Additionally, from these groups 4 YM, 3YF, 5EM and 4EF were studied again within 6 weeks under identical conditions. CMRglc in the YF group again was significantly hider than YM (p 0.05). No obvious relationships of CMRglc to the phase of the menstrual cycle was found in this small group. There was a trend (p=0.06) toward a higher CMRglc in YF than EF. These results support the findings of higher CBF in YF versus YM. The differences between the results of Kuhl et al (J. Cereb. and a reduction of CMRglc with age was found in a mixed group of males and females (58and female), and where no age effect was found the males, are also resolved by these findings. The authors suggest that the apparent age effect, in females in this study, is principally a hormonal one.

  19. 18 FDG-PET/CT: 21st century approach to leukemic tumors in 124 cases.

    PubMed

    Cunningham, Isabel; Kohno, Brigett

    2016-06-01

    Extramedullary tumors remain an obstacle to curing more acute leukemia patients. Their incidence is unknown because the presence of occult tumors that contribute to relapse is not routinely sought as in other cancers. No standard approach exists for treating tumors at most sites, apparent clinical response is typically followed by further tumors, and achievement of lengthy remission is uncommon. Body scanning with (18) FDG PET/CT now provides a means to identify the extent of occult tumors that enables directed tumor eradication and a way to evaluate tumor response. To evaluate its potential benefits, analysis was undertaken of 124 published cases scanned after apparent tumors were diagnosed. Clinical and radiologic exams underestimated extent of disease in over half of 100 cases. Among 70 cases that reported scans after various treatments, 70% achieved negative scans. Half relapsed subsequently but disease-free survivals up to 6 years were documented. These reported cases add to our knowledge of extramedullary leukemia in showing that further tumors are more likely than marrow relapse, clinical and radiologic evaluation of response is inadequate, intensive chemotherapy alone generally does not prevent progression and is associated with significant mortality, and tumor-directed plus systemic therapies appears the most effective approach, particularly to AML tumors. This analysis suggests this technology could increase our ability to eradicate all foci of leukemia, and identify tumors responsible for refractory, residual, and relapsed disease. PMID:26718745

  20. [¹⁸F-FDG PET-CT in cytomegalovirus-induced mononucleosis].

    PubMed

    Banzo, J; Ubieto, M A; Prats, E; Razola, P; Tardin, L; Andrés, A; Santapau, A; Parra, A

    2010-01-01

    The case of a 51 years-old woman with high fever, asthenia and weight loss of three weeks of evolution is presented. She had a personal history of breast cancer and liver metastases. The physical examination showed small painless enlarged lymph nodes in both latero-cervical chains. The blood analysis showed 9200 leukocytes with 69% of lymphocytes and elevated liver enzymes. Serological determinations as well as repeated blood and urine culture were negatives, only the anti-CMV IgM determination being positive. The CEA tumor marker was slightly elevated. PET/CT demonstrated hypermetabolic enlarged lymph nodes in the bilateral cervical chains and in celiac region, hepatosplenomegaly and diffusely increased ¹⁸F-FDG uptake in the spleen. These alterations were associated with CMV infection. Her evolution was favorable, and she was diagnosed of CMV mononucleosis. The appropriate clinical and immunological diagnosis of IM in patients aged over 40 years is important to avoid unnecessary diagnostic procedures. PMID:20869792

  1. Novel assessment of global metabolism by 18F-FDG-PET for localizing affected lobe in temporal lobe epilepsy.

    PubMed

    Peter, Jonah; Houshmand, Sina; Werner, Thomas J; Rubello, Domenico; Alavi, Abass

    2016-08-01

    The aim of this study was to develop a novel method of global quantitative analysis for use in the diagnosis and treatment evaluation of temporal lobe epilepsy (TLE). We studied 16 patients diagnosed with TLE who underwent fluorine-18 fluorodeoxyglucose-PET (F-FDG-PET) and MRI at the Hospital of the University of Pennsylvania. To quantify temporal lobe hypometabolism, we averaged the mean standardized uptake value across regions of interest (ROIs) encompassing each lobe in its entirety and calculated the metabolic ratios and lateralization indices for each patient on the basis of global measurements. For comparison, we carried out a traditional 'punch biopsy' ROI analysis by averaging the mean standardized uptake value within 1 cm diameter ROIs across select slices. Both techniques were performed twice by the same rater to test intraobserver variability. An expert observer carried out visual analyses of both F-FDG-PET and MRI for reference. The global quantitative analysis identified a seizure focus lateralization in agreement with clinical evaluations for 91% of patients on both trials, with intraclass correlation coefficients of 0.97 and 0.92 for metabolic ratios and lateralization indices, respectively. The punch biopsy analysis was in agreement for 91 and 82% of patients on respective trials, with intraclass correlation coefficients of 0.90 and 0.75. Expert visual analyses carried out on F-FDG-PET and MRI were in agreement for 64 and 9% of patients, respectively. The global quantitative analysis proved to be the most accurate and reliable of the methods tested. This technique has the potential to improve metabolic analysis in TLE and other neuropsychiatric disorders. PMID:27092666

  2. 18F-FDG PET/CT for Monitoring Treatment Responses to the Epidermal Growth Factor Receptor Inhibitor Erlotinib

    PubMed Central

    Walter, Franziska; Garon, Edward B.; Reckamp, Karen L.; Figlin, Robert; Phelps, Michael E.; Weber, Wolfgang A.; Czernin, Johannes; Allen-Auerbach, Martin S.

