Optimizing 18F-FDG PET/CT imaging of vessel wall inflammation: the impact of 18F-FDG circulation time, injected dose, uptake parameters, and fasting blood glucose levels

Abstract Aim The aim of this study was to investigate the impact of 18F-FDG-PET/CT on treatment decision making in metastatic gastrointestinal stromal tumor (GIST) patients. Methods This study retrospectively evaluated 18F-FDG-PET/CT scans to monitor response of metastatic GIST patients treated with palliative intent. Data from the Dutch GIST Registry was used. Early scans (<10 weeks after start of treatment) and late scans (>10 weeks after start of treatment) were scored on the impact in change of treatment. Results Sixty-one PET/CT scans were performed for treatment evaluation in 39 patients with metastatic GIST of which 36 were early scans and 25 were late scans. Early PET/CT scans led to a change in management in 5.6% of patients and late PET/CT scans led to a change in management in 56% of patients. Change in management was more often seen after scans with lack of metabolic response (48% vs. 11% in scans with metabolic response, p=0.002). Neither metabolic response nor change in treatment were more often seen in patients with KIT mutations compared to patients with non-KIT mutations (metabolic response 65% KIT vs. 46% non-KIT, p=0.33, and change in management 28% KIT vs. 21% non-KIT, p=0.74). Conclusion 18F-FDG-PET/CT is not recommended for early response evaluation in an unselected patient population with metastatic GIST, since it does not influence treatment decisions. 18F-FDG-PET/CT, however, can be useful for late response assessment, especially in case of indeterminate CT results.

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Normal blood glucose level and 18F-FDG PET/CT

Revista Española de Medicina Nuclear e Imagen Molecular ◽

10.1016/j.remn.2012.01.008 ◽

2012 ◽

Vol 31 (4) ◽

pp. 210-212

Author(s):

V. Peiro Valgañon ◽

J.C. Alonso Farto

Keyword(s):

Blood Glucose ◽

Blood Glucose Level ◽

Glucose Level ◽

Fdg Pet ◽

Normal Blood ◽

Pet Ct ◽

18F Fdg ◽

Normal Blood Glucose ◽

Fdg Pet Ct

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Additional Value of 2-[18F]FDG PET/CT Comparing to MRI in Treatment Approach of Anal Cancer Patients

Journal of Clinical Medicine ◽

10.3390/jcm9092715 ◽

2020 ◽

Vol 9 (9) ◽

pp. 2715

Author(s):

Reyhaneh Manafi-Farid ◽

Alexander Kupferthaler ◽

Helwig Wundsam ◽

Georg Gruber ◽

Reza Vali ◽

...

Keyword(s):

Lymph Nodes ◽

Anal Cancer ◽

Fdg Pet ◽

Prognostic Value ◽

Number Of Patients ◽

Pet Ct ◽

18F Fdg ◽

Pre Treatment ◽

Fdg Pet Ct ◽

The Impact

Accurate staging and treatment planning are imperative for precise management in Anal Cancer (ACa) patients. We aimed to evaluate the additive and prognostic value of pre-treatment 2-[18F]fluoro-2-deoxy-d-glucose positron emission tomography/computed tomography (2-[18F]FDG PET/CT) in the staging and management of ACa compared to magnetic resonance imaging (MRI). This retrospective study was conducted on 54 patients. Pre-treatment 2-[18F]FDG PET/CT studies and MRI reports were compared considering the primary tumor, pelvic lymph nodes, and metastatic lesions. The impact of 2-[18F]FDG PET/CT in the management and its prognostic value, using maximum standardized uptake value (SUVmax), were assessed. Discordant findings were found in 46.3% of patients (5 in T; 1 in T and N; 18 in N; and 1 in M stage). 2-[18F]FDG PET/CT resulted in up-staging in 9.26% and down-staging in 3.7% of patients. Perirectal lymph nodes were metabolically inactive in 12.9% of patients. Moreover, 2-[18F]FDG PET/CT resulted in management change in 24.1% of patients. Finally, SUVmax provided no prognostic value. 2-[18F]FDG PET/CT altered staging and management in a sizable number of patients in this study, and supports a need for a change in guidelines for it to be used as a routine complementary test in the initial management of ACa.

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Impact of blood glucose, diabetes, insulin, and obesity on standardized uptake values in tumors and healthy organs on 18F-FDG PET/CT

Nuclear Medicine and Biology ◽

10.1016/j.nucmedbio.2012.10.014 ◽

2013 ◽

Vol 40 (2) ◽

pp. 206-213 ◽

Cited By ~ 47

Author(s):

Karen A. Büsing ◽

Stefan O. Schönberg ◽

Joachim Brade ◽

Klaus Wasser

Keyword(s):

Blood Glucose ◽

Fdg Pet ◽

Standardized Uptake Values ◽

Pet Ct ◽

18F Fdg ◽

Fdg Pet Ct

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Diagnostic value and therapeutic impact of 18F-FDG-PET/CT in differentiated thyroid cancer

Nuklearmedizin ◽

10.3413/nukmed-0489-12-03 ◽

2013 ◽

Vol 52 (01) ◽

pp. 1-6 ◽

Cited By ~ 10

Author(s):

M. Dietlein ◽

D. Schmidt ◽

T. Kuwert ◽

R. Dorn ◽

J. Sciuk ◽

...

Keyword(s):

Thyroid Cancer ◽

Fdg Pet ◽

Differentiated Thyroid Cancer ◽

Tumour Tissue ◽

Therapeutic Management ◽

Whole Body ◽

Pet Ct ◽

18F Fdg ◽

Fdg Pet Ct ◽

The Impact

SummaryThe clinical significance of 18F-FDG-PET/CT in the follow-up of patients with differentiated thyroid carcinoma was evaluated and the results were compared with those of 18F-FDGPET, 131I-whole-body scintigraphy including SPECT/CT (WBS) and ultrasound. In addition, it was the aim to investigate the impact of 18F-FDG-PET/CT on the therapeutic management. Patients, methods: 327 patients (209 women, 118 men; mean age 53 ± 18 years) with differentiated thyroid cancer (242 papillary, 75 follicular, 6 mixed, 1 Hürthle cell and 3 poorly differentiated tumours) were analyzed retrospectively at four tertiary referral centres. 289 18F-FDG-PET/CT and 118 18F-FDG-PET studies were performed in these patients between 2007 and 2010. In addition, an overall clinical evaluation was performed, including cytology, histology, thyroglobulin level, ultrasound, WBS, and subsequent clinical course in order to compare the molecular imaging results. Finally, the change in therapeutic management due to findings of 18F-FDG-PET/CT was investigated. Results: The sensitivity of 18F-FDG-PET/CT was 92%, the specificity was 95%. Sensitivity and specificity of 18F-FDG-PET alone were 67% and 93%, respectively. WBS showed a sensitivity of 65% and a specificity of 94%. The corresponding values of ultrasound were 37% and 94%, respectively. The sensitivity of 18F-FDG-PET/CT in the group of patients with a negative WBS (n=194) amounted to 96%. When 18F-FDG-PET/CT and WBS were considered in combination, tumour tissue was missed in only 2 out of 133 patients; when 18F-FDG-PET and WBS were combined, tumour tissue was missed in 1 out of 24 patients. 18F-FDG-PET/CT resulted in management change in 43% (n=57/133) with a decision on surgical approach in 20% (n=27/133). Conclusions: 18F-FDG-PET/CT is superior to 18F-FDG-PET alone in patients with differentiated thyroid cancer and has a direct impact on the therapeutic management of patients with suspected local recurrence or metastases, particularly in those with negative WBS.

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