scholarly journals Traumatic myositis ossificans: multifocal lesions suggesting malignancy on FDG-PET/CT—a case report

2020 ◽  
Vol 50 (1) ◽  
pp. 249-254
Author(s):  
Miho Sasaki ◽  
Yuka Hotokezaka ◽  
Reiko Ideguchi ◽  
Masataka Uetani ◽  
Shuichi Fujita

AbstractMyositis ossificans (MO) is a benign soft-tissue lesion characterized by the heterotopic formation of the bone in skeletal muscles, usually due to trauma. MO is occasionally difficult to diagnose because of its clinical and radiological similarities with malignancy. We report a case of traumatic MO (TMO) in the masseter and brachial muscles of a 37-year-old man who presented with painless swelling in the left cheek and severe trismus. Due to the absence of a traumatic history at the first consultation and identification of a tumorous lesion in the left masseter muscle by magnetic resonance imaging (MRI), the lesion was suspected to be a malignant tumor. Subsequently, 18F-fluorodeoxyglucose positron-emission tomography/computed tomography (FDG-PET/CT) showed multiple regions of high FDG uptake across the whole body, suggestive of multiple metastases or other systemic diseases. However, intramuscular calcifications were also observed in the left masseter and brachial muscles, overlapping the areas with high FDG uptake. Moreover, multiple fractures were seen in the rib and lumbar spine, also overlapping the areas with high FDG uptake. Based on these imaging findings, along with a history of jet-ski trauma, TMO was suspected. The left cheek mass was surgically excised and histologically diagnosed as TMO. In this case report, FDG-PET/CT could detect multiple TMOs across the whole body. To the best of our knowledge, cases of multiple TMOs located far apart in different muscles are rare, and this may be the first report.

Author(s):  
Amal Ibrahim Ahmed Othman ◽  
Merhan Nasr ◽  
Moustafa Abdel-Kawi

Abstract Background The purpose of this study was to compare between contrast-enhanced computer tomography (CE CT) and 18F-FDG PET/CT in the detection of extranodal involvement in lymphoma and to correlate between SUVmax of the extranodal lesion and the hottest LN. One hundred patients with pathologically proven lymphoma underwent whole body 18F-FDG PET/CT and CECT scans. Images were compared regarding the ability of detection of extranodal lymphomatous sites. Kappa agreement was applied to find the degree of agreement between both modalities. Pearson’s correlation was used for correlating SUVmax of the extranodal lesions and hottest LN. The degree of FDG uptake was correlated with histopathological type. Results There was a poor agreement between PET/CT and CECT in the detection of extranodal sites (k = 0.32). There was a significant positive moderate correlation between SUVmax of the extranodal lesions and hottest LN (r = 0.45). PET/CT study resulted in up staging of 10% and down staging of 5% of cases. Conclusion In lymphoma staging, FDG PET/CT enables more detection of extranodal involved sites that show normal morphology at CECT. It differentiates lymphomatous infiltration from benign causes of increased FDG uptake with subsequent proper disease staging.


2021 ◽  
Vol 15 ◽  
Author(s):  
Rommani Mondal ◽  
Anthony-David Tawatao Campoy ◽  
Christopher Liang ◽  
Jogeshwar Mukherjee

Transgenic mice line M83 that express the A53T mutant α–synuclein protein at six times the level of endogenous mice α–synuclein are a model of α-synucleinopathy found in Parkinson’s disease (PD). This Hualpha-Syn (A53T) PD model is useful in assessing non-motor deficits at earlier stages of onset of PD. We report findings on metabolic changes using [18F]FDG PET/CT in the Hualpha-Syn (A53T) PD mouse model in comparison to non-carrier mice. Whole-body PET/CT imaging of male and female mice were carried out 2 h after [18F]FDG ip administration under 3% isoflurane anesthesia. Brain images were analyzed with PET images coregistered to a mouse brain MRI template. Hualpha-Syn (A53T) mice had significantly lower [18F]FDG uptake in several brain regions compared to the no-carrier mice. Significant hind limb muscle and lower spinal cord [18F]FDG hypometabolism at 9 months of age in A53T PD mice was also indicative of neurodegenerative disease, with a progressive motoric dysfunction leading to death. Significant decrease (up to 30%) in [18F]FDG uptake were observed in 9-month old male and female Hualpha-Syn (A53) mice. This is consistent with the cortical hypometabolism in PD patients. Hualpha-Syn (A53) mice may thus be a suitable model for studies related to PD α-synucleinopathy for the discovery of new biomarkers.