    2016-01-01

    Response rates of unselected non–small cell lung cancer (NSCLC) patients to the epidermal growth factor receptor inhibitor erlotinib are low and range from 10% to 20%. Early response assessments are needed to avoid costs and side effects of inefficient treatments. Here we determined whether early changes in tumor uptake of 18F-FDG can predict progression-free and overall survival in NSCLC patients who are treated with erlotinib. Methods Twenty-two patients (6 men, 16 women; mean age ± SD, 64 ± 13 y) with stage III or stage IV NSCLC who received erlotinib treatment were enrolled prospectively. 18F-FDG PET/CT was performed before the initiation of treatment (n = 22), after 2 wk (n = 22), and after 78 ± 21 d (n = 11). Tumor maximum standardized uptake values were measured for a maximum of 5 lesions for each patient. Tumor responses were classified using modified PET Response Criteria in Solid Tumors (use of maximum standardized uptake values). Median overall survival by Kaplan–Meier analysis was compared between groups using a log-rank test. Results The overall median time to progression was 52 d (95% confidence interval, 47–57 d). The overall median survival time was 131 d (95% confidence interval, 0–351 d). Patients with progressive metabolic disease on early follow-up PET showed a significantly shorter time to progression (47 vs. 119 d; P < 0.001) and overall survival (87 vs. 828 d; P = 0.01) than patients classified as having stable metabolic disease or partial or complete metabolic response. Conclusion These data suggest that 18F-FDG PET/CT performed early after the start of erlotinib treatment can help to identify patients who benefit from this targeted therapy. PMID:22045706

  3. Preoperative Prediction of Cervical Lymph Node Metastasis Using Primary Tumor SUVmax on 18F-FDG PET/CT in Patients with Papillary Thyroid Carcinoma

    PubMed Central

    Jung, Ji-hoon; Kim, Choon-Young; Son, Seung Hyun; Kim, Do-Hoon; Jeong, Shin Young; Lee, Sang-Woo; Lee, Jaetae; Ahn, Byeong-Cheol

    2015-01-01

    Objectives The aim of the current study was to evaluate the value of preoperative 18F-FDG (FDG) PET/CT in predicting cervical lymph node (LN) metastasis in patients with papillary thyroid carcinoma (PTC). Methods One hundred and ninety-three newly diagnosed PTC patients (M: F = 25:168, age = 46.8 ± 12.2) who had undergone pretreatment FDG PET/CT and had neck node dissection were included in this study. The FDG avidity of the primary tumor and the SUVmax of the primary tumor (pSUVmax) were analyzed for prediction of LN metastasis. Detectability by ultrasonography (US) and FDG PET/CT for cervical LN metastasis were also assessed and compared with the pSUVmax. Results The FDG avidity of the primary tumor was identified in 118 patients (FDG avid group: 61.0%, M: F = 16:102, age 47.0 ± 12.7 years) and pSUVmax ranged from 1.3 to 35.6 (median 4.6) in the FDG avid group. The tumor size in the FDG avid group was bigger and there was a higher incidence of LN metastasis compared to the FDG non-avid group (0.93 vs. 0.59 cm, p <0.001 and 49.2 vs. 33.3%, p <0.05). In the FDG avid group, patients with LN metastasis had higher pSUVmax than patients without LN metastasis (8.7 ± 8.3 vs. 5.7 ± 5.1, p <0.001). The incidence of central LN metastasis in patients with a pSUVmax >4.6 was 54%; however, the detectability of central LN metastasis by US and FDG PET/CT were 10.3% and 3.6%, respectively. Conclusion A high FDG avidity of the primary tumor was related to LN metastasis in PTC patients. Therefore, patients with a high pSUVmax should be cautiously assessed for LN metastasis and might need a more comprehensive surgical approach. PMID:26636824

  4. The usefulness of F-18 FDG PET/CT-mammography for preoperative staging of breast cancer: comparison with conventional PET/CT and MR-mammography

    PubMed Central

    Moon, Eun-Ha; Lim, Seok Tae; Han, Yeon-Hee; Jeong, Young Jin; Kang, Yun-Hee; Jeong, Hwan-Jeong; Sohn, Myung-Hee

    2013-01-01

    Background The objective of the study was to compare the diagnostic efficacy of an integrated Fluorine-18 fluorodeoxyglucose (F-18 FDG) PET/CT-mammography (mammo-PET/CT) with conventional torso PET/CT (supine-PET/CT) and MR-mammography for initial assessment of breast cancer patients. Patients and methods Forty women (52.0 ± 12.0 years) with breast cancer who underwent supine-PET/CT, mammo-PET/CT, and MR-mammography from April 2009 to August 2009 were enrolled in the study. We compared the size of the tumour, tumour to chest wall distance, tumour to skin distance, volume of axillary fossa, and number of meta-static axillary lymph nodes between supine-PET/CT and mammo-PET/CT. Next, we assessed the difference of focality of primary breast tumour and tumour size in mammo-PET/CT and MR-mammography. Histopathologic findings served as the standard of reference. Results In the comparison between supine-PET/CT and mammo-PET/CT, significant differences were found in the tumour size (supine-PET/CT: 1.3 ± 0.6 cm, mammo-PET/CT: 1.5 ± 0.6 cm, p < 0.001), tumour to thoracic wall distance (1.8 ± 0.9 cm, 2.2 ± 2.1 cm, p < 0.001), and tumour to skin distance (1.5 ± 0.8 cm, 2.1 ± 1.4 cm, p < 0.001). The volume of axillary fossa was significantly wider in mammo-PET/CT than supine-PET/CT (21.7 ± 8.7 cm3 vs. 23.4 ± 10.4 cm3, p = 0.03). Mammo-PET/CT provided more correct definition of the T-stage of the primary tumour than did supine-PET/CT (72.5% vs. 67.5%). No significant difference was found in the number of metastatic axillary lymph nodes. Compared with MR-mammography, mammo-PET/CT provided more correct classification of the focality of lesion than did MR-mammography (95% vs. 90%). In the T-stage, 72.5% of cases with mammo-PET/CT and 70% of cases with MR-mammography showed correspondence with pathologic results. Conclusions Mammo-PET/CT provided more correct definition of the T-stage and evaluation of axillary fossa may also be delineated more clearly than with supine-PET

  5. Use of FDG-PET to detect a chronic odontogenic infection as a possible source of the brain abscess.

    PubMed

    Sato, Jun; Kuroshima, Takeshi; Wada, Mayumi; Satoh, Akira; Watanabe, Shiro; Okamoto, Shozo; Shiga, Tohru; Tamaki, Nagara; Kitagawa, Yoshimasa

    2016-05-01

    This study describes the use of (18)F-fluoro-2-deoxyglucose positron emission tomography (FDG-PET) to detect a chronic odontogenic infection as the possible origin of a brain abscess (BA). A 74-year-old man with esophageal carcinoma was referred to our department to determine the origin of a BA in his oral cavity. He had no acute odontogenic infections. The BA was drained, and bacteria of the Staphylococcus milleri group were detected. Whole body FDG-PET revealed that the only sites of definite uptake of FDG were the esophageal carcinoma and the left upper maxillary region (SUVmax: 4.5). These findings suggested that the BA may have originated from a chronic periodontal infection. Six teeth with progressive chronic periodontal disease were extracted to remove the possible source of BA. These findings excluded the possibility of direct spread of bacteria from the odontogenic infectious lesion to the intracranial cavity. After extraction, there was no relapse of BA. PMID:26497357

  6. Bilateral symmetrical adrenal hypermetabolism on FDG PET/CT due to Cushing syndrome in well differentiated neuroendocrine carcinoma.

