Predictive value of 18F-FDG PET/CT in restaging patients affected by ovarian carcinoma: a multicentre study

According to European Society of Cardiology guidelines (ESC2015) for infective endocarditis (IE) management, modified Duke criteria (mDC) are implemented with a degree of clinical suspicion degree, leading to grades such as “possible” or “rejected” IE despite a persisting high level of clinical suspicion. Herein, we evaluate the 18F-FDG PET/CT diagnostic and therapeutic impact in IE suspicion, with emphasis on possible/rejected IE with a high clinical suspicion. Excluding cases of definite IE diagnosis, 53 patients who underwent 18F-FDG PET/CT for IE suspicion were selected and afterwards classified according to both mDC (possible IE/Duke 1, rejected IE/Duke 0) and clinical suspicion degree (high and low IE suspicion). The final status regarding IE diagnosis (gold standard) was based on the multidisciplinary decision of the Endocarditis Team, including the ‘imaging specialist’. PET/CT images of the cardiac area were qualitatively interpreted and the intensity of each focus of extra-physiologic 18F-FDG uptake was evaluated by a maximum standardized uptake value (SUVmax) measurement. Extra-cardiac 18F-FDG PET/CT pathological findings were considered to be a possible embolic event, a possible source of IE, or even a concomitant infection. Based on the Endocarditis Team consensus, final diagnosis of IE was retained in 19 (36%) patients and excluded in 34 (64%). With a sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and global accuracy of 79%, 100%, 100%, 89%, and 92%, respectively, PET/CT performed significantly better than mDC (p = 0.003), clinical suspicion degree (p = 0.001), and a combination of both (p = 0.001) for IE diagnosis. In 41 patients with possible/rejected IE but high clinical suspicion, sensitivity, specificity, PPV, NPV, and global accuracies were 78%, 100%, 100%, 85%, and 90%, respectively. Moreover, PET/CT contributed to patient management in 24 out of 53 (45%) cases. 18F-FDG PET/CT represents a valuable diagnostic tool that could be proposed for challenging IE cases with significant differences between mDC and clinical suspicion degree. 18F-FDG PET/CT allows a binary diagnosis (definite or rejected IE) by removing uncertain diagnostic situations, thus improving patient therapeutic management.

Download Full-text

Predictive value of 18F-FDG PET/CT for acute exacerbation of interstitial lung disease in patients with lung cancer and interstitial lung disease treated with chemotherapy

International Journal of Clinical Oncology ◽

10.1007/s10147-019-01584-x ◽

2019 ◽

Vol 25 (4) ◽

pp. 681-690 ◽

Cited By ~ 1

Author(s):

Kimitaka Akaike ◽

Koichi Saruwatari ◽

Seitaro Oda ◽

Shinya Shiraishi ◽

Hiroshi Takahashi ◽

...

Keyword(s):

Lung Cancer ◽

Interstitial Lung Disease ◽

Lung Disease ◽

Acute Exacerbation ◽

Predictive Value ◽

Fdg Pet ◽

Pet Ct ◽

18F Fdg ◽

Fdg Pet Ct

Download Full-text

Predictive value of LN metastasis detected by 18F‑FDG PET/CT in patients with papillary thyroid cancer receiving iodine‑131 radiotherapy

Oncology Letters ◽

10.3892/ol.2019.10500 ◽

2019 ◽

Author(s):

Chao Li ◽

Jian Zhang ◽

Hui Wang

Keyword(s):

Thyroid Cancer ◽

Papillary Thyroid Cancer ◽

Predictive Value ◽

Fdg Pet ◽

Papillary Thyroid ◽

Pet Ct ◽

Iodine 131 ◽

18F Fdg ◽

Fdg Pet Ct

Download Full-text

333018F-Fluorodeoxyglucose Positron Emission Tomography Computed Tomography (PET/CT) for the diagnosis of prosthetic valve infective endocarditis (PVIE): a prospective multicenter study

European Heart Journal ◽

10.1093/eurheartj/ehz745.0082 ◽

2019 ◽

Vol 40 (Supplement_1) ◽

Author(s):

M Philip ◽

L Tessonnier ◽

J Mancini ◽

J L Mainardi ◽

D Lussato ◽

...

Keyword(s):