2019 ◽  
Vol 9 (3) ◽  
pp. 530-534
Author(s):  
Geetika Bhatt ◽  
Angita Jain ◽  
Aashish Bhatt ◽  
Ali Cahid Civelek

2019 ◽  
Vol 9 (1) ◽  
Author(s):  
Maria E. S. Takahashi ◽  
Camila Mosci ◽  
Edna M. Souza ◽  
Sérgio Q. Brunetto ◽  
Elba Etchebehere ◽  
...  

Abstract Many efforts have been made to standardize the interpretation of 18F-FDG PET/CT in multiple myeloma (MM) with qualitative visual analysis or with quantitative metabolic parameters using various methods for lesion segmentation of PET images. The aim of this study was to propose a quantitative method for bone and bone marrow evaluation of 18F-FDG PET/CT considering the extent and intensity of bone 18F-FDG uptake: Intensity of Bone Involvement (IBI). Whole body 18F-FDG PET/CT of 59 consecutive MM patients were evaluated. Compact bone tissue was segmented in PET images using a global threshold for HU of the registered CT image. A whole skeleton mask was created and the percentage of its volume with 18F-FDG uptake above hepatic uptake was calculated (Percentage of Bone Involvement - PBI). IBI was defined by multiplying PBI by mean SUV above hepatic uptake. IBI was compared with visual analysis performed by two experienced nuclear medicine physicians. IBI calculation was feasible in all images (range:0.00–1.35). Visual analysis categorized PET exams into three groups (negative/mild, moderate and marked bone involvement), that had different ranges of IBI (multi comparison analysis, p < 0.0001). There was an inverse correlation between the patients’ hemoglobin values and IBI (r = −0.248;p = 0.02). IBI score is an objective measure of bone and bone marrow involvement in MM, allowing the categorization of patients in different degrees of aggressiveness of the bone disease. The next step is to validate IBI in a larger group of patients, before and after treatment and in a multicentre setting.


2020 ◽  
Vol 13 (3) ◽  
pp. 243-248
Author(s):  
Marco Spadafora ◽  
Laura Evangelista ◽  
Salvatore Fiordoro ◽  
Francesco Porcaro ◽  
Marilena Sicignano ◽  
...  