    PubMed

    Aktas, G E; Soyluoglu Demir, S; Sarikaya, A

    2016-01-01

    The (18)F-FDG PET/CT scan has been suggested for whole-body imaging to identify ectopic adrenocorticotrophic hormone secreting tumours, but there are some challenges involved. The case of a patient is presented, who was admitted with the pre-diagnosis of ectopic ACTH syndrome. On the CT, a nodular lesion was detected in the medial segment of the right lung. The FDG uptake of the lesion seemed to be increased visually, but was not pathological quantitatively (SUVmax: 1.8) on the PET/CT. There was also diffuse increased uptake (SUVmax: 14.2) in the enlarged adrenal glands. The lesion was reported as a possible malignant lesion with low FDG affinity, such as a low grade neuroendocrine tumour, while the diffuse enlarged adrenal glands with high uptake were interpreted as diffusely hyperplasic, due to Cushing's syndrome. The patient was treated with a surgical wedge resection. The histopathological diagnosis confirmed that the tumour was a grade 1 well-differentiated neuroendocrine carcinoma. PMID:26522002

  7. Using 18F Fluorodeoxyglucose Positron Emission Tomography (FDG PET) to Monitor Clinical Outcomes in Patients Treated with Neoadjuvant Chemo-Radiotherapy for Locally Advanced Pancreatic Cancer

    PubMed Central

    Choi, Minsig; Heilbrun, Lance K.; Venkatramanamoorthy, Raghu; Lawhorn-Crews, Jawana M.; Zalupski, Mark M.; Shields, Anthony F.

    2013-01-01

    BACKGROUND Pancreatic cancer ranks as the fourth leading cause of cancer death in the United States with five year survival ranging from 1-5%. Positron emission tomography (PET) is a metabolic imaging system that is widely used for the initial staging of cancer and detecting residual disease after treatment. There are limited data, however, on the use of this molecular imaging technique to assess early tumor response after treatment in pancreatic cancer. METHODS The objective of the study was to explore the relationship of early treatment response using the 18 F- fluorodeoxyglucose (FDG) PET with surgical outcome and overall survival in patients with locally advanced pancreatic cancer. FDG-PET measurements of maximum standardized uptake value (SUV) and kinetic parameters were compared to the clinical outcome. RESULTS Twenty patients were enrolled in the study evaluating neoadjuvant induction chemotherapy followed by concurrent chemoradiotherapy (chemo-RT) for locally advanced pancreatic cancer. All twenty patients had pre-study PET scans and a total of fifty PET scans were performed. Among patients who were PET responders (≥50% decrease in SUV after cycle 1), 100% (2/2) had complete surgical resection. Only 6% (1/16) had surgical resection in the PET non-responders (<50% decrease). Two patients did not have the second PET scan due to clinical progression or treatment toxicity. Mean survival was 23.2 months for PET responders and 11.3 months for non-responders (p=0.234). Similar differences in survival were also noted when response was measured using Patlak analysis. CONCLUSION FDG-PET can aid in monitoring the clinical outcome of patients with locally advanced pancreatic cancer treated with neoadjuvant chemo-RT. FDG-PET may be used to aid patients who could have complete surgical resection as well as prognosticate patients’ survival. PMID:19806035

  8. ¹⁸F-FDG PET/CT and contrast enhanced CT in differential diagnosis between leiomyoma and gastrointestinal stromal tumor.

    PubMed

    Hirose, Yasumitus; Kaida, Hayato; Kawahara, Akihiko; Kurata, Seiji; Ishibashi, Masatoshi; Abe, Toshi

    2015-01-01

    In a 49 years old woman a large abdominal tumor was diagnosed by abdominal ultrasound. Dynamic contrast-enhanced computed tomography (CECT) showed a large tumor with minute calcification and poor contrast enhancement in the left abdominal cavity. The fluorine-18-fluorodeoxyglucose positron emission tomography/computed tomography (¹⁸F-FDG PET/CT) scan showed low ¹⁸F-FDG uptake in the tumor. The SUV max (early image) was 1.90, and that of the delayed image was 2.86. A gastrointestinal stromal tumor (GIST) was suspected. Tumor resection revealed that it was a leiomyoma originating in the major curvature of the stomach. In conclusion, the findings of low ¹⁸F-FDG uptake on ¹⁸F-FDG PET and poor contrast enhancement on CECT in a gastric submucosal tumor suggested of a gastric leiomyoma rather than GIST. PMID:26574696

  9. 18F-FDG PET/CT in diagnosis and response evaluation in an unusual case of antisynthetase syndrome presenting as pyrexia of unknown origin.

    PubMed

    Jain, T K; Basher, R K; Bhattacharya, A; Mittal, B R; Shukla, J; Prakash, M

    2016-01-01

    Anti-histidyl (Jo-1) antibodies have been implicated in the pathogenesis of anti-synthetase syndrome (ASS). A case is presented of a 55-year-old male patient presenting with pyrexia of unknown origin and inconclusive routine investigations. (18)F-FDG PET/CT was performed to locate any abnormal focus, which showed increased FDG uptake in the proximal shoulder muscles, as well as lung lesions. Subsequent investigation showed the presence of anti Jo-1 antibody, and diagnosed as an anti-synthetase syndrome. The patient was successfully treated with glucocorticoids and cyclophosphamide, and the response was assessed with symptomatic relief and disappearance of FDG uptake in lung and muscle lesions on post-treatment FDG PET/CT. PMID:26687469

  10. Comparison of prone versus supine 18F-FDG-PET of locally advanced breast cancer: Phantom and preliminary clinical studies

    SciTech Connect

    Williams, Jason M.; Rani, Sudheer D.; Li, Xia; Whisenant, Jennifer G.; Abramson, Richard G.; Arlinghaus, Lori R.; Lee, Tzu-Cheng; MacDonald, Lawrence R.; Partridge, Savannah C.; Kang, Hakmook; Linden, Hannah M.; Kinahan, Paul E.; Yankeelov, Thomas E.