Infective Endocarditis ◽

Predictive Value ◽

Fdg Pet ◽

Prosthetic Valve ◽

Cardiac Uptake ◽

Pet Ct ◽

Major Criterion ◽

18F Fdg ◽

Fdg Pet Ct

Abstract Background and objectives 18F-FDG PET/CT has recently been added as a major criterion in the ESC 2015 infective endocarditis (IE) guidelines, but the value of this new diagnostic algorithm has never been prospectively assessed. Purposes 1. Primary objective: to assess the value of the new ESC criteria including 18F-FDG PET/CT in prosthetic valve infective endocarditis (PVIE). 2. Secondary objectives: to determine the reproducibility of 18F-FDG PET/CT; to assess its ability to predict embolic events. Methods Between 2014 and 2017, 175 patients with suspected PVIE were prospectively included in 3 French centers. After exclusion of patients with uninterpretable or not feasible PET/CT,115 patients were finally included in the analysis, including 91 definite IE and 24 rejected IE, as defined by an expert Consensus of Endocarditis Team after 3-month follow-up as Gold Standard Nuclear data were blindly analyzed by two independent nuclear medicine physicians. Patients follow-up was scheduled at one and three months after hospitalization Results Significant cardiac uptake by PET/CT (major criterion) was observed in 67 among 91 patients with definite PVIE and 6 patients with rejected IE (sensitivity 73.6%, specificity 75%, positive predictive value 91%, negative predictive value 42%). Considering cardiac uptake as a major criterion, the ESC 2015 classification increased the sensitivity of Duke criteria from 57 to 84% (p<0.001) but decreased its specificity from 84 to 70% (p<0.001). Intraobserver reproducibility of cardiac uptake evaluation was good (kappa = 0.84) but inter observer reproductibility was less satisfactory (kappa = 0.63). Embolic events occurred in 31 patients (27%) and were correlated with vegetation size by ECHO (p<0.001), Staphylococcus infection (p=0.003), and PET/CT cardiac uptake (p=0.02). Conclusion 1. the value of PET CT and ESC criteria is confirmed and may allow earlier diagnosis of PVIE 2. PET CT is associated with an increased risk of false positive results probably related to the technical improvements 3. Reproducibility of nuclear measurements seems unsatisfactory, justifying efforts to standardize PET studies interpretation 4. Our study describes for the first time a positive correlation between a positive PET/Ct and occurrence of embolic events, warranting additional studies.

Download Full-text

Multicentre study of 18F-FDG-PET/CT prostate incidental uptake

Japanese Journal of Radiology ◽

10.1007/s11604-015-0453-y ◽

2015 ◽

Vol 33 (9) ◽

pp. 538-546 ◽

Cited By ~ 2

Author(s):

Francesco Bertagna ◽

Arnoldo Piccardo ◽

Bassam Dib ◽

Mattia Bertoli ◽

Federica Fracassi ◽

...

Keyword(s):

Multicentre Study ◽

Fdg Pet ◽

Pet Ct ◽

18F Fdg ◽

Fdg Pet Ct

Download Full-text

The predictive value of 18F-FDG PET/CT after ipilimumab for treatment response evaluation in metastatic melanoma patients

Annals of Oncology ◽

10.1093/annonc/mdy486.019 ◽

2018 ◽

Vol 29 ◽

pp. x23

Author(s):

S. Vari ◽

A. Annovazzi ◽

R. Pasqualoni ◽

R. Sciuto ◽

D. Giannarelli ◽

...

Keyword(s):

Metastatic Melanoma ◽

Treatment Response ◽

Predictive Value ◽

Fdg Pet ◽

Response Evaluation ◽

Treatment Response Evaluation ◽

Pet Ct ◽

Melanoma Patients ◽

18F Fdg ◽

Fdg Pet Ct

Download Full-text

Diagnostic Value of 18F-FDG-PET/CT in Patients with FUO

Journal of Clinical Medicine ◽

10.3390/jcm9072112 ◽

2020 ◽

Vol 9 (7) ◽

pp. 2112

Author(s):

Stamata Georga ◽

Paraskevi Exadaktylou ◽

Ioannis Petrou ◽

Dimitrios Katsampoukas ◽

Vasilios Mpalaris ◽

...

Keyword(s):

Predictive Value ◽

Fdg Pet ◽

Final Diagnosis ◽

Diagnostic Value ◽

Whole Body ◽

Considerable Proportion ◽

Clinical Criteria ◽

Pet Ct ◽

18F Fdg ◽

Fdg Pet Ct

Conventional diagnostic imaging is often ineffective in revealing the underlying cause in a considerable proportion of patients with fever of unknown origin (FUO). The aim of this study was to assess the diagnostic value of fluorine-18 fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG-PET/CT) in patients with FUO. We retrospectively reviewed 18F-FDG-PET/CT scans performed on 50 consecutive adult patients referred to our department for further investigation of classic FUO. Final diagnosis was based on histopathological and microbiological findings, clinical criteria, or clinical follow-up. Final diagnosis was established in 39/50 (78%) of the patients. The cause of FUO was infection in 20/50 (40%), noninfectious inflammatory diseases in 11/50 (22%), and malignancy in 8/50 (16%) patients. Fever remained unexplained in 11/50 (22%) patients. 18F-FDG-PET/CT scan substantially contributed to the diagnosis in 70% of the patients, either by identifying the underlying cause of FUO or by directing to the most appropriate site for biopsy. Sensitivity, specificity, accuracy, positive predictive value (PPV) and negative predictive value (NPV) of 18F-FDG-PET/CT for active disease detection in patients with FUO were 94.7%, 50.0%, 84.0%, 85.7%, and 75.0%, respectively. In conclusion, whole-body 18F-FDG-PET/CT is a highly sensitive method for detection of the underlining cause of FUO or for correctly targeting suspicious lesions for further evaluation.

Download Full-text