Purpose: The Italian Tailored Assessment of Lung Indeterminate Accidental Nodule (ITALIAN) trial is a trial drawn to determine the performance of 18F-FDG-PET/CT in patients with solitary pulmonary nodules (SPN), stratified for a different kind of risk. An additional end-point was to compare the diagnostic information and estimated dosimetry, provided by a segmental PET/CT (s-PET/CT) acquisition instead of a whole body PET/CT (wb-PET/CT), in order to evaluate if segmental thoracic PET/CT can be used in patients with SPN. Methods: 18F-FDG PET/CT of 502 patients, stratified for pre-test cancer risk, was retrospectively analyzed. FDG uptake in SPN was assessed by a 4-point scoring (4PS) system and a semiquantitative analysis using the ratio between SUVmax in SPN and SUVmean in mediastinal blood pool (BP), and between SUVmax in SPN and SUVmean in the liver (L). Histopathology and/or follow-up data were used as a standard of reference. Data obtained on the thoracic part of wb-PET/CT, defined as s - PET/CT, were compared with those deriving from wb-PET/CT. Results: SPNs were malignant in 180 patients (36%), benign in 175 (35%), and indeterminate in 147 (29%). The 355 patients diagnosed with a definitive SPN nature (malignant or benign) were considered for the analysis of PET performance. Sensitivity, specificity, positive (PPV) and negative (NPV) predictive values, and accuracy were 85.6%, 85.7%, 86%, 85.2%, and 85.6%, respectively. Sensitivity and PPV were higher in intermediate and high-risk patients. : 18F-FDG uptake indicative of thoracic and extra-thoracic lesions was detectable in 13% and 3% of the patients. Compared to wb-PET/CT, s-PET/CT could save about 2/3 of 18F-FDG dose, radiation exposure or scan-time, without affecting the clinical impact of PET/CT. Conclusion: In patients with SPN, the pre-test likelihood of malignancy stratification allows to better define PET clinical setting and its diagnostic power. In subjects with low-intermediate pre-test likelihood of malignancy, s-PET/CT might be planned in advance. The adoption of this segmental strategy could reduce radiation exposure, scan-time, and might allow individually targeted protocols.


Diagnostics ◽  
2021 ◽  
Vol 11 (4) ◽  
pp. 672
Author(s):  
Naja Enevold Olsen ◽  
Marie Øbro Fosbøl ◽  
Jorgen Thorup ◽  
Helle Hjorth Johannesen ◽  
Lise Borgwardt

Eosinophilic cystitis (EC) is a relatively rare, but benign inflammatory bladder disease compared to that of the malignant pediatric rhabdomyosarcoma (RMS), in which it can be mimicking on initial suspicion. The origin, symptoms and findings of both EC and RMS are still discussed and hence, lead to the challenge in distinguishing them by cystoscopy and several image modalities. We present a case in which cross-sectional imaging modalities including fluorine-18-fluro-2-deoxy-D-glucose (18F-FDG)-positron emission tomography (PET) / computed tomography (CT) / magnetic resonance imaging (MRI) (18F-FDG-PET/CT/MRI (The imaging modality 18F-FDG-PET/CT/MRI referring to two continuous scans scanned on the same 18F-FDG-tracer dose for both the whole-body 18F-FDG-PET/CT and the regional 18F-FDG-PET/MRI of the pelvis.)) raised suspicion of RMS. Hence, the final diagnosis of EC was established by repeated histopathology. It is important to have EC in mind when seeking differential diagnosis of malignant diseases like RMS in order to provide the correct treatment for the patient and highly homogenously increased 18F-FDG-uptake should raise the suspicion of EC as a differential diagnosis. Furthermore, 18F-FDG-uptake rate is suggested as a future potential biomarker for monitoring of therapeutic response in eosinophilic inflammatory diseases, thus more research on this topic is needed.


2012 ◽  
Vol 2012 ◽  
pp. 1-4 ◽  
Author(s):  
L. I. Sonoda ◽  
B. Sanghera ◽  
W. L. Wong

Introduction.18F-FDG-PET-CT plays an important role in the management of lymphoma postchemotherapy followup. Some centres perform prechemotherapy baseline CT and postchemotherapy PETCT. With a concern of radiation burden, especially in young patients, this study aimed to assess if PETCT radiation dose could be reduced.Methods. Retrospective analysis of 100 lymphoma patients was performed to record sites of disease on prechemotherapy CT and postchemotherapy PETCT. The potential reduction in radiation and time achieved with PETCT limited to sites of known disease identified on prechemotherapy CT was calculated.Results. No FDG-uptake was seen in 72 cases. FDG uptake at known disease sites was seen in 24. Of the remaining 4, one had clinically significant pathology, a rectal adenocarcinoma. PETCT did not reveal any unexpected sites of lymphoma. Limiting PETCT to sites of known disease would have saved a mean radiation dose of 4 mSv (27.3%), with a mean time of 16 minutes.Conclusion. Our study suggests that young patients may benefit from reduced radiation by limiting PETCT to sites of known disease with low risk of missing significant pathology. However, in older patients, with increased incidence of asymptomatic synchronous malignancies, whole-body PETCT is advisable unless prechemotherapy PETCT has been performed.