    2015-07-15

    Purpose: Previous studies have demonstrated how imaging of the breast with patients lying prone using a supportive positioning device markedly facilitates longitudinal and/or multimodal image registration. In this contribution, the authors’ primary objective was to determine if there are differences in the standardized uptake value (SUV) derived from [{sup 18}F]fluorodeoxyglucose (18F-FDG) positron emission tomography (PET) in breast tumors imaged in the standard supine position and in the prone position using a specialized positioning device. Methods: A custom positioning device was constructed to allow for breast scanning in the prone position. Rigid and nonrigid phantom studies evaluated differences in prone and supine PET. Clinical studies comprised 18F-FDG-PET of 34 patients with locally advanced breast cancer imaged in the prone position (with the custom support) followed by imaging in the supine position (without the support). Mean and maximum values (SUV{sub peak} and SUV{sub max}, respectively) were obtained from tumor regions-of-interest for both positions. Prone and supine SUV were linearly corrected to account for the differences in 18F-FDG uptake time. Correlation, Bland–Altman, and nonparametric analyses were performed on uptake time-corrected and uncorrected data. Results: SUV from the rigid PET breast phantom imaged in the prone position with the support device was 1.9% lower than without the support device. In the nonrigid PET breast phantom, prone SUV with the support device was 5.0% lower than supine SUV without the support device. In patients, the median (range) difference in uptake time between prone and supine scans was 16.4 min (13.4–30.9 min), which was significantly—but not completely—reduced by the linear correction method. SUV{sub peak} and SUV{sub max} from prone versus supine scans were highly correlated, with concordance correlation coefficients of 0.91 and 0.90, respectively. Prone SUV{sub peak} and SUV{sub max} were

  11. Small animal radiotherapy research platforms

    NASA Astrophysics Data System (ADS)

    Verhaegen, Frank; Granton, Patrick; Tryggestad, Erik

    2011-06-01

    Advances in conformal radiation therapy and advancements in pre-clinical radiotherapy research have recently stimulated the development of precise micro-irradiators for small animals such as mice and rats. These devices are often kilovolt x-ray radiation sources combined with high-resolution CT imaging equipment for image guidance, as the latter allows precise and accurate beam positioning. This is similar to modern human radiotherapy practice. These devices are considered a major step forward compared to the current standard of animal experimentation in cancer radiobiology research. The availability of this novel equipment enables a wide variety of pre-clinical experiments on the synergy of radiation with other therapies, complex radiation schemes, sub-target boost studies, hypofractionated radiotherapy, contrast-enhanced radiotherapy and studies of relative biological effectiveness, to name just a few examples. In this review we discuss the required irradiation and imaging capabilities of small animal radiation research platforms. We describe the need for improved small animal radiotherapy research and highlight pioneering efforts, some of which led recently to commercially available prototypes. From this, it will be clear that much further development is still needed, on both the irradiation side and imaging side. We discuss at length the need for improved treatment planning tools for small animal platforms, and the current lack of a standard therein. Finally, we mention some recent experimental work using the early animal radiation research platforms, and the potential they offer for advancing radiobiology research.

  12. Response Assessment and Prediction in Esophageal Cancer Patients via F-18 FDG PET/CT Scans

    NASA Astrophysics Data System (ADS)

    Higgins, Kyle J.

    Purpose: The purpose of this study is to utilize F-18 FDG PET/CT scans to determine an indicator for the response of esophageal cancer patients during radiation therapy. There is a need for such an indicator since local failures are quite common in esophageal cancer patients despite modern treatment techniques. If an indicator is found, a patient's treatment strategy may be altered to possibly improve the outcome. This is investigated with various standard uptake volume (SUV) metrics along with image texture features. The metrics and features showing the most promise and indicating response are used in logistic regression analysis to find an equation for the prediction of response. Materials and Methods: 28 patients underwent F-18 FDG PET/CT scans prior to the start of radiation therapy (RT). A second PET/CT scan was administered following the delivery of ~32 Gray (Gy) of dose. A physician contoured gross tumor volume (GTV) was used to delineate a PET based GTV (GTV-pre-PET) based on a threshold of >40% and >20% of the maximum SUV value in the GTV. Deformable registration was used in VelocityAI software to register the pre-treatment and intra-treatment CT scans so that the GTV-pre-PET contours could be transferred from the pre to intra scans (GTV-intra-PET). The fractional decrease in the maximum, mean, volume to the highest intensity 10%-90%, and combination SUV metrics of the significant previous SUV metrics were compared to post-treatment pathologic response for an indication of response. Next for the >40% threshold, texture features based on a neighborhood gray-tone dimension matrix (NGTDM) were analyzed. The fractional decrease in coarseness, contrast, busyness, complexity, and texture strength were compared to the pathologic response of the patients. From these previous two types of analysis, SUV and texture features, the two most significant results were used in logistic regression analysis to find an equation to predict the probability of a non

  13. Design and evaluation of objective methods for analyzing hypometabolism from PET FDG brain images while taking into account finite resolution effects

    SciTech Connect

    Faber, T.L.; Galt, J.R.; Votaw, J.R. |

    1994-05-01

    Objective analyses of positron emission tomographic (PET) FDG brain metabolism studies are complicated by intersubject anatomical differences as well as finite resolution effects within patents. The goal of this study was to design and test techniques that could duplicate the diagnostic interpretation of PET FDG brain studies by clinicians. The clinicians had access to both PET and magnetic resonance images (MRI) of each patent and could discriminate physiological from anatomical effects. The methods create a predicted normal cortical metabolic (PM) image for each individual from his MRI. The PM is compared to actual count levels seen in the PET image. The PM incorporates resolution effects, but not physiological anomalies; the PET image incorporates both. Thus, comparisons between them should highlight physiological differences.

  14. A Solitary Metastasis for a Malignant Schwannoma in the Gallbladder Detected by 18F-FDG PET/CT.

    PubMed

    Evangelista, Laura; Burei, Marta; Basso, Umberto

    2016-08-01

    A 63-year-old woman with a history of malignant schwannoma in the left shoulder (pT1aNxMx) was treated with surgical resection in 2012. During follow-up, patient developed a metastasis in the right lung treated by further surgical intervention. For a suspicion on persistent disease in the lung, patient was sent to FDG PET/CT examination, which showed a focal uptake in the gallbladder. The patient underwent cholecystectomy, and a solitary metastasis from schwannoma was diagnosed by pathology. This case highlights that, in patients with a malignant schwannoma, a careful differential diagnosis should be made in case of a significant FDG uptake in the gallbladder. PMID:27280905

  15. 18F-FDG PET/CT Findings in Two Cases With Myelodysplastic Syndrome Accompanied by Behçet's Disease.

    PubMed

    Ito, Kimiteru; Kubota, Kazuo

    2016-08-01

    Recently, the co-occurrence of myelodysplastic syndrome (MDS) and Behçet's disease (BD) has been reported in association with trisomy 8 and HLA 51, with the pathology varying from vasculitis to acute neutrophilic inflammation. We report for the first time about imaging findings of F-fluorodeoxyglucose (FDG) positron emission/computed tomography (PET/CT) in 2 cases having MDS accompanied by BD. In these cases, 18 F-FDG PET/CT images clearly revealed high uptake by bone marrow in MDS and by genital aphthous or ileocecal ulcers in BD. F-FDG PET/CT may be the ideal modality for the detection of comorbidity of MDS and BD. PMID:26909715

  16. [18F-FDG PET/CT diagnosis of liver cyst infection in a patient with autosomal dominant polycystic kidney disease and fever of unknown origin].

    PubMed

    Banzo, J; Ubieto, M A; Gil, D; Prats, E; Razola, P; Tardín, L; Andrés, A; Rambalde, E F; Ayala, S M; Cáncer, L; Velilla, J

    2013-01-01

    The diagnosis, localization and treatment of infected cysts in the kidney or liver of patients with autosomal dominant polycystic kidney disease (ADPKD) remain a clinical challenge. We report the findings of (18)F-FDG PET-CT in an ADPKD diagnosed patient who required renal transplantation five years before and in his follow up presented repeated episodes of bacteriemia without known focus on radiological tests performed. The (18)F-FDG PET-CT scan showed numerous hypermetabolic images with focal or ring-shaped morphology related to the content and the wall of some hepatic cysts. The increased metabolic activity was localized on segments VI and VII. We proceeded to drainage of one cyst in segment VI, removing 110 cc of purulent fluid which grew E. Coli BLEE. The (18)F-FDG PET/CT scan should be included in the diagnostic algorithm for detecting infected liver cysts in patients with ADPKD and fever of unknown origin. PMID:23153986

  17. Anti-inflammatuar and anti-oxidative effects of Nigella sativa L.: 18FDG-PET imaging of inflammation.

    PubMed

    Entok, Emre; Ustuner, Mehmet Cengiz; Ozbayer, Cansu; Tekin, Neslihan; Akyuz, Fahrettin; Yangi, Berat; Kurt, Hulyam; Degirmenci, Irfan; Gunes, Hasan Veysi

    2014-05-01

    Inflammation has an important role in many diseases such as cystic fibrosis, allergies and cancer. The free radicals produced during inflammation, can induce gene mutations and posttranslational modifications of cancer related proteins. Nigella sativa L. (N. sativa) is herbaceous plant and commonly used as a natural food. It has many pharmacological effects including antibacterial, antifungal, antitumor, analgesic, antipyretic activity. The aim of this study was to investigate the anti-inflammatuar and anti-oxidant activity of N. sativa in acute inflammation. Thus we used the experimental lipopolysaccharides (LPS)-induced model. Intraperitoneal LPS 1 mg/kg was administered to groups. N. sativa (500 mg/kg) and essential oil (5 ml/kg) were given orally to treatment groups, after 24-h of intraperitoneal LPS-injection. To determine the lung inflammation, 18F-fluoro-deoxy-D-glucose (0.8 ml/kg) was administrated under the anesthesia before the 1 h of PET-scanning. After the FDG-PET, samples were collected. Lung and liver 18F-FDG-uptake was calculated. Serum AST, ALT, LDH and hcCRP levels were determined and liver, lung and erythrocyte SOD, MDA and CAT levels were measured. Liver and lung NO and DNA fragmentation levels were determined. MDA levels were decreased in treated inflammation groups whereas increased in untreated inflammation group. SOD and CAT activities in untreated inflammation group were significantly lower. According to the control group, increased AST and ALT levels were found in untreated inflammation group. 18F-FDG uptake of inflammation groups were increased when compare the control group. We found increased 18F-FDG uptake, DNA fragmentation and NO levels in LPS-induced inflammation groups. We conclude that, in LPS-induced inflammation, N. sativa have therapeutic and anti-oxidant effects. PMID:24474661

  18. Pre-Chemoradiotherapy FDG PET/CT cannot Identify Residual Metabolically-Active Volumes within Individual Esophageal Tumors

    PubMed Central

    Lu, W; Tan, S; Chen, W; Kligerman, S; Feigenberg, SJ; Zhang, H; Suntharalingam, M; Kang, M; D’Souza, WD

    2015-01-01

    Objective To study whether subvolumes with a high pre-chemoradiotherapy (CRT) FDG uptake could identify residual metabolically-active volumes (MAVs) post-CRT within individual esophageal tumors. Accurate identification will allow simultaneous integrated boost to these subvolumes at higher risk to improve clinical outcomes. Methods Twenty patients with esophageal cancer were treated with CRT plus surgery and underwent FDG PET/CT scans before and after CRT. The two scans were rigidly registered. Seven MAVs pre-CRT and four MAVs post-CRT within a tumor were defined with various SUV thresholds. The similarity and proximity between the MAVs pre-CRT and post-CRT were quantified with three metrics: fraction of post-CRT MAV included in pre-CRT MAV, volume overlap and centroid distance. Results Eight patients had no residual MAV. Six patients had local residual MAV (SUV ≥2.5 post-CRT) within or adjoining the original MAV (SUV ≥2.5 pre-CRT). On average, less than 65% of any post-CRT MAVs was included in any pre-CRT MAVs, with a low volume overlap <45%, and large centroid distance >8.6 mm. In general, subvolumes with higher FDG-uptake pre-CRT or post-CRT had lower volume overlap and larger centroid distance. Six patients had new distant MAVs that were determined to be inflammation from radiation therapy. Conclusions Pre-CRT PET/CT cannot reliably identify the residual MAVs within individual esophageal tumors. Simultaneous integrated boost to subvolumes with high FDG uptake pre-CRT may not be feasible. PMID:26594591

  19. Physiologic facial muscle uptake on 18F-FDG PET/CT by chewing-like habitual movement in patient with Sjögren syndrome.