2020 ◽  
Author(s):  
Zhongyun Xu ◽  
Chao Li ◽  
Feng Fang ◽  
Linlin Zhang ◽  
Hui Wang ◽  
...  

Abstract Background: We usually use 131 I whole body scan and serum thyroglobulin (Tg) values to determine whether differentiated thyroid cancer (DTC) patients need to receive 131 I treatment, but not all 131 I-avid (functioning) patients have good responses, which is more likely to cause the 131 I-avid patient to receive overtreatment. Our study aims to assess the date of 18 F-FDG PET/CT to avoid 131 I overtreatment and research the status of 131 I-avid pulmonary metastases (PMs) and the prognosis of the patients. Methods: The 131 I-avid PMs of DTC patients who underwent 18 F-FDG PET/CT scans were included. The SUVmax (maximum standardized uptake value), MTV (metabolic tumour volume) and TLG (total lesion glycolysis) were used to estimate 18 F-FDG uptake. The mean follow-up period was 34.14 ± 18.64months. Progression-free survival (PFS) was estimated by the Kaplan-Meier method.The study was based on per-patient and per-lesion analyses. Results: Among the 42 included patients, 34 (34/42, 81%) showed 18 F-FDG uptake, which was defined as abnormal foci (SUVmax >1.0) in the lungs. SUVmax, MTV and TLG and tumour size were the factors that influenced the outcome of 131 I treatment based on Tg levels (p=0.000,0.016,0.000,0.000). The only independent factor was the size of the lesion. There was a significant difference in response to 131 I therapy between PMs with F-I+ and F+/I+ according to both Tg levels and RECIST (version 1.1) (p= 0.044,0.001), according to the per-lesion analysis. When the changes in size or metabolism of some lesions are inconsistent with therapeutic efficacy of patients, it indicates that these patients have a poor prognosis (P=0.003). Conclusions: We concluded that higher 18 F-FDG uptake and larger tumour size predict poor therapeutic effects and a high risk of disease progression in 131 I-avid PMs of DTC. For evaluating the efficiency of 131 I treatment, per-lesion analyses and assessing the data of 18 F-FDG PET/CT would be more reliable than per-patient evaluation only. The increasing 18 F-FDG uptake or diameter of PMs may lead to a poor prognosis for the patient, and early focal treatment modalities may improve their life span.


2021 ◽  
pp. 1-4
Author(s):  
Kornelia Kajary ◽  
Kornelia Kajary ◽  
Zsolt Lengyel ◽  
Anna-Maria Tokes ◽  
Janina Kulka ◽  
...  

18-fluorine-fluorodeoxyglucose (FDG) positron emission tomography (PET) and mainly combined with computed tomography (CT), abbreviated as FDG PET/CT is a useful and accurate tool for staging and restaging in locally advanced breast cancer. In daily practice static images are prepared during the PET/CT examinations. However, despite the success of static PET and PET/CT imaging, the role of precise quantification of FDG-uptake – measured by dynamic acquisition – is ambiguous in the staging and management of different malignancies. In this case report, we described our experience with staging, interim and restaging dynamic PET/CT examinations of a woman suffering from breast cancer. Based on the described case we concluded that dynamic PET/CT is suitable for accurate quantification of FDG-uptake in primary breast tumors. However, performing dynamic PET/CT examinations is time-consuming, therefore, it is important to define the group of patients where their use is with the most favourable benefit/risk ratio. Furthermore, using of interim PET/CT scan is recommended in cases with clinically controversial baseline tests. Based on literature in vivo biomarkers of the dynamic PET/CT are predictive of more favourable tumor response and longer disease-free survival, as confirmed by our own results.


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