    PubMed

    Lee, Dong Hyun; Yoon, Joon-Kee; Yoon, Seok-Ho; Lee, Su Jin; An, Young-Sil

    2015-03-01

    An 84-year-old female patient with known Sjögren syndrome underwent 18F-FDG PET/CT to detect recurrence of uterine cervix cancer. Sjögren syndrome is autoimmune disease that typically produces symptoms of dry mouth and eyes. We report a case of physiologic 18F-FDG uptake on facial muscles by chewing-like habitual movement, which was confused with salivary retention at first. The physiologic FDG uptake in oral cavity and facial muscles has to be reviewed carefully not to be confused with abnormal uptake. PMID:25608147

  20. Advanced [18F]FDG and [11C]flumazenil PET analysis for individual outcome prediction after temporal lobe epilepsy surgery for hippocampal sclerosis

    PubMed Central

    Yankam Njiwa, J.; Gray, K.R.; Costes, N.; Mauguiere, F.; Ryvlin, P.; Hammers, A.

    2014-01-01

    Purpose We have previously shown that an imaging marker, increased periventricular [11C]flumazenil ([11C]FMZ) binding, is associated with failure to become seizure free (SF) after surgery for temporal lobe epilepsy (TLE) with hippocampal sclerosis (HS). Here, we investigated whether increased preoperative periventricular white matter (WM) signal can be detected on clinical [18F]FDG-PET images. We then explored the potential of periventricular FDG WM increases, as well as whole-brain [11C]FMZ and [18F]FDG images analysed with random forest classifiers, for predicting surgery outcome. Methods Sixteen patients with MRI-defined HS had preoperative [18F]FDG and [11C]FMZ-PET. Fifty controls had [18F]FDG-PET (30), [11C]FMZ-PET (41), or both (21). Periventricular WM signal was analysed using Statistical Parametric Mapping (SPM8), and whole-brain image classification was performed using random forests implemented in R (http://www.r-project.org). Surgery outcome was predicted at the group and individual levels. Results At the group level, non-seizure free (NSF) versus SF patients had periventricular increases with both tracers. Against controls, NSF patients showed more prominent periventricular [11C]FMZ and [18F]FDG signal increases than SF patients. All differences were more marked for [11C]FMZ. For individuals, periventricular WM signal increases were seen at optimized thresholds in 5/8 NSF patients for both tracers. For SF patients, 1/8 showed periventricular signal increases for [11C]FMZ, and 4/8 for [18F]FDG. Hence, [18F]FDG had relatively poor sensitivity and specificity. Random forest classification accurately identified 7/8 SF and 7/8 NSF patients using [11C]FMZ images, but only 4/8 SF and 6/8 NSF patients with [18F]FDG. Conclusion This study extends the association between periventricular WM increases and NSF outcome to clinical [18F]FDG-PET, but only at the group level. Whole-brain random forest classification increases [11C]FMZ-PET's performance for predicting

  1. Variability of Gross Tumor Volume in Nasopharyngeal Carcinoma Using 11C-Choline and 18F-FDG PET/CT.

    PubMed

    Jiang, Jun; Wu, Hubing; Huang, Meiyan; Wu, Yao; Wang, Quanshi; Zhao, Jianqi; Yang, Wei; Chen, Wufan; Feng, Qianjin

    2015-01-01

    This study was conducted to evaluate the variability of gross tumor volume (GTV) using 11C-Choline and 18F-FDG PET/CT images for nasopharyngeal carcinomas boundary definition. Assessment consisted of inter-observer and inter-modality variation analysis. Four radiation oncologists were invited to manually contour GTV by using PET/CT fusion obtained from a cohort of 12 patients with nasopharyngeal carcinoma (NPC) and who underwent both 11C-Choline and 18F-FDG scans. Student's paired-sample t-test was performed for analyzing inter-observer and inter-modality variability. Semi-automatic segmentation methods, including thresholding and region growing, were also validated against the manual contouring of the two types of PET images. We observed no significant variation in the results obtained by different oncologists in terms of the same type of PET/CT volumes. Choline fusion volumes were significantly larger than the FDG volumes (p < 0.0001, mean ± SD = 18.21 ± 8.19). While significantly consistent results were obtained between the oncologists and the standard references in Choline volumes compared with those in FDG volumes (p = 0.0025). Simple semi-automatic delineation methods indicated that 11C-Choline PET images could provide better results than FDG volumes (p = 0.076, CI = [-0.29, 0.025]). 11C-Choline PET/CT may be more advantageous in GTV delineation for the radiotherapy of NPC than 18F-FDG. Phantom simulations and clinical trials should be conducted to prove the possible improvement of the treatment outcome. PMID:26161910

  2. Role of (18)F-FDG PET-CT in Monitoring the Cyclophosphamide Induced Pulmonary Toxicity in Patients with Breast Cancer - 2 Case Reports.

    PubMed

    Taywade, Sameer Kamalakar; Kumar, Rakesh; Bhethanabhotla, Sainath; Bal, Chandrasekhar

    2016-09-01

    Drug induced pulmonary toxicity is not uncommon with the use of various chemotherapeutic agents. Cyclophosphamide is a widely used chemotherapeutic drug in the treatment of breast cancer. Although rare, lung toxicity has been reported with cyclophosphamide use. Detection of bleomycin induced pulmonary toxicity and pattern of (18)F-fluorodeoxyglucose ((18)F-FDG) uptake in lungs on fluorodeoxyglucose positron emission tomography-computed tomography ((18)F-FDG PET-CT) has been elicited in literature in relation to lymphoma. However, limited data is available regarding the role of (18)F-FDG PET-CT in monitoring drug induced pulmonary toxicity in breast cancer. We here present two cases of cyclophosphamide induced drug toxicity. Interim (18)F-FDG PET-CT demonstrated diffusely increased tracer uptake in bilateral lung fields in both these patients. Subsequently there was resolution of lung uptake on (18)F-FDG PET-CT scan post completion of chemotherapy. These patients did not develop significant respiratory symptoms during chemotherapy treatment and in follow up. PMID:27540432

  3. Statistical Voxel-Based Methods and [18F]FDG PET Brain Imaging: Frontiers for the Diagnosis of AD.

    PubMed

    Gallivanone, Francesca; Della Rosa, Pasquale Anthony; Castiglioni, Isabella

    2016-01-01

    Recommended guidelines for the diagnosis of dementia due to Alzheimer's Disease (AD) were revised in recent years, including Positron Emission Tomography (PET) as an in-vivo diagnostic imaging technique for the diagnosis of neurodegeneration. In particular PET, using 18Ffluorodeoxiglucouse ([18F]FDG), is able to detect very early changes of glucose consumption at the synaptic level, enabling to support both early and differential diagnosis of AD. In standard clinical practice, interpretation of [18F] FDG-PET images is usually achieved through qualitative assessment. Visual inspection although only reveals information visible at human eyes resolution, while information at a higher resolution is missed. Furthermore, qualitative assessment depends on the degree of expertise of the clinician, preventing from the definition of accurate and standardized imaging biomarkers. Automated and computerized image processing methods have been proposed to support the in-vivo assessment of brain PET studies. In particular, objective statistical image analyses, enabling the comparison of one patient's images to a group of control images have been shown to carry important advantages for detecting significant metabolic changes, including the availability of more objective, cross-center reliable metrics and the detectability of brain subtle functional changes, as occurring in prodromal AD. The purpose of the current review is to provide a systematic overview encompassing the frontiers recently reached by quantitative approaches for the statistical analysis of PET brain images in the study of AD, with a particular focus on Statistical Parametric Mapping. Main achievements, e.g. in terms of standardized biomarkers of AD as well as of sensitivity and specificity, will be discussed. PMID:26567733

  4. Kinetic quantitation of cerebral PET-FDG studies without concurrent blood sampling: statistical recovery of the arterial input function.

    PubMed

    O'Sullivan, F; Kirrane, J; Muzi, M; O'Sullivan, J N; Spence, A M; Mankoff, D A; Krohn, K A

    2010-03-01

    Kinetic quantitation of dynamic positron emission tomography (PET) studies via compartmental modeling usually requires the time-course of the radio-tracer concentration in the arterial blood as an arterial input function (AIF). For human and animal imaging applications, significant practical difficulties are associated with direct arterial sampling and as a result there is substantial interest in alternative methods that require no blood sampling at the time of the study. A fixed population template input function derived from prior experience with directly sampled arterial curves is one possibility. Image-based extraction, including requisite adjustment for spillover and recovery, is another approach. The present work considers a hybrid statistical approach based on a penalty formulation in which the information derived from a priori studies is combined in a Bayesian manner with information contained in the sampled image data in order to obtain an input function estimate. The absolute scaling of the input is achieved by an empirical calibration equation involving the injected dose together with the subject's weight, height and gender. The technique is illustrated in the context of (18)F -Fluorodeoxyglucose (FDG) PET studies in humans. A collection of 79 arterially sampled FDG blood curves are used as a basis for a priori characterization of input function variability, including scaling characteristics. Data from a series of 12 dynamic cerebral FDG PET studies in normal subjects are used to evaluate the performance of the penalty-based AIF estimation technique. The focus of evaluations is on quantitation of FDG kinetics over a set of 10 regional brain structures. As well as the new method, a fixed population template AIF and a direct AIF estimate based on segmentation are also considered. Kinetics analyses resulting from these three AIFs are compared with those resulting from radially sampled AIFs. The proposed penalty-based AIF extraction method is found to

  5. [{sup 18}FDG] PET-CT-Based Intensity-Modulated Radiotherapy Treatment Planning of Head and Neck Cancer

    SciTech Connect

    El-Bassiouni, Mazen; Ciernik, I. Frank Davis, J. Bernard; El-Attar, Inas; Reiner, Beatrice; Burger, Cyrill; Goerres, Gerhard W.; Studer, Gabriela M.

    2007-09-01

    Purpose: To define the best threshold for tumor volume delineation of the (18) fluoro-2-deoxy-glucose positron emission tomography ({sup 18}FDG-PET) signal for radiotherapy treatment planning of intensity-modulated radiotherapy (IMRT) in head and neck cancer. Methods and Materials: In 25 patients with head-and-neck cancer, CT-based gross tumor volume (GTV{sub CT}) was delineated. After PET-CT image fusion, window level (L) was adapted to best fit the GTV{sub CT}, and GTV{sub PET} was delineated. Tumor maximum (S) and background uptake (B) were measured, and the threshold of the background-subtracted tumor maximum uptake (THR) was used for PET signal segmentation. Gross tumor volumes were expanded to planning target volumes (PTVs) and analyzed. Results: The mean value of S was 40 kBq/mL, S/B ratio was 16, and THR was 26%. The THR correlated with S (r = -0.752), but no correlation between THR and the S/B ratio was seen (r = -0.382). In 77% of cases, S was >30 kBq/mL, and in 23% it was {<=}30 kBq/mL, with a mean THR of 21.4% and 41.6%, respectively (p < 0.001). Using PTV{sub PET} in radiotherapy treatment planning resulted in a reduced PTV in 72% of cases, while covering 88.2% of GTV{sub CT}, comparable to the percentage of GTV{sub PET} covered by PTV{sub CT} (p = 0.15). Conclusions: A case-specific PET signal threshold is optimal in PET-based radiotherapy treatment planning. Signal gating using a THR of 20% in tumors with S >30% {+-} 1.6% kBq/mL and 40% in tumors with S {<=}30% {+-} 1.6% kBq/mL is suitable.

  6. Neurobehavioral Abnormalities in the HIV-1 Transgenic Rat Do Not Correspond to Neuronal Hypometabolism on 18F-FDG-PET

    PubMed Central

    Papadakis, Georgios Z.; Muthusamy, Siva; Lee, Dianne E.; Ibrahim, Wael G.; Nair, Anand; Koziol, Deloris; Maric, Dragan; Hammoud, Dima A.

    2016-01-01

    Motor and behavioral abnormalities are common presentations among individuals with HIV-1 associated neurocognitive disorders (HAND). We investigated whether longitudinal motor and behavioral performance in the HIV-1 transgenic rat (Tg), a commonly used neuro-HIV model, corresponded to in vivo neuronal death/dysfunction, by using rotarod and open field testing in parallel to [18F] 2-fluoro-2-deoxy-D-glucose (FDG) positron emission tomography (PET). We demonstrated that age-matched non-Tg wild type (WT) rats outperformed the HIV-1 Tg rats at most time points on rotarod testing. Habituation to rotarod occurred at 8 weeks of age (fifth weekly testing session) in the WT rats but it never occurred in the Tg rats, suggesting deficits in motor learning. Similarly, in open field testing, WT rats outperformed the Tg rats at most time points, suggesting defective exploratory/motor behavior and increased emotionality in the Tg rat. Despite the neurobehavioral abnormalities, there were no concomitant deficits in 18F-FDG uptake in Tg rats on PET compared to age-matched WT rats and no significant longitudinal loss of FDG uptake in either group. The negative PET findings were confirmed using 14C- Deoxy-D-glucose autoradiography in 32 week-old Tg and WT rats. We believe that the neuropathology in the HIV-1 Tg rat is more likely a consequence of neuronal dysfunction rather than overt neurodegeneration/neuronal cell death, similar to what is seen in HIV-positive patients in the post-ART era. PMID:27010205

  7. The diagnostic value of 18F-FDG-PET/CT in hematopoietic radiation toxicity: a Tibet minipig model.

    PubMed

    Chen, Chi; Yan, Li-Meng; Guo, Kun-Yuan; Wang, Yu-Jue; Zou, Fei; Gu, Wei-Wang; Tang, Hua; Li, Yan-Ling; Wu, Shao-Jie

    2012-07-01

    This study was undertaken to assess the diagnostic value of 2-[(18)F]-fluoro-2-deoxy-D-glucose positron emission tomography with computed tomography ([(18)F]-FDG-PET/CT) in the detection of radiation toxicity in normal bone marrow using Tibet minipigs as a model. Eighteen Tibet minipigs were caged in aseptic rooms and randomly divided into six groups. Five groups (n = 3/group) were irradiated with single doses of 2, 5, 8, 11 and 14 Gy of total body irradiation (TBI) using an 8-MV X-ray linear accelerator. These pigs were evaluated with [(18)F]-FDG-PET/CT, and their marrow nucleated cells were counted. The data were initially collected at 6, 24 and 72 h after treatment and were then collected on Days 5-60 post-TBI at 5-day intervals. At 24 and 72 h post-TBI, marrow standardized uptake value (SUV) data showed a dose-dependent decrease in the radiation dose range from 2-8 Gy. Upon long-term observation, SUV and marrow nucleated cell number in the 11-Gy and 14-Gy groups showed a continuous and marked reduction throughout the entire time course, while Kaplan-Meier curves of survival showed low survival. In contrast, the SUVs in the 2-, 5- and 8-Gy groups showed early transient increases followed by a decline from approximately 72 h through Days 5-15 and then normalized or maintained low levels through the endpoint; marrow nucleated cell number and survival curves showed approximately the same trend and higher survival, respectively. Our findings suggest that [(18)F]-FDG-PET/CT may be helpful in quickly assessing the absorbed doses and predicting the prognosis in patients. PMID:22843618

  8. Variance of Standardized Uptake Values for FDG-PET/CT Greater in Clinical Practice than Under Ideal Study Settings

    PubMed Central

    Kumar, Virendra; Nath, Kavindra; Berman, Claudia G.; Kim, Jongphil; Tanvetyanon, Tawee; Chiappori, Alberto A; Gatenby, Robert A.; Gillies, Robert J.; Eikman, Edward A.

    2012-01-01

    Purpose Measurement variance affects the clinical effectiveness of PET-based measurement as a semi-quantitative imaging biomarker for cancer response in individual patients and for planning clinical trials. In this study, we measured test-retest reproducibility of SUV measurements under clinical practice conditions, and recorded recognized deviations from protocol compliance. Methods Instrument performance calibration, display and analyses conformed to manufacture recommendations. Baseline clinical 2-deoxy-2-[F-18]fluoro-D-glucose (FDG)-PET/CT examinations were performed and then repeated at 1 – 7 days. Intended scan initiation uptake period was to repeat the examinations at the same time for each study after injection of 12 mCi FDG tracer. Avidity of uptake was measured in 62 tumors in 21 patients as standardized uptake value for maximum voxel (SUVmax) and for a mean of sampled tumor voxels (SUVmean). Results The range of SUVmax and SUVmean was 1.07–21.47 and 0.91–14.69, respectively. Intraclass correlation coefficient (ICC) between log of SUVmax and log of SUVmean was 0.93 (95% CI: 0.88–0.95) and 0.92 (95% CI: 0.87–0.95), respectively. Correlation analysis failed to show an effect on uptake period variation on SUV measurements between the two examinations, suggesting additional sources of noise. The threshold criteria for relative difference from baseline for the 95% confidence interval were ±49% or ±44% for SUVmax or SUVmean, respectively. Conclusion Variance of SUV for FDG-PET/CT in current clinical practice in a single institution was greater than expected when compared to benchmarks reported under stringent efficacy study settings. Under comparable clinical practice conditions, interpretation of changes in tumor avidity in individuals, and assumptions in planning clinical trials may be affected. PMID:23354032

  9. (18)F-FDG-PET imaging of rat spinal cord demonstrates altered glucose uptake acutely after contusion injury.

    PubMed

    von Leden, Ramona E; Selwyn, Reed G; Jaiswal, Shalini; Wilson, Colin M; Khayrullina, Guzal; Byrnes, Kimberly R

    2016-05-16